Getting back to Marc's original question, we've had health issues and now always insure. I do wish we'd have just put the money we've spent on insurance in the last 15 years in a separate account and self-insured.
HOWEVER, we're aware that in most instances, you must insure all (or at least all non-refundable) costs of the trip to insure coverage if something goes awry. KLT has real experts on this, including Ngaire herself but now almost all questions go to Jennifer or in her absence, Julie. I've always gotten real solid information and the best prices from B&K/KLT, even using them to insure trips we've booked elsewhere because they don't sell that particular line, event or tour.
I hope this helps.