This is an interesting topic that begs for discussion. In the past, I have traveled all over the world with NO supplemental travel insurance (in fact, as a broke youth I traveled with NO insurance whatsoever. The folly of youth…). I am not saying this is wise, simply the way it happened.
That said, I have also paid for it on a few select occasions. In particular, I traveled to Malaysia last year and did extensive scuba diving there with the awesome Ocean Rover crew; they insist you have diving insurance from DAN, a recognized leader in this field. I also paid for trip insurance, not knowing what to expect with traveling in that part of the world.
Honestly, I think I would use travel insurance more in teh USA that overseas; we ahve some of the latest, mst over-packed flights in teh world and a bad rep for missing flights and bumping passengers.
Anyone else have anything to add? Thoughts? Experiences with insurance?