Insurance is insurance; you never need it until you need it. Your health insurance doesn't cover you for an illness on ship or overseas, and if you have to cancel for medical or family crisis issues you're out every penny paid for the cruise. For a number of years we paid for insurance because my father was in poor health ... and never needed it. In 2009 I fell ill on a Celebrity cruise in Alaska and ended up in a hospital in Juneau ... recouped all of the prior year premiums + coverage for loss of that cruise. In 2010 my mother in law died on the third day of a 16 day cruise while we were in Amsterdam ... insurance reimbursed us for loss of the cruise, the 600 Euros we paid to get to Paris to fly home, etc. If you get unlucky and are uninsured you're out a lot of $$$ w/ no recourse.