Thank you all. This is very helpful. I missed the point about economy class ticket but I thought that this means that if I route with connection and b-class is cheaper than direct economy it would still work. Regarding the second point how does this square with:

Covered Losses include Trip Cancellations or Trip Interruptions that result from the following:
Accidental Bodily Injury or loss of life or Sickness of either the Eligible Traveler, Traveling Companion or a Family Member of the Eligible Traveler or Traveling Companion;

Sickness means ill health, disorder, or unsound condition of the Eligible Traveler.

Thus, is what you posted de facto nullifying what is written later. I think it is OR there and so it should quality no?

Again even forget the economy part, I exactly want to know if I need to purchase additional coverage or will my Amex get me out of trouble.