I used to not buy insurance, but do it for international flights now. Made a big time profit when my bags were delayed 13 hours in London. Insurance gave us each $500 to spend on clothing.

Had United cancel my flight on another international trip and my insurance got me a nicer hotel than United’s and paid for my very nice dinner.

I agree it is not worth it in all circumstances, but also the medical for international is piece of mind for me.