I bought it for the first time, through insuremytrip.com, and will probably do it again. I was careful to restrict coverage only to the non-refundable portions of the trip; we were flying in Business Class and although we had paid up front for the hotel, it was refundable with 24 hours' notice. My main concerns were that DH might be too unhealthy to travel, which is something we'd probably know by a few days before the trip, and also the costs of medical care in another country plus any extra costs of getting back home. (A friend who fell in her hotel room in Istanbul in the middle of the night and needed major orthopedic surgery described her trip home in Coach as "the seventh circle of hell".) Oh, yeah- and cancellation of flights due to volcanoes since we were going to Iceland!
While DH has a balance problem so a bad fall might have caused a claim, I'm 15 years younger and inclined to hike up moderate-sized mountains, go out for a run in the city, or take a trip down inside a volcano. Really, I'm probably as risky as he is but for different reasons. Well worth the peace of mind.