In general, outside of weather disruptions, what do most people "use" the insurance for? We're taking our little ones on their first cruise and trying to find out what would have to happen in order for the insurance to be beneficial.
Well, besides weather disruptions -
Someone could be running downstairs, trip, fall down and break an arm.
Someone could pick up a nasty bug in a port.
Generally, medical issues. Since most US health plans do not cover "out of country". Once you board the ship you are out of country.
Any visits to the medical center have a cost. Billed to your onboard account.
Any illness or injury requiring hospitalization (removal from ship) and subsequent evacuation from port to home, must usually be paid for up front.
Generally, it's "how lucky to you feel" whether insurance is a good idea.
I will report that, even with "perfectly healthy" people/kids, things can happen. I know of one case of a young boy evacuated from a
DCL cruise in Mexico due to appendicitis. Happily they had insurance. Covered mom staying with child and returning to US later. Dad & other kids continued on cruise (the child was evacuated in the final port call of the cruise).