IMO travel insurance sometimes makes sense. Circumstances like high altitude trekking that may require expensive evacuation. Expensive non-refundable trips, especially those that a broken ankle before or during the trip could put a rapid stop to.
That said, I've only purchased travel insurance maybe a half-dozen times out of probably hundreds of trips.
You need to make sure it covers that altitude. They top out around a certain altitude in the fine print you usually need to pay a little extra for altitudes like Kilimanjaro. Make sure it has helo evacuation covered for all altitudes.
Good point. The few times I was up at that sort of elevation or higher, the insurance was always through someone the guide company specifically recommended. Fortunately, I've never had any significant altitude issues.
That said, I've only purchased travel insurance maybe a half-dozen times out of probably hundreds of trips.