Luckily, I didn't have to use this insurance. I particularly liked the advance payment feature in case of hospitalization.
I had to file a claim for some minor medical expenses. It took too long and they wanted denials from my domestic health insurance, but waited weeks to ask. I protested through Insure My Trip that Medicare and United Health care don't cover such things and that I should not have to actually file claims based on this common knowledge. I was eventually reimbursed, but they took forever, even farming out translations of simple documents that they ought to be able to do in house.
Did not have to use the plan, thankfully. I am glad that I purchased the plan.