For travel medical emergency or any other travel insurance, my advice is, if you travel from the USA or Canada, try not to buy insurance in North America – be it via a travel agency or some local banks or insurance companies, or online. Unless – for medical or other safety reasons – insurance must be bought starting from the home location to the destination country. My experience has taught me, to get far better deals buying the insurance either in Europe or wherever you travel to, in that country. Example: In 2010 I travelled to Germany and spent over 4 months there in Berlin. I had taken out a medical insurance on a broker’s internet site. The insurance had their seat in Toronto, Canada. I had a claim, tried to call the insurance from Germany, on my cell phone, told them I need a claim number. They put me on hold while some old guy in the background walked away from his desk ?  In conclusion, I cancelled this insurance requesting a refund on my credit card. Immediately one day after I bought a travel medical insurance in Germany (including every coverage possible) at a fraction of the cost that the one in Canada had cost me. The insurance in Canada eventually processed the refund, but not my lost telephone costs.
Cost comparison: Canada/USA = $2,000; Germany = €130 same length of trip. Next example: Previously I had bought several package travels with a German agency (also online) including for each a good travel medical emergency insurance. Low cost again (for one month travel = €100).  You can trust these agencies there, they will deliver. And most importantly, they are reachable. I find it more disturbing if an insurance carrier cannot be reached in the event of an emergency (even taking into consideration the time difference) than the higher cost. Reason for the high cost of insurances headquartered in North America is more likely than not the enormous cost for law suits and third party liability suits.

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