Insurance dont forget about it

The primary reason for insurance is medical. Most policies cover medical evacuation cost as well as the medical bill while your in the hospital. In Peru, this might amount to a free trip on the back of a donkey and a three night stay at a clinic for treatment of amebic dysentery amounting to only $500.00. Though while climbing in Alaska a flight evacuation and a three night stay in hospital that your health care doesn't recognize could add up real quick.
Another reason to get insurance is to cover the untimely manner of airlines for baggage delays as well as cancellation insurance for the services you've contracted in country. Say your bags showed up three days late and you missed the internal flight booked by your mountaineering guide service. Your policy would cover the cost of booking a new flight.
Or say, you've booked a mountaineering trip in Bolivia through a local guide service and when you fly in to La Paz they tell you're trip is cancelled due to political unrest. Your policy would cover that loss.