Yes, travel insurance is close to essential for a trip to Ine, a small settlement on Arno Atoll in the Marshall Islands reached only by boat or a short flight from Majuro. The honest core of the answer here is remoteness itself: Arno's outer islets have no meaningful medical infrastructure of their own, and the atoll's scattered geography means even reaching the nearest clinic can take hours by boat. This is not a destination where routine trip-disruption cover is the main point - it is a destination where genuine medical evacuation cover is the reason to carry a policy at all.
Care on Arno itself is limited to basic first aid at best, so anything beyond the minor is handled by transferring first to Majuro, the Marshall Islands' capital and the location of the country's main hospital. For serious cases, onward referral typically continues to Honolulu, the nearest major regional medical center with the specialist capacity Majuro cannot always provide. Confirm your policy explicitly covers inter-island evacuation within the Marshall Islands as well as international medical transport, since a policy that only covers treatment received locally misses the two steps that actually matter here.
There is little in the way of organized adventure tourism around Ine, and the practical risk profile is defined by isolation rather than any specific activity - limited boat schedules, no regular medical transport, and long gaps between inter-island flights. Travelers should budget for the real possibility that an evacuation from Arno becomes a multi-day undertaking rather than a same-day transfer, and a policy that hedges on evacuation timelines is the wrong one for this itinerary.
Keep any clinic paperwork from Arno or Majuro, boat or flight tickets showing the route taken, and receipts for any emergency transport, since documentation is thin and easily lost in a place this remote. Many policies require notice before major expenses like evacuation are arranged, so review the claims process in your policy wording well before departure rather than assuming it can be sorted out afterward from an outer atoll with limited communications.