Yes, travel insurance is essential for a trip through Suketar airstrip into Taplejung, the gateway for trekking toward Kanchenjunga, the world's third-highest peak. This is genuinely remote, high-altitude terrain, and the honest core of the insurance question is altitude and evacuation logistics rather than everyday travel risk.
Local medical facilities around Taplejung are basic, and serious altitude sickness or injury on the Kanchenjunga trekking routes typically means stabilization at a lodge or checkpoint followed by evacuation, most often by helicopter, back toward Kathmandu, Nepal's real medical hub. Confirm your policy explicitly names helicopter evacuation and high-altitude rescue, since a policy without this cover can leave you responsible for arranging and coordinating a rescue yourself in genuinely difficult terrain. Weather is the other major variable: cloud cover and high winds regularly ground helicopters here for a day or more, turning a quick lift into a longer wait, so build that into your planning.
Altitude is the defining risk on any Kanchenjunga-area trek, with routes regularly climbing well above the elevations where acute mountain sickness becomes a real concern. Kanchenjunga's border-area location also means this route requires a restricted-area permit and travel with a licensed guide or agency, a rule enforced for security rather than insurance reasons, but worth building into your evacuation plan regardless. A policy should explicitly cover high-altitude trekking up to the maximum elevation your itinerary reaches, not just general hiking. Many trekkers here also arrange rescue-specific cover on top of standard travel insurance, given how directly helicopter evacuation cost and coordination depend on the policy actually naming it.
Keep any permit paperwork, guide or lodge incident reports, and documentation of the evacuation itself, since claims from a region this remote rely heavily on paper trails that are easy to lose track of on the trail. Many policies require notice before a helicopter evacuation is arranged if at all possible, so check your policy's emergency-contact and notification process before you set out rather than mid-trek.