Travel insurance isn't a condition of the Maldives' visa-on-arrival, which means it's easy to treat as optional — but the specific shape of a Maldives trip (remote islands, diving, seaplanes) makes a generic policy worth double-checking rather than assuming it's covered.
Diving cover, specifically
Standard travel insurance policies frequently exclude scuba diving by default, or cap the depth they'll cover. If diving is any part of the trip — even a single try-dive — confirm your policy explicitly covers it, including the certification level and depth you'll actually be diving to.
Medical evacuation
Serious medical care is concentrated in Malé; a health issue on a remote resort island can mean a speedboat or seaplane evacuation before proper treatment, which is exactly the kind of cost a good policy is built to absorb. Confirm your policy covers medical evacuation and repatriation specifically, not just in-destination treatment.
Trip disruption from weather or transfers
Seaplane transfers are grounded after dark and can be delayed by weather — rarely a major issue, but worth knowing your policy's stance on missed onward connections caused by a delayed inter-island transfer, particularly if your itinerary is tight.