Having taken out a five month worldwide backpackers policy, we asked to extend by one month (and for one single country). The premium to cover that final part of the trip, when we couldn't shop around elsewhere (most companies require you to be in your home country when you apply for the policy) was as much as the five preceding months combined (£212). According to sales reps this had nothing to do with a claim made in December (and which multi trip paid out only £36 on, towards the £145 I paid for medical treatment) - I had specifically asked if making the claim would impact on the extension premium as such a small claim could easily be outweighed by excess charges. Their explanation was that the insurers might be charging the same for one month as for multiple month periods, so we're forced to pay up or not have coverage. And to add insult to injury, their call centre attempted to add an £8 charge when I called (the number they provided) to pay for the policy. Honestly, I feel shafted.
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