Medical insurance claims are the most expensive for New Zealand's largest online travel insurer.

Southern Cross Travel Insurance has released a list of its ten largest insurance claims in 2014 today, all of which were medical.

The most expensive was a $400,000 surgery in the United States.

Southern Cross's Craig Morrison admits other types of claims are small in comparison.

"After medical, the biggest claim we pay for is accidental death - for car accidents...things like that, and that's a pay out of around $50,000."

Morrison points out the list shows the importance of travel insurance.

"My experience tells me that the unexpected events indeed happened and it happened in a random nature."