To me a lot of FFVII seemed to scream out to me 1900 ish. (Obviously some things were more advanced.) Obviously very modern compared to a medieval setting, but it seemed far from 'modern' to me. (Obviously the revisionist compilation f***ed it all up.)

To answer the original question, originality is key. I love unique and strange settings, but a traditional "medieval" game world can be just as great when done well (hello there, DQVIII).
Exactly. It is the quality of the world that is created, not the level of technology that is important.