Joe - I always check with the credit card on which I am charging the car rental. Some do and some don't include insurance for catastrophic damage or acts of god. And as Ron mentioned, my US insurance policy covers me when I am driving in the EU. However, I think all bets are off in Italy. I buy the agency's supplemental insurance because Italians are nutty drivers and for however many dollars, life and time are too precious.

Double checking with your own insurer is a good practice. There appears to be a lot of anecdotal stories about rental agencies in the New Orleans area sticking renters with total/major replacement of rental car repair costs after Hurricane Katrina. With all the pages of fine print, it seems like some renters did not have coverage from "acts of God or Nature". Most rental agencies, at least when I checked several years ago, have exclusions for these "acts of God or Nature". Most US insurers may or may not have coverage for the country you are going to, so you have to shop around for insurers like Access America, or web sites like <www.alltripinsurance.com/> to find foreign coverage.

This is a "friend of a friend" story, so you can take it for what it's worth.

Last year, some friends of my neighbors rented a car in France and were
driving through Normandy when a hail storm suddenly developed and did quite
a bit of damage to the car. When they returned the car, the rental car company
(not sure which one and really don't have any details) refused to accept/acknowledge
their personal insurance (they also paid via AMEX) and demanded cash/credit card payment
on the spot for the repairs. They paid and were reimbursed sometime later by their insurance
company. The question is should they have purchased the rental car company's insurance?
I know in the states I never purchase the optional insurance (I think most people
decline this coverage).

I have never had an accident in a rental, and I'm not sure how most companies handle
the insurance thing if an accident occurs. I would assume Hertz, Avis, etc. would
be willing to work with the customer's insurance company.

I advised my neighbors who will be renting a car in Normandy to contact their
insurance company (USAA) and make sure that they have comprehensive coverage
in the unlikely event they are involved in an accident.

Any thoughts?