I usually don't but sometimes I do depending on the risk scenario for the rental. Driving mostly highway to a small town for a weekend where the car is parked and limited travel during the day? Low risk of anything happening! Renting a car while in a large, congested city you don't know and the cost is really negligible like $50-80 or whatever? Then sure. You may have duplicate coverages but sometimes the headaches involved with dealing with credit card insurance are a nightmare. I have dealt with credit card insurance for 100% easily confirmed travel claims and it's enough to drive someone mad, let alone a car accident claim.
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