Yes I do. I too thought it was a waste until an insurance agent explained car renting insurance to me...If you damage or total a rental car, not only do you pay for the value or replacement of the car but also the dollar value of how ever many days that car is not being able to be rented.
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Whenever I've gone on a trip and have needed to rent a car, I make sure I also get car renter's insurance. Getting in an accident isn't likely, but it's always good to be prepared. I know I always feel more at ease if I have the insurance.