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Martyn – agree with you re: Amex Platinum.
I hire a lot of cars, both in the US and Continental Europe and one of their insurance features means you can always turn down the policy the local operator tries to flog to you.
Just a cautionary warning, their insurance does not cover pre-existing medical conditions, and to benefit from the travel delay / baggage delay feature I believe you need to have paid for your flights with an Amex card.