I've noticed that some of the aggregators now only offer zero $0 CDW with no ability to opt out (for the US mainly but a couple of European bookings also had that).I need to purchase separate insurance because my card, PE, does not provide hire car cover.
The old zero excess international car hire free insurance that some cards used to provide is sorely missed.
I've hired cars probably over 50 times since 2000 (up to 5 weeks at a time) and (touching wood as I type) have never needed to make a claim.
However, three times it required me to hold up my phone and let them know that the 'pick-up' photos are identical to the drop-off photos, so they could forget saying I'd damaged the tyres (2x was what they tried on) and rear bumper (1x). All 3 were in the UK, never had a problem in Germany nor France, and never in the US.
2 of the 3 were in underground car parks where only around 1 flourescent light in 4 had a single bulb. So I moved the car to the only well lit area (by the fire stairs) to take the photos. Well worth the extra few minutes. Also take photos of the top of the vehicle, the bonnet & boot.
Still, on my latest US rental for 30 odd days I did have the option of having a USD 750 excess or paying an extra AUD 93 for zero excess - I wimped out, despite the actuarial calculation being very much in my favour.