I've never had a claim with AutoEurope (after many years of renting through them -
knock wood!) but it is my understanding that the insurance they offer is exactly the same as from the rental car company but usually cheaper. I know that
@artnbarb had a claim with them once. Maybe they can confirm this.
We live in the UK now and things are not the same as they were in the US with rental car insurance. Our car insurance does not cover us in rental cars and our credit cards do not offer rental car insurance. I book through
AutoEurope.co.uk where all car rentals come with insurance (different from the US site). But there is a large excess - the deductible you must pay if you claim on the insurance - usually over 1000 Euro.
When you pickup your rental car the local company tries to sell you excess coverage. I have rental car excess insurance with
Insurance4CarHire. For about £50/year they cover that excess. Unfortunately I've had to use it twice. The car rental company charges me for the damage, up to the excess limit. Then I email the paperwork and photos and Insurance4CarHire reimburses me. AutoEurope.co.uk offers this same type of excess insurance and it is handled the same way - you are charged and reimbursed after you send info to them.
When we pickup the car they first try to sell us excess coverage but we say we already have it. Next they try to sell us super-excess because they say that excess coverage does not cover the roof and the undercarriage. I don't know if this is true but we've never bought that extra coverage.
So, my advice would be to get the insurance from AutoEurope. It works the same as if you buy it from the rental car company and is cheaper. I have compared the prices before but you can compare by looking at the websites for the rental car companies. As for the excess insurance, which is a whole different thing, see what the deductible is with AutoEurope, see if they offer excess coverage - or maybe you can purchase that in Italy like I purchase mine in the UK.