This reminds me of my friends who met an elderly retired couple on a cruise. They were Amex black card holders, and said that the biggest reason they carried it was that if something happened to them medically (the husband was a retired physician to boot), Amex would come through and get them to the best hospital in whatever part of the world they'd be in.

That kind of support and service can be a huge difference maker to people who have experienced or can perceive such niche cases.