> out of pocket costs easily come below the total amount of insurance fees I'd have paid
Most major credit cards come with a good amount of rental car insurance.
Most major credit cards come with a good amount of rental car insurance.
One of the few cards that provides primary rental car insurance is the Chase United Explorer card. If you rent cars regularly it can be worth the annual fee for that feature alone.
(Assuming you have car insurance to begin with -- if you don't, then there is no difference between primary and secondary coverage)