rental car liability/human injury insurance?

Injury to people and property outside the vehicle is covered by law by the rental company, the car owner, to a very high value in western and central Europe.

Injury to people inside the car would be covered by your home health insurance in some cases, but not by Medicare (as I understand it), or else by a separate travel insurance policy.

Start by checking your own car insurance policy to see if it covers your liability when driving a rental car - some do, some don't. If it does, you have no worries. If not, and you're concerned, you can purchase additional optional liability insurance when renting a car, but it is expensive.

Thank you for posting the question. Laura's answer is very helpful since I will be renting a car in Naples to drive to Calabria.

It’s also know as third party insurance – as Laura says it covers the parties outside the vehicle when you’re at fault. It’s a legal requirement in Europe and will be covered in your rental agreement. You don’t really need to think about it as it’s compulsory and automatic.

What insurance you decide to take to cover your medical costs, or repair any damage to the hire car that you cause, that’s the insurance you might have with credit cards, or other insurer, or where the car rental company tries and sells you their insurance cover.

At least in Spain, and I think Britain, and I suspect most European countries, third party insurance will be included in the price. That covers you for running over someone or driving into another car or someone's house. Within the EU it will currently be a minimum of €1.2 million per individual and €6 million per claim for multiple people, and €1.2 million for a property claim. It usually, I think also covers the car being stolen or catching fire. But separately you also need to consider insuring for damage to your own hire car, theft from the car or costs of injuring yourself, etc. which wouldn't be covered

Be sure you read the fine print (and understand it) -- including the limits of coverage and exclusions -- for whatever policy you will be relying on, whether that's included by law, something provided by a credit card, or purchased as an extra along with the rental.

I know, not exactly the fun part of your vacation, but once I started making a habit of doing that, I've found all sorts of surprises in that fine print and list of exclusions. Examples included: no coverage if you take a ferry, no coverage if you cross a border, no coverage on unpaved roads, and cases where the mandated (government-required) liability insurance was limited to a wildly unrealistic low number (which meant in practice that if you hit a cow or something, you could get tossed in jail and held until the value of said cow was determined by a local court and you paid for it...tip: in Mexico, when renting a car, they do have a minimum level of liability insurance required by law, but the limits for liability are crazy low, so you will want to buy more coverage). Crazy stuff. Read the fine print.

Your home auto insurance policy often covers you in Mexico or Canada, but not in Europe.
Most credit cards cover you for CDW in Europe. If you purchase the rental company's CDW, chances are your credit card coverage will be null and void.
Liability is provided by the rental company to protect themselves. When you buy the CDW, they just pocket the money and don't buy any insurance. Most rental companies are self insured, and CDW is just another big profit department for them.
There are a few countries where optional CDW is required--mostly Ireland and Italy. I have found Italy's CDW to be reasonably priced due to regulations, however I didn't find Ireland's CDW to be priced right.
You might want to read a copy of your credit card's list of terms and conditions--available online--about rental car coverage.
The rental car companies have got to be watched closely as they'll often put personal property coverage on the rental automatically. Your homeowner's policy at home often covers stolen suitcases, etc., and it's just a rip off.

Your home auto insurance policy often covers you in Mexico or Canada, but not in Europe

Probably true for Canada, but unlikely for Mexico. Be sure to check BEFORE you go.

There's lots of good advice above, and also a few bits that are often but not always true in all cases. The little details can matter a great deal, and there may be a lot of those little details. Miss one of them, then have some bad luck, and you can be in a heap of trouble. That's why, as unpopular as this advice is, you really need to read all the fine print AND understand it.

Car rentals, and car rental insurance especially, is a business that's fraught with potential peril for a consumer who is not diligent and obsessed with (admittedly tediously boring) details. It's a business that's ripe for disruption by some smart entrepreneur/developer (although it is not an easy problem to solve, it wouldn't be impossible, and there's a huge potential market - I've seen a couple attempts to do that, but none I've seen tackle this tricky aspect of it - in order to be the next successful Uber or AirBnB for car rentals, it would have to greatly simplify and nail the whole insurance end of the business). I'm hoping that someone comes along someday to fix all that.

Until then, I try to read and understand all the fine print, and know what I'm getting (and what I'm not). And I try hard not to hit cows (which was actually a great hazard on my last car rental a couple weeks ago - seriously!).

I often marvel at how people will confidently state things that are just not true. I’m referring to the issue about your own car insurance covering you in Mexico. Years ago, when my daughter was a student at U.C. San Diego, we went to Mexico for a day. We had to buy insurance at the border, because ours did not cover us in Mexico. It’s such a common situation that a business exists just for that purpose.
The issue of rental car insurance is quite murky. I once thought I would take the super coverage until I noticed it excluded windows and tires. You must read the fine print, as others have advised. I usually rely on my cc coverage, AMEX, except in Italy, which is excluded. There, I rely on my Chase Visa card. I have had experience with claims on both and have no complaints on their handling. Again, you have to read the fine print, at least metaphorically. I always call, before a trip, to ensure that nothing has changed. There are many kinds of Visa cards and many kinds of exclusions, and I know for sure that AMEX excludes Ireland, Israel, and Jamaica. Some countries of Eastern Europe are also excluded by some cc’s.

Vandalism is normally covered by credit card insurance, but not covered by CDW.

That is why one must pay attention to what the coverage is-

CDW= Collision Damage Waiver ( Impact with another vehicle or object)

LDW= Loss Damage Waiver ( Any damage, not specifically excluded)

Thanks all. Good info.....though can leave it still 'clear as mud'. I have learned over time, that insurance is not consistent globally - particularly not travel insurance or health insurance - so I know to investigate my own. I also realize, that not using the correct term the other week left my question misunderstood and incorrectly answered. I reviewed the company website again, and note that 3rd party liability is an add on to one of several levels of CDW. I also went back to Europcar website and see that they do include 3rd party in their base insurance.
I do read my card(s) fine print and investigate with my auto club before I rent cars outside of North America, so will do that again before I head to Italy next year.
As to insurance rip off and differences between locals and tourists, I don't think it is surprising, or a rip off. Same happens for visitors to North America, and then look at the cruise industry or airlines with 2 tier pricing. It may not seem ethical, but there are generally economic reasons for it all. For airlines, it can be to cost to allow locals (with a considerably lower income) to actually afford to fly. Tourists may be considered bigger risks and we all know insurance thrives of forecasting and analyzing risk. As fr as cruises go - I still haven't figured out that pricing disparity....

Maybe, this is what you were thinking of. My husband and I have umbrella coverage of at least a million USD, to cover any liability for injury to others by us or something we own. People with pools and trampolines tend to get this insurance, but it covers you if someone should sue if they fall on the sidewalk in front of your house or any number of things. It is my understanding that it would also cover any lawsuits from car accidents. Personal car insurance covers anyone involved in car accident. I believe it would also cover pedestrians should they be involved.

Tom, my coverage covers liability AFTER any car insurance has been applied, just as it would apply after any home owner's insurance. Since I was using my own insurance situation as an example, I think it is hard to argue unless you want to come over and read my policy. In terms of the person in Illinois who believes that her insurance covers her in Europe, I would also have my doubts. But as long as it is pointed out to less experienced travelers that U.S. insurance does not typically cover one in Europe, I don't know that further discussion of it is necessary. Maybe her insurance is different? There are many policies and many situations.