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If you rent from one of the bigger US-based companies in the EU (Avis, Hertz, etc.), the additional insurance they offer can be ridiculously expensive (likely dependent on where you are and what car you rent). It's a healthy revenue-stream for them no doubt, and a lot of agents at the counter will try and scare you into purchasing the extra insurance.
Regarding nav, I just use my phone w/ Google maps/navigation, as some (most?) of the on-board car nav systems are a pain to use anyway. Any modern GSM phone should suffice, and you can pick up a pre-paid SIM card (w/ adequate data allowance/coverage) once you hit the ground. YMMV...
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