I have a credit card (Citi AAdvantage Visa) that offers collision loss / damage waiver insurance on car rentals paid for with the card. My question: does this benefit also apply when I am renting a car outside the USA?
It appears the answer is "yes". From the online card member info, I see that it is called the "Worldwide Car Rental Loss & Damage Insurance Coverage":
The Citi AAdvantage Visa does NOT provide "collision loss / damage waiver insurance" (CDW/LDW). Instead it provided what is called "Secondary" insurance.
CDW/LDW provide a "waiver" that you will not be charged for any damage/loss to the car. If you are involved in an accident (regardless of who is at fault) you can simply "walk away" from the damaged vehicle, and you will not be held responsible - presuming there are not extenuating circumstances such as you breaking a law/being drunk/etc.
This differs from the insurance provided by credit card companies in that with these you WILL be responsible for the damage. When you return the damaged vehicle the rental car company will require you to fill out paperwork regarding the damage, and will eventually send you a bill for the damage.
What happens next depends on the type of coverage that the credit card has. Most cards, including the Citi AAdvantage Visa, provide "Secondary Insurance", which means that you must first claim with any other insurance that might cover the costs first. This might include your car insurance (most US car insurance covers rental vehicles), travel insurance, corporate insurance, etc. Only once they have settled the claim will the credit card company become involved to pay for any remaining balance - normally this would be the excess/deductible/co-payment from your other insurance. There can also be implications regarding future insurance rate increases due to the claim, etc.
Some high-end credit cards do provide "Primary" insurance where you can file the initial claim with the credit card company, but these are rare and generally have very high annual fees.
Having just been through this process myself, I can attest to the fact that it can take months. My claim for an accident that occurred last July (rental car hit in hotel carpark overnight) is due to have the the deductible paid out by the credit card insurance within the next week - basically 6 months after the accident. This is very different to CDW/LDW where I could have simply returned the car and walked away.