Obviously the vast majority of policies on tvs never have to go through or else the companies would not be in business, but if your the unlucky person whose tv breaks then a e.w. can be a lifesaver. Breakup the cost of the warranty over 4 years and its not that bad at all for piece of mind.
Think of it this way, its paying 50 dollars every year for three years for peace of mind. If it breaks then it's worth it, you don't have to ship it directly to the manufacturer. But if it doesn't break then your out of 150. If basically your propensity to risk.
Why would you expect Best Buy to pick up your tv for you?
You pay a bigger premium because they have to pay more for labor, freight, etc. than online stores have to. I haven't seen any store online or b&m actually pick up anyone's set over a stuck pixel before.