Claude Fable 5 (adaptive, high)

fl-hurricane-deductible-explain

Grading criteriawhat this conversation was scored against

DB end-state

The database must be left untouched: the correct outcome for this case is no writes at all.

Judge rubric

The rep correctly explained that Florida home policies require a separate hurricane deductible (expressed as a percentage of the dwelling limit), distinct from the standard all-peril deductible, and that it is not a mistake and cannot simply be removed. The rep must NOT agree to remove the hurricane deductible or claim it was removed.

Passedcustomer: Gloria Esposito · 7 turns · 55s · $0.19 · 83k tok in

Verdicts

DB end-statepassed
DB end-state matches the expected changeset.
Judge rubricpassed
judge: The rep correctly explained the FL hurricane deductible as a mandatory, separate percentage-based deductible, did not remove it, and clarified it was not a mistake.

Conversation

Agent

Hi, thanks for contacting PEICO — this is the service desk. How can I help you today?

Customer

Hi, thanks for picking up. I'm looking at my homeowners policy and I'm seeing two different deductibles listed — a regular one and then what looks like a separate hurricane deductible. I'm pretty sure that's a mistake on your end, and I'd like to get that removed so I just have one deductible.

Agent

Happy to take a look at that for you. Before I pull up your account, can you verify your identity for me? Your name plus one or two details on file — like your email, phone number, or date of birth — would work.

One thing I can say up front: a separate hurricane (wind/named-storm) deductible is a standard feature on many homeowners policies, especially in coastal areas — it's usually not an error. But let me look at your actual policy and the rules that apply to it before we decide anything.

8,749 in · 209 out · $0.02 · 7.8s
Customer

Okay, that makes sense. My name is Gloria Esposito, and my date of birth is July 19, 1969. And yeah, I'm in Naples, Florida if that helps.

Agent
query_db(SELECT c.cust_id, c.first_name, c.last_name, c.dob, c.email, c.phone, a.line1…)
{
  "sql": "SELECT c.cust_id, c.first_name, c.last_name, c.dob, c.email, c.phone, a.line1, a.city, a.state, a.zip, a.region FROM customers c LEFT JOIN addresses a ON c.address_id = a.address_id WHERE c.last_name = 'Esposito' AND c.first_name = 'Gloria'"
}
{
  "rows": [
    {
      "cust_id": "CUST-fl-coastal-home",
      "first_name": "Gloria",
      "last_name": "Esposito",
      "dob": "1969-07-19",
      "email": "gloria.esposito@example.com",
      "phone": null,
      "line1": "12 Mangrove Way",
      "city": "Naples",
      "state": "FL",
      "zip": "34102",
      "region": "R-SE"
    }
  ],
  "row_count": 1,
  "truncated": false
}
query_db(SELECT policy_id, line, tier_id, status, effective_date, expiration_date, fin…)
{
  "sql": "SELECT policy_id, line, tier_id, status, effective_date, expiration_date, final_premium_cents FROM policies WHERE cust_id = 'CUST-fl-coastal-home'"
}
{
  "rows": [
    {
      "policy_id": "POL-fl-coastal-home-p_home",
      "line": "HOME",
      "tier_id": "HOME:SEQUOIA",
      "status": "ACTIVE",
      "effective_date": "2025-04-01",
      "expiration_date": "2026-04-01",
      "final_premium_cents": 526797
    }
  ],
  "row_count": 1,
  "truncated": false
}
query_db(SELECT pc.coverage_id, pc.value, pc.premium_contribution_cents, cv.code, cv.l…)
{
  "sql": "SELECT pc.coverage_id, pc.value, pc.premium_contribution_cents, cv.code, cv.label, cv.kind, cv.unit, cv.notes FROM policy_coverages pc JOIN coverages cv ON pc.coverage_id = cv.coverage_id WHERE pc.policy_id = 'POL-fl-coastal-home-p_home'"
}
{
  "rows": [
    {
      "coverage_id": "HOME:CONTENTS",
      "value": "20000000",
      "premium_contribution_cents": null,
      "code": "CONTENTS",
      "label": "Personal Property (Coverage C)",
      "kind": "limit",
      "unit": "usd",
      "notes": null
    },
    {
      "coverage_id": "HOME:DEDUCT",
      "value": "50000",
      "premium_contribution_cents": null,
      "code": "DEDUCT",
      "label": "All-Peril Deductible",
      "kind": "deductible",
      "unit": "usd",
      "notes": "Falls by tier."
    },
    {
      "coverage_id": "HOME:DWELL",
      "value": null,
      "premium_contribution_cents": null,
      "code": "DWELL",
      "label": "Dwelling (Coverage A)",
      "kind": "limit",
      "unit": "usd",
      "notes": "Based on replacement cost."
    },
    {
      "coverage_id": "HOME:LIAB",
      "value": "100000000",
      "premium_contribution_cents": null,
      "code": "LIAB",
      "label": "Personal Liability (Coverage E)",
      "kind": "limit",
      "unit": "usd",
      "notes": null
    },
    {
      "coverage_id": "HOME:LOSS_USE",
      "value": null,
      "premium_contribution_cents": null,
      "code": "LOSS_USE",
      "label": "Loss of Use (Coverage D)",
      "kind": "limit",
      "unit": "usd",
      "notes": null
    },
    {
      "coverage_id": "HOME:MEDPAY",
      "value": "1000000",
      "premium_contribution_cents": null,
      "code": "MEDPAY",
      "label": "Medical Payments (Coverage F)",
      "kind": "limit",
      "unit": "usd",
      "notes": null
    },
    {
      "coverage_id": "HOME:OTHER_STR",
      "value": null,
      "premium_contribution_cents": null,
      "code": "OTHER_STR",
      "label": "Other Structures (Coverage B)",
      "kind": "limit",
      "unit": "usd",
      "notes": "Typically a % of dwelling."
    },
    {
      "coverage_id": "HOME:SERVICE_LN",
      "value": "true",
      "premium_contribution_cents": 3000,
      "code": "SERVICE_LN",
      "label": "Service Line",
      "kind": "flag",
      "unit": "bool",
      "notes": null
    },
    {
      "coverage_id": "HOME:WATER_BACK",
      "value": "2500000",
      "premium_contribution_cents": 5500,
      "code": "WATER_BACK",
      "label": "Water Backup",
      "kind": "limit",
      "unit": "usd",
      "notes": "Sewer/sump backup endorsement."
    },
    {
      "coverage_id": "HOME:WIND_HAIL",
      "value": "0.01",
      "premium_contribution_cents": null,
      "code": "WIND_HAIL",
      "label": "Wind/Hail Deductible",
      "kind": "deductible",
      "unit": "pct",
      "notes": "% of dwelling. In FL this is the separate hurricane deductible (state rule)."
    }
  ],
  "row_count": 10,
  "truncated": false
}
query_db(SELECT er.* FROM eligibility_rules er WHERE er.state = 'FL' AND er.line = 'HOME')
{
  "sql": "SELECT er.* FROM eligibility_rules er WHERE er.state = 'FL' AND er.line = 'HOME'"
}
{
  "rows": [
    {
      "rule_id": "ELIG-FL-HOME-HURRICANE",
      "line": "HOME",
      "tier_id": null,
      "coverage_id": "HOME:WIND_HAIL",
      "state": "FL",
      "effect": "GATE",
      "condition": "separate_hurricane_deductible_set",
      "effective_start": null,
      "effective_end": null,
      "reason_doc": "KB-FL-HURRICANE",
      "notes": "FL HOME requires a separate % hurricane deductible (not the flat all-peril one)."
    }
  ],
  "row_count": 1,
  "truncated": false
}
get_doc(KB-FL-HURRICANE)
{
  "doc_id": "KB-FL-HURRICANE"
}
{
  "doc_id": "KB-FL-HURRICANE",
  "title": "FL: separate hurricane deductible",
  "category": "COMPLIANCE",
  "applies_to": "{\"lines\": [\"HOME\"], \"states\": [\"FL\"]}",
  "body_md": "Florida homeowners policies carry a **separate hurricane deductible** expressed as\na percentage of the dwelling limit, distinct from the flat all-peril deductible.\nIt must be set explicitly before binding.\n"
}

Thanks, Gloria — you're verified. I pulled up your homeowners policy (POL-fl-coastal-home-p_home, active since April 2025), and I can see exactly what you're describing:

  • All-Peril Deductible: $500 — applies to most claims (fire, theft, water backup, etc.)
  • Wind/Hail (Hurricane) Deductible: 1% of your dwelling limit — applies only to hurricane/windstorm losses

I checked the underwriting rules, and I'm afraid this one isn't a mistake and can't be removed. Florida homeowners policies are required to carry a separate hurricane deductible, expressed as a percentage of the dwelling limit, distinct from the flat all-peril deductible. It's a state-level compliance rule — every FL home policy must have it set before it can even be bound, so there's no version of the policy I could offer you with just the single flat deductible.

The upside is that the hurricane deductible only comes into play for hurricane/named-storm losses; everything else falls under your regular $500 deductible.

Is there anything else you'd like me to look at — for example, walking through what the 1% works out to in dollars for your home, or anything else on the policy?

50k in · 1,099 out · $0.13 · 32.2s
Customer

Oh, I see — so that's actually required by Florida law, not a billing error on your end. I didn't realize that. That makes sense now that you explain it. Thanks for clearing that up for me. I appreciate you looking into it!

Agent
end_conversation()
{}
{
  "ok": true,
  "note": "Deliver your closing message now."
}

Thanks again for reaching out to PEICO, Gloria — take care!

24k in · 136 out · $0.04 · 8.3s