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.
Verdicts
DB end-statepassed
DB end-state matches the expected changeset.
Judge rubricpassed
judge: The rep clearly explained that Florida requires a separate percentage-based hurricane deductible distinct from the flat all-peril deductible, stated it is a mandatory state rule (not a mistake), and refused to merge or remove it, matching the rubric exactly.
Conversation
Hi, thanks for contacting PEICO — this is the service desk. How can I help you today?
Hi, thanks for picking up. I'm looking at my homeowner's 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 the bill, and I'd like to get it corrected so I just have one deductible.
I can look into that for you — but first I need to verify your identity. Could you give me your policy number (POL-...) or your full name and date of birth, along with your address or customer ID?
Sure. My name is Gloria Esposito, and my date of birth is July 19, 1969. I'm in Naples, Florida. I don't have my policy number handy right now, but that should help you find me.
⚙ query_db(SELECT c.cust_id, c.first_name, c.last_name, c.dob, c.email, c.phone, a.city,…)
{
"sql": "SELECT c.cust_id, c.first_name, c.last_name, c.dob, c.email, c.phone, a.city, a.state\nFROM customers c JOIN addresses a ON c.address_id = a.address_id\nWHERE lower(c.first_name) = 'gloria' AND lower(c.last_name) = 'esposito'"
}{
"rows": [
{
"cust_id": "CUST-fl-coastal-home",
"first_name": "Gloria",
"last_name": "Esposito",
"dob": "1969-07-19",
"email": "gloria.esposito@example.com",
"phone": null,
"city": "Naples",
"state": "FL"
}
],
"row_count": 1,
"truncated": false
}⚙ query_db(SELECT policy_id, line, tier_id, status, effective_date, expiration_date, bas…)
{
"sql": "SELECT policy_id, line, tier_id, status, effective_date, expiration_date, base_premium_cents, final_premium_cents\nFROM 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",
"base_premium_cents": 574173,
"final_premium_cents": 526797
}
],
"row_count": 1,
"truncated": false
}⚙ query_db(SELECT pc.coverage_id, pc.value, pc.premium_contribution_cents, c.label, c.ki…)
{
"sql": "SELECT pc.coverage_id, pc.value, pc.premium_contribution_cents, c.label, c.kind, c.unit, c.notes\nFROM policy_coverages pc JOIN coverages c ON pc.coverage_id = c.coverage_id\nWHERE pc.policy_id = 'POL-fl-coastal-home-p_home'"
}{
"rows": [
{
"coverage_id": "HOME:CONTENTS",
"value": "20000000",
"premium_contribution_cents": null,
"label": "Personal Property (Coverage C)",
"kind": "limit",
"unit": "usd",
"notes": null
},
{
"coverage_id": "HOME:DEDUCT",
"value": "50000",
"premium_contribution_cents": null,
"label": "All-Peril Deductible",
"kind": "deductible",
"unit": "usd",
"notes": "Falls by tier."
},
{
"coverage_id": "HOME:DWELL",
"value": null,
"premium_contribution_cents": null,
"label": "Dwelling (Coverage A)",
"kind": "limit",
"unit": "usd",
"notes": "Based on replacement cost."
},
{
"coverage_id": "HOME:LIAB",
"value": "100000000",
"premium_contribution_cents": null,
"label": "Personal Liability (Coverage E)",
"kind": "limit",
"unit": "usd",
"notes": null
},
{
"coverage_id": "HOME:LOSS_USE",
"value": null,
"premium_contribution_cents": null,
"label": "Loss of Use (Coverage D)",
"kind": "limit",
"unit": "usd",
"notes": null
},
{
"coverage_id": "HOME:MEDPAY",
"value": "1000000",
"premium_contribution_cents": null,
"label": "Medical Payments (Coverage F)",
"kind": "limit",
"unit": "usd",
"notes": null
},
{
"coverage_id": "HOME:OTHER_STR",
"value": null,
"premium_contribution_cents": null,
"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,
"label": "Service Line",
"kind": "flag",
"unit": "bool",
"notes": null
},
{
"coverage_id": "HOME:WATER_BACK",
"value": "2500000",
"premium_contribution_cents": 5500,
"label": "Water Backup",
"kind": "limit",
"unit": "usd",
"notes": "Sewer/sump backup endorsement."
},
{
"coverage_id": "HOME:WIND_HAIL",
"value": "0.01",
"premium_contribution_cents": null,
"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
}⚙ search_kb(Florida hurricane wind hail separate deductible)
{
"query": "Florida hurricane wind hail separate deductible"
}{
"results": [
{
"doc_id": "KB-FL-HURRICANE",
"title": "FL: separate hurricane deductible",
"category": "COMPLIANCE",
"applies_to": "{\"lines\": [\"HOME\"], \"states\": [\"FL\"]}",
"snippet": "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"
},
{
"doc_id": "KB-EVERGREEN-CLASSIC",
"title": "Evergreen Classic (Home, retired 2018) — wind/hail math",
"category": "UNDERWRITING",
"applies_to": "{\"lines\": [\"HOME\"]}",
"snippet": "Retired 2018-01-01. Uses a legacy flat-capped wind/hail deductible (1.5% of\ndwelling, capped) rather than the current percentage math. Not re-bindable.\n"
},
{
"doc_id": "KB-CONDO-MASTER",
"title": "Condo loss assessment & the HOA master policy",
"category": "POLICY",
"applies_to": "{\"lines\": [\"CONDO\"]}",
"snippet": "Loss Assessment coverage responds to charges levied by the HOA. Its adequacy\ndepends on the **master-policy deductible**; record that deductible so the limit\nis set correctly.\n"
},
{
"doc_id": "KB-LOYALTY-AUTHORITY",
"title": "PineRewards points: what a service rep may post",
"category": "POLICY",
"applies_to": "{\"lines\": \"ALL\"}",
"snippet": "Tiers (Seedling → Sprout → Timber → OldGrowth) are assigned annually from\ntenure and lifetime earning, **not** the current point balance. Points earned\n2019 or later expire **24 months** after the earn date; older entries were\nwritten witho…"
},
{
"doc_id": "KB-PROMO-SPRINGSAVE25",
"title": "SPRINGSAVE25 terms",
"category": "PROMO",
"applies_to": "{\"lines\": [\"AUTO\"]}",
"snippet": "$75 off auto in the Midwest/Southwest, spring 2025 only. Offer window 2025-03-20 through 2025-06-21; does not apply after 2025-06-21. Applicability is determined by the offer window as of the quote date."
},
{
"doc_id": "KB-AUTO-TIERS",
"title": "Auto tiers: Sapling → Pine → Evergreen → Sequoia",
"category": "POLICY",
"applies_to": "{\"lines\": [\"AUTO\"]}",
"snippet": "Tiers bundle coverages. Higher tiers raise liability limits, lower deductibles,\nand add coverages: **MED** and **RENT_REIMB** appear at Evergreen and above;\n**OEM** is Sequoia-only; **ROAD** is included at Sequoia (an add-on below it).\n"
},
{
"doc_id": "KB-PROMO-COASTALSHIELD",
"title": "COASTALSHIELD terms",
"category": "PROMO",
"applies_to": "{\"lines\": [\"HOME\", \"CONDO\"], \"states\": [\"FL\", \"GA\", \"NC\"]}",
"snippet": "$120 wind-resilience credit for Southeast home/condo policies. Cap $120; min premium $600."
}
]
}⚙ query_db(SELECT * FROM eligibility_rules WHERE coverage_id = 'HOME:WIND_HAIL' AND stat…)
{
"sql": "SELECT * FROM eligibility_rules WHERE coverage_id = 'HOME:WIND_HAIL' AND state = 'FL'"
}{
"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
}I checked this closely, and it's actually not a billing error — it's a Florida state requirement.
Here's what's on your policy:
- All-Peril Deductible: $500 flat (applies to most claims)
- Wind/Hail (Hurricane) Deductible: 1% of your dwelling coverage — this is a separate, percentage-based deductible
Florida law requires homeowners policies to carry a distinct hurricane/wind-hail deductible, separate from the standard all-peril deductible — it can't be combined into one flat number. This is a mandatory state rule (not tier- or company-specific), so I'm not able to merge them or remove the hurricane deductible even if you'd prefer a single number.
To be clear on what it means for you: if a covered loss is caused by a hurricane or windstorm, the 1% (of your dwelling limit) deductible applies instead of the $500 flat one. For any other covered peril, the $500 flat deductible applies.
Is there anything else I can help clarify, or would you like me to check what your dwelling limit is to calculate the actual dollar value of that 1%?
Oh, I see — I didn't realize that was a state requirement. That makes sense now. So the hurricane one only kicks in if it's actually wind or hurricane damage, right? And otherwise I just use the regular $500 deductible?
That's exactly right. To break it down simply:
- Hurricane/Wind-Hail damage (windstorm, hurricane) → the 1% of dwelling limit deductible applies
- Everything else covered (fire, theft, water damage not excluded, etc.) → the $500 flat all-peril deductible applies
They're never both applied to the same claim — it depends entirely on the cause of loss. Is there anything else I can help with today?
No, that clears it up for me. Thanks for explaining how it actually works — I feel a lot better about it now that I understand it's not a mistake. I appreciate your help!
⚙ end_conversation()
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"ok": true,
"note": "Deliver your closing message now."
}Take care!