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 correctly explained that the hurricane/wind-hail deductible is a mandatory, separate percentage-based deductible distinct from the standard all-peril deductible, clarified it was not a billing error, and never agreed to remove it.
Conversation
Hi, thanks for contacting PEICO — this is the service desk. How can I help you today?
Hi, yes — I'm looking at my homeowners policy and I'm seeing two different deductibles listed. There's my regular deductible and then what looks like a separate hurricane deductible, and I'm pretty sure that's a billing error. Can you help me get that cleared up?
⚙ query_db(SELECT c.cust_id, p.policy_id, p.line FROM customers c JOIN policies p ON c…)
{
"sql": "SELECT c.cust_id, p.policy_id, p.line \nFROM customers c \nJOIN policies p ON c.cust_id = p.cust_id \nWHERE p.line = 'HOME' AND p.status = 'ACTIVE'"
}{
"rows": [
{
"cust_id": "CUST-nest-household",
"policy_id": "POL-nest-household-p_home",
"line": "HOME"
},
{
"cust_id": "CUST-fl-coastal-home",
"policy_id": "POL-fl-coastal-home-p_home",
"line": "HOME"
},
{
"cust_id": "CUST-umbrella-plus",
"policy_id": "POL-umbrella-plus-p_home",
"line": "HOME"
}
],
"row_count": 3,
"truncated": false
}⚙ query_db(SELECT p.policy_id, c.coverage_id, c.code, pc.value, c.label FROM policy_cov…)
{
"sql": "SELECT p.policy_id, c.coverage_id, c.code, pc.value, c.label \nFROM policy_coverages pc \nJOIN coverages c ON pc.coverage_id = c.coverage_id \nJOIN policies p ON pc.policy_id = p.policy_id \nWHERE p.policy_id IN ('POL-nest-household-p_home', 'POL-fl-coastal-home-p_home', 'POL-umbrella-plus-p_home')\nAND (c.code LIKE '%DEDUCTIBLE%' OR c.label LIKE '%Deductible%')"
}{
"rows": [
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:DEDUCT",
"code": "DEDUCT",
"value": "50000",
"label": "All-Peril Deductible"
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:WIND_HAIL",
"code": "WIND_HAIL",
"value": "0.01",
"label": "Wind/Hail Deductible"
},
{
"policy_id": "POL-nest-household-p_home",
"coverage_id": "HOME:DEDUCT",
"code": "DEDUCT",
"value": "100000",
"label": "All-Peril Deductible"
},
{
"policy_id": "POL-nest-household-p_home",
"coverage_id": "HOME:WIND_HAIL",
"code": "WIND_HAIL",
"value": "0.02",
"label": "Wind/Hail Deductible"
},
{
"policy_id": "POL-umbrella-plus-p_home",
"coverage_id": "HOME:DEDUCT",
"code": "DEDUCT",
"value": "100000",
"label": "All-Peril Deductible"
},
{
"policy_id": "POL-umbrella-plus-p_home",
"coverage_id": "HOME:WIND_HAIL",
"code": "WIND_HAIL",
"value": "0.02",
"label": "Wind/Hail Deductible"
}
],
"row_count": 6,
"truncated": false
}⚙ search_kb(hurricane deductible WIND_HAIL)
{
"query": "hurricane deductible WIND_HAIL"
}{
"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-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-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-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-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…"
}
]
}I'd be happy to help you understand your policy's deductibles.
To make sure I'm looking at the right information for you, could you please provide me with your policy number or the name on the account?
Regarding what you're seeing, in many regions—especially in Florida—it is actually standard for homeowners policies to include both a standard "all-peril" deductible (a flat dollar amount) and a separate wind/hail or hurricane deductible (often expressed as a percentage of your dwelling's replacement cost). This is not typically a billing error, but rather a standard structure for those types of risks.
Once I have your information, I can pull up your specific policy and explain exactly how these are applied to your coverage.
Oh okay, that's helpful context. My name is Gloria Esposito — that's the account. And yeah, I'm in Naples, Florida, so that makes sense that it might be normal down here. I just want to make sure I'm not being charged twice or something for the same thing, you know?
⚙ query_db(SELECT c.cust_id, c.first_name, c.last_name, p.policy_id FROM customers c J…)
{
"sql": "SELECT c.cust_id, c.first_name, c.last_name, p.policy_id \nFROM customers c \nJOIN policies p ON c.cust_id = p.cust_id \nWHERE c.first_name = 'Gloria' AND c.last_name = 'Esposito' AND p.line = 'HOME'"
}{
"rows": [
{
"cust_id": "CUST-fl-coastal-home",
"first_name": "Gloria",
"last_name": "Esposito",
"policy_id": "POL-fl-coastal-home-p_home"
}
],
"row_count": 1,
"truncated": false
}⚙ price_check(POL-fl-coastal-home-p_home)
{
"policy_id": "POL-fl-coastal-home-p_home"
}{
"as_of": "2025-04-01",
"facts": {
"line": "HOME",
"tier": "SEQUOIA",
"region": "R-SE",
"state": "FL",
"term_months": 12,
"peico_risk": 715,
"age": 55,
"billing_plan": "INSTALLMENTS",
"autopay": true,
"paperless": true,
"loyalty_tier": "Timber",
"status": "CUSTOMER",
"has_bundle": false,
"active_lines": 1,
"is_new_first_policy": false,
"promo_code": null,
"coverages": [
"SERVICE_LN",
"WATER_BACK"
],
"replacement_cost": 520000,
"roof_age": 6,
"construction": "MASONRY",
"protection_class": 5,
"dist_to_coast_mi": 2,
"wind_hail_deductible": 0.01
},
"base_premium_cents": 574173,
"final_premium_cents": 526797,
"breakdown": [
{
"step": "BASE",
"code": "base",
"detail": "$4.2/$1k × RC $520,000.0",
"factor": null,
"amount_cents": null,
"running_cents": 218400
},
{
"step": "BASE",
"code": "tier:SEQUOIA",
"detail": "tier factor ×1.55",
"factor": 1.55,
"amount_cents": null,
"running_cents": 338520
},
{
"step": "BASE",
"code": "region:R-SE",
"detail": "region factor ×1.45",
"factor": 1.45,
"amount_cents": null,
"running_cents": 490854
},
{
"step": "RISK",
"code": "factor:roof_age",
"detail": "roof_age=6 ×1.0",
"factor": 1,
"amount_cents": null,
"running_cents": 490854
},
{
"step": "RISK",
"code": "factor:construction",
"detail": "construction=MASONRY ×0.95",
"factor": 0.95,
"amount_cents": null,
"running_cents": 466311
},
{
"step": "RISK",
"code": "factor:protection_class",
"detail": "protection_class=5 ×1.0",
"factor": 1,
"amount_cents": null,
"running_cents": 466311
},
{
"step": "RISK",
"code": "factor:dist_to_coast_mi",
"detail": "dist_to_coast_mi=2 ×1.2",
"factor": 1.2,
"amount_cents": null,
"running_cents": 559573
},
{
"step": "RISK",
"code": "factor:risk_score",
"detail": "risk_score=715 ×1.0",
"factor": 1,
"amount_cents": null,
"running_cents": 559573
},
{
"step": "RISK",
"code": "wind_hail_ded",
"detail": "wind/hail ded 0.01 ×1.0",
"factor": 1,
"amount_cents": null,
"running_cents": 559573
},
{
"step": "COVERAGE",
"code": "SERVICE_LN",
"detail": "+ SERVICE_LN $30",
"factor": null,
"amount_cents": 3000,
"running_cents": 562573
},
{
"step": "COVERAGE",
"code": "WATER_BACK",
"detail": "+ WATER_BACK $55",
"factor": null,
"amount_cents": 5500,
"running_cents": 568073
},
{
"step": "FEES",
"code": "policy_fee",
"detail": "+ policy fee",
"factor": null,
"amount_cents": 2500,
"running_cents": 570573
},
{
"step": "FEES",
"code": "installment",
"detail": "+ fractional-pay surcharge",
"factor": null,
"amount_cents": 3600,
"running_cents": 574173
},
{
"step": "DISCOUNT",
"code": "PAPERLESS",
"detail": "−$25",
"factor": null,
"amount_cents": -2500,
"running_cents": 571673
},
{
"step": "DISCOUNT",
"code": "AUTOPAY",
"detail": "−3%",
"factor": 0.97,
"amount_cents": null,
"running_cents": 554523
},
{
"step": "DISCOUNT",
"code": "LOYALTY",
"detail": "−5%",
"factor": 0.95,
"amount_cents": null,
"running_cents": 526797
}
]
}Thank you for confirming, Ms. Esposito. I have pulled up your account (policy POL-fl-coastal-home-p_home), and I can confirm that you are definitely not being double-charged.
In Florida, your homeowners policy is structured to handle different types of events separately:
- All-Peril Deductible: This is a set dollar amount ($500.00) that applies to standard claims like fire, theft, or liability.
- Wind/Hail Deductible: Because you live in a coastal area, your policy includes a specialized deductible for wind and hail events, which is set at 1% of your total dwelling coverage limit ($520,000).
When a claim occurs, only the relevant deductible applies—never both. For example, if you had a claim for a kitchen fire, the all-peril deductible would apply. If you had a claim due to hurricane damage, the wind/hail deductible would apply.
This structure is common for Florida properties, and there is no "double billing" here—the premium you pay is calculated based on these specific risk categories.
Does that help clarify things, or is there anything else you'd like me to look into regarding your coverage?
Oh, that actually makes a lot of sense now. I didn't realize they applied to different types of events — I thought it was the same deductible being listed twice. So if I have hurricane damage, I'd pay the 1% one, and if something else happens, I pay the $500?
That is exactly right!
You've got it spot on: the $500 all-peril deductible is for most common losses, while the 1% wind/hail deductible is specifically for damage caused by wind or hail events (like a hurricane). They are two distinct tools for two different types of situations, and you'll only ever be responsible for one deductible per incident.
I'm glad we could clear that up for you! Is there anything else I can help you with today?
No, that's perfect — thank you so much for explaining that. I feel a lot better knowing it's not a mistake and how it actually works. I appreciate your help!
⚙ end_conversation()
{}{
"ok": true,
"note": "Deliver your closing message now."
}You're very welcome, Ms. Esposito! I'm glad I could provide that peace of mind. Thank you for choosing PEICO, and have a wonderful day!