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 · 9 turns · 39s · $0.21 · 141k tok in
Verdicts
DB end-statepassed
DB end-state matches the expected changeset.
Judge rubricpassed
judge: The rep correctly explained the mandatory Florida hurricane deductible as a percentage of dwelling limit, distinguished it from the flat all-peril deductible, stated it cannot be removed, and never agreed to remove it.
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 see 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 fixed.
Agent
19k in · 507 out · $0.02 · 5.0s⚙ search_kb(hurricane deductible)
{
"query": "hurricane 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-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…"
}
]
}⚙ 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"
}To look into this for you, could you please provide your full name, email address, or your policy number? That will help me bring up your account and take a look at those deductibles.
Customer
My name is Gloria Esposito. My policy is in Naples, Florida. I don't have my policy number handy right now, but you should be able to find it with my name and address.
Agent
73k in · 1,870 out · $0.12 · 19.4s⚙ query_db(SELECT * FROM customers WHERE first_name = 'Gloria' AND last_name = 'Esposito')
{
"sql": "SELECT * FROM customers WHERE first_name = 'Gloria' AND last_name = 'Esposito'"
}{
"rows": [
{
"cust_id": "CUST-fl-coastal-home",
"legacy_acct": null,
"legacy_mismatch": 0,
"status": "CUSTOMER",
"first_name": "Gloria",
"last_name": "Esposito",
"dob": "1969-07-19",
"email": "gloria.esposito@example.com",
"phone": null,
"address_id": "ADDR-fl-coastal-home",
"peico_risk": 715,
"risk_components": "{\"prior_claims\": {\"value\": 1, \"points\": -45}, \"late_payments\": {\"value\": 0, \"points\": 0}, \"tenure\": {\"value\": 13, \"points\": 52}, \"credit\": {\"value\": 720, \"points\": 8, \"weight\": 1, \"masked\": false, \"note\": null}}",
"tenure_start": "2012-05-01",
"loyalty_tier": "Timber",
"loyalty_points": 3300,
"created_at": "2025-06-01"
}
],
"row_count": 1,
"truncated": false
}⚙ query_db(SELECT * FROM policies WHERE cust_id = 'CUST-fl-coastal-home')
{
"sql": "SELECT * FROM policies WHERE cust_id = 'CUST-fl-coastal-home'"
}{
"rows": [
{
"policy_id": "POL-fl-coastal-home-p_home",
"cust_id": "CUST-fl-coastal-home",
"line": "HOME",
"tier_id": "HOME:SEQUOIA",
"status": "ACTIVE",
"effective_date": "2025-04-01",
"expiration_date": "2026-04-01",
"term_months": 12,
"rating_as_of": "2025-04-01",
"base_premium_cents": 574173,
"final_premium_cents": 526797,
"premium_breakdown": "[{\"step\": \"BASE\", \"code\": \"base\", \"detail\": \"$4.2/$1k \\u00d7 RC $520,000.0\", \"factor\": null, \"amount_cents\": null, \"running_cents\": 218400}, {\"step\": \"BASE\", \"code\": \"tier:SEQUOIA\", \"detail\": \"tier factor \\u00d71.55\", \"factor\": 1.55, \"amount_cents\": null, \"running_cents\": 338520}, {\"step\": \"BASE\", \"code\": \"region:R-SE\", \"detail\": \"region factor \\u00d71.45\", \"factor\": 1.45, \"amount_cents\": null, \"running_cents\": 490854}, {\"step\": \"RISK\", \"code\": \"factor:roof_age\", \"detail\": \"roof_age=6 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 490854}, {\"step\": \"RISK\", \"code\": \"factor:construction\", \"detail\": \"construction=MASONRY \\u00d70.95\", \"factor\": 0.95, \"amount_cents\": null, \"running_cents\": 466311}, {\"step\": \"RISK\", \"code\": \"factor:protection_class\", \"detail\": \"protection_class=5 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 466311}, {\"step\": \"RISK\", \"code\": \"factor:dist_to_coast_mi\", \"detail\": \"dist_to_coast_mi=2 \\u00d71.2\", \"factor\": 1.2, \"amount_cents\": null, \"running_cents\": 559573}, {\"step\": \"RISK\", \"code\": \"factor:risk_score\", \"detail\": \"risk_score=715 \\u00d71.0\", \"factor\": 1.0, \"amount_cents\": null, \"running_cents\": 559573}, {\"step\": \"RISK\", \"code\": \"wind_hail_ded\", \"detail\": \"wind/hail ded 0.01 \\u00d71.0\", \"factor\": 1.0, \"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\": \"\\u2212$25\", \"factor\": null, \"amount_cents\": -2500, \"running_cents\": 571673}, {\"step\": \"DISCOUNT\", \"code\": \"AUTOPAY\", \"detail\": \"\\u22123%\", \"factor\": 0.97, \"amount_cents\": null, \"running_cents\": 554523}, {\"step\": \"DISCOUNT\", \"code\": \"LOYALTY\", \"detail\": \"\\u22125%\", \"factor\": 0.95, \"amount_cents\": null, \"running_cents\": 526797}]",
"rating_inputs": "{\"billing\": {\"plan\": \"INSTALLMENTS\", \"autopay\": true, \"paperless\": true}, \"incidents_5yr\": 0, \"smoker\": false, \"promo_code\": null}",
"underlying_policy_id": null,
"bundle_id": null,
"rep_id": "REP-1007",
"created_at": "2025-06-01"
}
],
"row_count": 1,
"truncated": false
}⚙ query_db(SELECT * FROM policy_coverages WHERE policy_id = 'POL-fl-coastal-home-p_home')
{
"sql": "SELECT * FROM policy_coverages WHERE policy_id = 'POL-fl-coastal-home-p_home'"
}{
"rows": [
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:CONTENTS",
"value": "20000000",
"premium_contribution_cents": null
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:DEDUCT",
"value": "50000",
"premium_contribution_cents": null
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:DWELL",
"value": null,
"premium_contribution_cents": null
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:LIAB",
"value": "100000000",
"premium_contribution_cents": null
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:LOSS_USE",
"value": null,
"premium_contribution_cents": null
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:MEDPAY",
"value": "1000000",
"premium_contribution_cents": null
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:OTHER_STR",
"value": null,
"premium_contribution_cents": null
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:SERVICE_LN",
"value": "true",
"premium_contribution_cents": 3000
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:WATER_BACK",
"value": "2500000",
"premium_contribution_cents": 5500
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:WIND_HAIL",
"value": "0.01",
"premium_contribution_cents": null
}
],
"row_count": 10,
"truncated": false
}⚙ query_db(SELECT * FROM coverages WHERE line = 'HOME')
{
"sql": "SELECT * FROM coverages WHERE line = 'HOME'"
}{
"rows": [
{
"coverage_id": "HOME:DWELL",
"line": "HOME",
"code": "DWELL",
"label": "Dwelling (Coverage A)",
"kind": "limit",
"unit": "usd",
"notes": "Based on replacement cost."
},
{
"coverage_id": "HOME:OTHER_STR",
"line": "HOME",
"code": "OTHER_STR",
"label": "Other Structures (Coverage B)",
"kind": "limit",
"unit": "usd",
"notes": "Typically a % of dwelling."
},
{
"coverage_id": "HOME:CONTENTS",
"line": "HOME",
"code": "CONTENTS",
"label": "Personal Property (Coverage C)",
"kind": "limit",
"unit": "usd",
"notes": null
},
{
"coverage_id": "HOME:LOSS_USE",
"line": "HOME",
"code": "LOSS_USE",
"label": "Loss of Use (Coverage D)",
"kind": "limit",
"unit": "usd",
"notes": null
},
{
"coverage_id": "HOME:LIAB",
"line": "HOME",
"code": "LIAB",
"label": "Personal Liability (Coverage E)",
"kind": "limit",
"unit": "usd",
"notes": null
},
{
"coverage_id": "HOME:MEDPAY",
"line": "HOME",
"code": "MEDPAY",
"label": "Medical Payments (Coverage F)",
"kind": "limit",
"unit": "usd",
"notes": null
},
{
"coverage_id": "HOME:DEDUCT",
"line": "HOME",
"code": "DEDUCT",
"label": "All-Peril Deductible",
"kind": "deductible",
"unit": "usd",
"notes": "Falls by tier."
},
{
"coverage_id": "HOME:WIND_HAIL",
"line": "HOME",
"code": "WIND_HAIL",
"label": "Wind/Hail Deductible",
"kind": "deductible",
"unit": "pct",
"notes": "% of dwelling. In FL this is the separate hurricane deductible (state rule)."
},
{
"coverage_id": "HOME:WATER_BACK",
"line": "HOME",
"code": "WATER_BACK",
"label": "Water Backup",
"kind": "limit",
"unit": "usd",
"notes": "Sewer/sump backup endorsement."
},
{
"coverage_id": "HOME:ROOF_ACV",
"line": "HOME",
"code": "ROOF_ACV",
"label": "Roof Actual-Cash-Value Schedule",
"kind": "flag",
"unit": "bool",
"notes": "Older-roof endorsement; pays ACV not replacement."
},
{
"coverage_id": "HOME:SERVICE_LN",
"line": "HOME",
"code": "SERVICE_LN",
"label": "Service Line",
"kind": "flag",
"unit": "bool",
"notes": null
}
],
"row_count": 11,
"truncated": false
}⚙ query_db(SELECT * FROM addresses WHERE address_id = 'ADDR-fl-coastal-home')
{
"sql": "SELECT * FROM addresses WHERE address_id = 'ADDR-fl-coastal-home'"
}{
"rows": [
{
"address_id": "ADDR-fl-coastal-home",
"line1": "12 Mangrove Way",
"city": "Naples",
"state": "FL",
"zip": "34102",
"region": "R-SE"
}
],
"row_count": 1,
"truncated": false
}⚙ query_db(SELECT * FROM dwellings WHERE cust_id = 'CUST-fl-coastal-home')
{
"sql": "SELECT * FROM dwellings WHERE cust_id = 'CUST-fl-coastal-home'"
}{
"rows": [
{
"dwelling_id": "DWL-fl-coastal-home-d1",
"cust_id": "CUST-fl-coastal-home",
"type": "home",
"year_built": 1998,
"construction": "MASONRY",
"roof_age": 6,
"sq_ft": 2800,
"replacement_cost_cents": 52000000,
"protection_class": 5,
"dist_to_coast_mi": 2,
"hoa_master_deductible_cents": null
}
],
"row_count": 1,
"truncated": false
}⚙ query_db(SELECT * FROM eligibility_rules WHERE state = 'FL' OR line = 'HOME')
{
"sql": "SELECT * FROM eligibility_rules WHERE state = 'FL' OR 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
}Hello Gloria,
I was able to locate your policy for your home at 12 Mangrove Way in Naples, FL (Policy #POL-fl-coastal-home-p_home).
I can certainly explain what you are seeing and reassure you that this is not a mistake on your policy. Under Florida insurance regulations, homeowners policies are legally required to carry a separate hurricane/windstorm deductible that is distinct from your standard all-peril deductible.
Here is how your specific deductibles are structured:
- All-Peril Deductible: This is a flat $500 deductible that applies to most standard, non-weather-related losses (like fire or theft).
- Hurricane Deductible (listed under Wind/Hail): This is set at 1% of your dwelling coverage limit. Because your home’s replacement cost is insured at $520,000, this 1% hurricane deductible comes out to $5,200. It applies specifically to damage caused by wind, hail, or named hurricanes.
This separate percentage-based deductible is standard and mandatory for homeowners policies in Florida to ensure compliance with state insurance laws. It cannot be removed or combined into a single flat deductible.
Does that make sense, and is there any other detail on your policy you'd like me to look into?
Customer
Oh, okay — I didn't realize that was a Florida requirement. So it's not a billing error, it's just how the policy has to be set up down here?
Agent
24k in · 456 out · $0.04 · 5.3s⚙ query_db(SELECT * FROM claims WHERE policy_id = 'POL-fl-coastal-home-p_home')
{
"sql": "SELECT * FROM claims WHERE policy_id = 'POL-fl-coastal-home-p_home'"
}{
"rows": [],
"row_count": 0,
"truncated": false
}Yes, exactly! It is not a billing error at all; it is simply how the policy is legally required to be structured for homes in Florida.
Because Florida is prone to tropical storms and hurricanes, the state mandates that windstorm and hurricane risks are carved out into their own percentage-based deductible (typically 1%, 2%, 5%, or 10% of the home's total insured dwelling value) rather than a flat dollar amount. Your flat $500 deductible is there for everyday risks (like a pipe burst or a fire), while the 1% ($5,200) deductible would only apply if your home suffered damage specifically from wind, hail, or a named hurricane.
Everything on your policy is completely correct and in full compliance with Florida insurance guidelines.
Is there anything else I can help you review or adjust on your policy today?
Customer
No, that makes sense now. I understand how it works. Thanks for explaining that — I appreciate you clearing it up for me.
Agent
25k in · 148 out · $0.04 · 3.1s⚙ end_conversation()
{}{
"ok": true,
"note": "Deliver your closing message now."
}You are very welcome, Gloria! I'm glad I could clear that up and give you some peace of mind.
Thank you for being a valued PEICO customer. If you ever need anything else, please don't hesitate to reach back out. Have a wonderful rest of your day in Naples!