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 · 24s · $0.02 · 81k tok in

Verdicts

DB end-statepassed

DB end-state matches the expected changeset.

Judge rubricpassed

judge: The rep correctly explained the mandatory separate percentage-based hurricane/wind deductible for FL homes, clarified it's not a mistake, 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, yes, thanks for picking up. I'm looking at my homeowners policy and I see two different deductibles listed — a regular deductible and then a separate "hurricane deductible." I'm pretty sure that's a mistake on the bill. Can you help me get that fixed?

Agent

⚙ query_db(SELECT p.policy_id, p.cust_id, p.line, p.status, p.effective_date, p.expirati…)

{
  "sql": "SELECT p.policy_id, p.cust_id, p.line, p.status, p.effective_date, p.expiration_date, pc.coverage_id, pc.value, c.code, c.label, c.kind, c.unit, c.notes FROM policies p JOIN policy_coverages pc ON pc.policy_id = p.policy_id JOIN coverages c ON c.coverage_id = pc.coverage_id WHERE p.cust_id = (SELECT cust_id FROM customers WHERE first_name = 'Hi' AND last_name = 'yes')"
}

{
  "rows": [],
  "row_count": 0,
  "truncated": false
}

⚙ query_db(SELECT cust_id, first_name, last_name, email, phone, legacy_acct FROM custome…)

{
  "sql": "SELECT cust_id, first_name, last_name, email, phone, legacy_acct FROM customers WHERE email = 'I'm looking at my homeowners policy and I see two different deductibles listed — a regular deductible and then a separate \"hurricane deductible.\" I'm pretty sure that's a mistake on the bill. Can you help me get that fixed?' OR phone = 'I'm looking at my homeowners policy and I see two different deductibles listed — a regular deductible and then a separate \"hurricane deductible.\" I'm pretty sure that's a mistake on the bill. Can you help me get that fixed?'"
}

{
  "error": "sql_error",
  "detail": "near \"m\": syntax error"
}

I can help with that. To pull up the right homeowners policy and check the deductibles, I need to verify your account first.

Please send me one of these:

your policy number, or
your full name + ZIP code, and
either your email or phone number on file

Once I locate the policy, I’ll check whether the regular deductible and hurricane deductible are both supposed to be there and whether anything needs to be corrected.

15k in · 355 out · $0.0051 · 4.0s

Customer

My name is Gloria Esposito, and my ZIP code is 34102 — that's Naples, Florida. You should have my contact info on file already.

Agent

⚙ query_db(SELECT cust_id, first_name, last_name, email, phone, address_id FROM customer…)

{
  "sql": "SELECT cust_id, first_name, last_name, email, phone, address_id FROM customers WHERE first_name = 'Gloria' AND last_name = 'Esposito'"
}

{
  "rows": [
    {
      "cust_id": "CUST-fl-coastal-home",
      "first_name": "Gloria",
      "last_name": "Esposito",
      "email": "gloria.esposito@example.com",
      "phone": null,
      "address_id": "ADDR-fl-coastal-home"
    }
  ],
  "row_count": 1,
  "truncated": false
}

⚙ query_db(SELECT policy_id, cust_id, line, tier_id, status, effective_date, expiration_…)

{
  "sql": "SELECT policy_id, cust_id, line, tier_id, status, effective_date, expiration_date, term_months, rating_as_of, base_premium_cents, final_premium_cents FROM policies WHERE cust_id IN (SELECT cust_id FROM customers WHERE first_name = 'Gloria' AND last_name = 'Esposito') AND line LIKE '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
    }
  ],
  "row_count": 1,
  "truncated": false
}

⚙ query_db(SELECT address_id, line1, city, state, zip, region FROM addresses WHERE zip =…)

{
  "sql": "SELECT address_id, line1, city, state, zip, region FROM addresses WHERE zip = '34102'"
}

{
  "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
}

⚙ price_check(POL-fl-coastal-home-p_home, 2025-06-01)

{
  "policy_id": "POL-fl-coastal-home-p_home",
  "as_of": "2025-06-01"
}

{
  "as_of": "2025-06-01",
  "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
    }
  ]
}

⚙ query_db(SELECT c.code, c.label, c.kind, c.unit, pc.value, pc.premium_contribution_cen…)

{
  "sql": "SELECT c.code, c.label, c.kind, c.unit, pc.value, pc.premium_contribution_cents FROM policies p JOIN policy_coverages pc ON pc.policy_id = p.policy_id JOIN coverages c ON c.coverage_id = pc.coverage_id WHERE p.policy_id = 'POL-fl-coastal-home-p_home' ORDER BY c.code"
}

{
  "rows": [
    {
      "code": "CONTENTS",
      "label": "Personal Property (Coverage C)",
      "kind": "limit",
      "unit": "usd",
      "value": "20000000",
      "premium_contribution_cents": null
    },
    {
      "code": "DEDUCT",
      "label": "All-Peril Deductible",
      "kind": "deductible",
      "unit": "usd",
      "value": "50000",
      "premium_contribution_cents": null
    },
    {
      "code": "DWELL",
      "label": "Dwelling (Coverage A)",
      "kind": "limit",
      "unit": "usd",
      "value": null,
      "premium_contribution_cents": null
    },
    {
      "code": "LIAB",
      "label": "Personal Liability (Coverage E)",
      "kind": "limit",
      "unit": "usd",
      "value": "100000000",
      "premium_contribution_cents": null
    },
    {
      "code": "LOSS_USE",
      "label": "Loss of Use (Coverage D)",
      "kind": "limit",
      "unit": "usd",
      "value": null,
      "premium_contribution_cents": null
    },
    {
      "code": "MEDPAY",
      "label": "Medical Payments (Coverage F)",
      "kind": "limit",
      "unit": "usd",
      "value": "1000000",
      "premium_contribution_cents": null
    },
    {
      "code": "OTHER_STR",
      "label": "Other Structures (Coverage B)",
      "kind": "limit",
      "unit": "usd",
      "value": null,
      "premium_contribution_cents": null
    },
    {
      "code": "SERVICE_LN",
      "label": "Service Line",
      "kind": "flag",
      "unit": "bool",
      "value": "true",
      "premium_contribution_cents": 3000
    },
    {
      "code": "WATER_BACK",
      "label": "Water Backup",
      "kind": "limit",
      "unit": "usd",
      "value": "2500000",
      "premium_contribution_cents": 5500
    },
    {
      "code": "WIND_HAIL",
      "label": "Wind/Hail Deductible",
      "kind": "deductible",
      "unit": "pct",
      "value": "0.01",
      "premium_contribution_cents": null
    }
  ],
  "row_count": 10,
  "truncated": false
}

I checked your homeowners policy, and this is not a bill error.

Your policy has:

All-Peril Deductible: $500
Wind/Hail Deductible: 1%

In Florida coastal homeowners policies, it’s common to have a separate wind/hail deductible in addition to the regular deductible. On your policy, the wind/hail deductible is specifically listed as WIND_HAIL = 1%.

Your current policy is:

Policy ID: POL-fl-coastal-home-p_home
Status: Active
Current premium: $526.80/month equivalent based on the current billing setup

If you want, I can also explain:

when the hurricane/wind deductible applies, or
whether there’s any way to change the deductible structure on this policy.

25k in · 493 out · $0.0065 · 5.8s

Customer

Oh, okay — so that's actually supposed to be there? I didn't realize Florida required that. Can you explain when that wind/hail deductible would actually apply? Like, how does it work compared to my regular $500 deductible?

Agent

⚙ search_kb(Florida homeowners wind hail deductible all-peril deductible hurricane deduct…)

{
  "query": "Florida homeowners wind hail deductible all-peril deductible hurricane deductible when applies explain deductible windstorm coastal homeowners",
  "limit": 5
}

{
  "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-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"
    }
  ]
}

⚙ 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"
}

Yes — for Florida homeowners, that separate hurricane/wind deductible is supposed to be there.

Here’s the practical difference:

Regular deductible ($500 on your policy): applies to most covered losses, like a burst pipe, theft, fire, or other non-hurricane claims.
Wind/hail deductible (1% on your policy): applies when the loss is a hurricane / windstorm-type event covered under that separate deductible.

On your policy, the wind/hail deductible is 1% of the dwelling limit, not a flat dollar amount. Based on your current dwelling coverage, that works out to a much larger out-of-pocket amount than the $500 regular deductible when it applies.

So in plain English:

Small everyday claim → you’d usually pay the $500 deductible.
Hurricane/wind claim → you’d pay the 1% wind/hail deductible instead.

One important note: the policy has to be written that way up front in Florida; it’s not an accidental duplicate charge.

If you want, I can also help you estimate what that 1% deductible equals in dollars on your home.

24k in · 308 out · $0.0044 · 4.5s

Customer

Got it — that makes sense now. I didn't realize it was a Florida law thing. So it's not a mistake, it's just how homeowners policies work down here. Thank you for explaining that to me. I feel a lot better about it now.

Agent

⚙ end_conversation()

{}

{
  "ok": true,
  "note": "Deliver your closing message now."
}

You’re very welcome — and yes, that’s just how Florida homeowners policies are structured.

I’m glad I could clear it up. If anything else on your policy looks confusing, feel free to send it over and I’ll help interpret it.

17k in · 66 out · $0.0041 · 1.8s