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 Florida homeowners policies require a separate percentage-based hurricane deductible distinct from the all-peril deductible, confirmed it was not a mistake, and did not agree to remove it.
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 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 the bill. Can you help me get that sorted out?
I can help check that. Homeowners policies can sometimes show both an “all other perils” deductible and a separate wind/hurricane deductible, depending on the state, coastal distance, and policy tier—but I’ll need to look at your specific policy before saying whether it’s correct or a billing error.
To pull it up, please provide either:
- Your PEICO policy number or legacy account number, and
- Your full name and date of birth for verification.
Sure, my name is Gloria Esposito. My date of birth is July 19, 1969. But I don't have my policy number handy right now — can you look it up another way, or do I need to dig that out?
⚙ query_db(SELECT c.cust_id, c.legacy_acct, c.status, c.first_name, c.last_name, c.dob, …)
{
"sql": "SELECT c.cust_id, c.legacy_acct, c.status, c.first_name, c.last_name, c.dob, c.email, c.phone, a.line1, a.city, a.state, a.zip FROM customers c LEFT JOIN addresses a ON c.address_id=a.address_id WHERE c.first_name='Gloria' AND c.last_name='Esposito' AND c.dob='1969-07-19'"
}{
"rows": [
{
"cust_id": "CUST-fl-coastal-home",
"legacy_acct": null,
"status": "CUSTOMER",
"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"
}
],
"row_count": 1,
"truncated": false
}⚙ query_db(SELECT p.policy_id, p.line, p.tier_id, p.status, p.effective_date, p.expirati…)
{
"sql": "SELECT p.policy_id, p.line, p.tier_id, p.status, p.effective_date, p.expiration_date, p.final_premium_cents, p.rating_inputs, d.dwelling_id, d.type, d.dist_to_coast_mi, d.replacement_cost_cents, d.roof_age, a.state, a.region FROM policies p JOIN policy_objects po ON po.policy_id=p.policy_id AND po.object_type='dwelling' JOIN dwellings d ON d.dwelling_id=po.object_id JOIN customers c ON c.cust_id=p.cust_id JOIN addresses a ON a.address_id=c.address_id WHERE p.cust_id='CUST-fl-coastal-home' AND p.line='HOME' ORDER BY p.effective_date DESC"
}{
"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,
"rating_inputs": "{\"billing\": {\"plan\": \"INSTALLMENTS\", \"autopay\": true, \"paperless\": true}, \"incidents_5yr\": 0, \"smoker\": false, \"promo_code\": null}",
"dwelling_id": "DWL-fl-coastal-home-d1",
"type": "home",
"dist_to_coast_mi": 2,
"replacement_cost_cents": 52000000,
"roof_age": 6,
"state": "FL",
"region": "R-SE"
}
],
"row_count": 1,
"truncated": false
}⚙ query_db(SELECT pc.policy_id, c.coverage_id, c.code, c.label, c.kind, c.unit, c.notes,…)
{
"sql": "SELECT pc.policy_id, c.coverage_id, c.code, c.label, c.kind, c.unit, c.notes, pc.value, pc.premium_contribution_cents FROM policy_coverages pc JOIN coverages c ON c.coverage_id=pc.coverage_id WHERE pc.policy_id='POL-fl-coastal-home-p_home' ORDER BY c.code"
}{
"rows": [
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:CONTENTS",
"code": "CONTENTS",
"label": "Personal Property (Coverage C)",
"kind": "limit",
"unit": "usd",
"notes": null,
"value": "20000000",
"premium_contribution_cents": null
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:DEDUCT",
"code": "DEDUCT",
"label": "All-Peril Deductible",
"kind": "deductible",
"unit": "usd",
"notes": "Falls by tier.",
"value": "50000",
"premium_contribution_cents": null
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:DWELL",
"code": "DWELL",
"label": "Dwelling (Coverage A)",
"kind": "limit",
"unit": "usd",
"notes": "Based on replacement cost.",
"value": null,
"premium_contribution_cents": null
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:LIAB",
"code": "LIAB",
"label": "Personal Liability (Coverage E)",
"kind": "limit",
"unit": "usd",
"notes": null,
"value": "100000000",
"premium_contribution_cents": null
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:LOSS_USE",
"code": "LOSS_USE",
"label": "Loss of Use (Coverage D)",
"kind": "limit",
"unit": "usd",
"notes": null,
"value": null,
"premium_contribution_cents": null
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:MEDPAY",
"code": "MEDPAY",
"label": "Medical Payments (Coverage F)",
"kind": "limit",
"unit": "usd",
"notes": null,
"value": "1000000",
"premium_contribution_cents": null
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:OTHER_STR",
"code": "OTHER_STR",
"label": "Other Structures (Coverage B)",
"kind": "limit",
"unit": "usd",
"notes": "Typically a % of dwelling.",
"value": null,
"premium_contribution_cents": null
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:SERVICE_LN",
"code": "SERVICE_LN",
"label": "Service Line",
"kind": "flag",
"unit": "bool",
"notes": null,
"value": "true",
"premium_contribution_cents": 3000
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:WATER_BACK",
"code": "WATER_BACK",
"label": "Water Backup",
"kind": "limit",
"unit": "usd",
"notes": "Sewer/sump backup endorsement.",
"value": "2500000",
"premium_contribution_cents": 5500
},
{
"policy_id": "POL-fl-coastal-home-p_home",
"coverage_id": "HOME:WIND_HAIL",
"code": "WIND_HAIL",
"label": "Wind/Hail Deductible",
"kind": "deductible",
"unit": "pct",
"notes": "% of dwelling. In FL this is the separate hurricane deductible (state rule).",
"value": "0.01",
"premium_contribution_cents": null
}
],
"row_count": 10,
"truncated": false
}⚙ query_db(SELECT er.rule_id, er.line, er.tier_id, er.coverage_id, er.state, er.effect, …)
{
"sql": "SELECT er.rule_id, er.line, er.tier_id, er.coverage_id, er.state, er.effect, er.condition, er.effective_start, er.effective_end, er.reason_doc, er.notes FROM eligibility_rules er WHERE er.line='HOME' AND (er.state='FL' OR er.state IS NULL) AND (er.tier_id='HOME:SEQUOIA' OR er.tier_id IS NULL) ORDER BY er.rule_id"
}{
"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
}⚙ search_kb(Florida homeowners hurricane deductible separate all other peril deductible c…)
{
"query": "Florida homeowners hurricane deductible separate all other peril deductible coastal mandatory",
"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-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"
},
{
"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"
}
]
}⚙ 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 — I was able to look it up using your name and date of birth.
For your active Florida homeowners policy, POL-fl-coastal-home-p_home, the two deductibles shown are not a billing mistake:
-
All-Peril Deductible: $500
This is the regular deductible for most covered losses. -
Wind/Hail / Hurricane Deductible: 1% of the dwelling limit
Your dwelling replacement cost limit is $520,000, so 1% equals $5,200 for a covered hurricane/wind event.
Florida homeowners policies are required to carry a separate hurricane deductible, distinct from the regular all-peril deductible. Your home is also listed in Naples, FL, about 2 miles from the coast, and the hurricane deductible is explicitly part of the Florida homeowners rule setup.
So the bill is showing two deductibles because they apply to different kinds of losses—not because you’re being charged twice for the same deductible.
Oh, okay — I didn't realize that was a Florida requirement. So just to make sure I understand, if I have a regular claim like water damage or something, I'd pay the $500 deductible, but if there's a hurricane, I'd pay the $5,200 instead, right?
That’s the general idea, yes:
- For most covered non-hurricane losses, your $500 all-peril deductible applies.
- For a covered hurricane/wind loss, the separate 1% hurricane/wind deductible applies — on your policy that is $5,200 based on the $520,000 dwelling limit.
One important nuance: “water damage” can mean different things under a homeowners policy. For example, an interior plumbing leak may be treated differently from storm-driven water or flood-related water. Your policy also shows Water Backup coverage with a $25,000 limit, but flood damage is typically separate from homeowners coverage.
So the deductible depends on the cause of loss, but your understanding is right for the basic distinction: regular covered claim = $500; covered hurricane/wind claim = $5,200.
That makes sense now. I appreciate you explaining that — I was worried I was being overcharged, but it sounds like that's just how it works in Florida. Thanks for clearing it up!
⚙ end_conversation()
{}{
"ok": true,
"note": "Deliver your closing message now."
}You’re very welcome — I’m glad we could clear that up. Thanks for being a PEICO customer, and have a great day!