What is a Deductible?

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Contributor, Benzinga
November 14, 2023

The insurance industry loves to use confusing terms - like deductible, coinsurance, and copay. But, a deductible isn’t particularly confusing. Deductibles can affect your coverage in different ways, depending on the insurance type, causing many consumers to misunderstand how deductibles work.

In its most basic definition, a deductible is a part of the claim that you pay, there might be other parts of a claim that you’ll pay, depending on the type of insurance you have.

Quick Answer: What is a Deductible?

A deductible is a portion of the payment owed that you are responsible for. Your insurance will likely cover the rest.

Home Insurance Deductibles

Your home insurance or renters insurance policy has a deductible for any covered claims for damage to your home, and there might be as many as three deductibles for your policy. Since only one deductible will apply to any given claim, we’ll start with the standard deductible.

Dwelling Coverage Deductible

Typically, a home insurance policy deductible is at least $500. Some insurers make $1,000 the default choice, and as a result, many of their policies are written with a $1,000 deductible.

You can often choose a higher deductible, but be aware that any claim you make will be affected by the higher deductible, lowering your claim payout. Your lender might also have some rules regarding higher deductibles. If you have a home loan, your house is their collateral for the loan, so they'll want to be sure that any damage is repaired. A high deductible can stand in the way of needed repairs simply because the homeowner doesn't have enough money to make the repairs.

For home insurance policies, the deductible you've chosen applies per occurrence, which means if you have a claim and then have another claim a month later you would pay the deductible for each claim.

It seems odd to say that you would “pay a deductible” because that's really not what happens at all. The deductible is deducted from your claim payment. If the deductible is higher than your claim payment, your insurer won't send a claim payment at all.

Personal Property and Deductibles

The contents of your home (your personal property) are also covered by your homeowner insurance policy, up to your chosen coverage limit. Because there is a deductible, many legitimate claims for damage to personal property won’t be paid. If a $1,000 item, like a laptop, is damaged or stolen and your deductible is $1,000, your insurer won’t pay the claim. However, if several items were damaged or stolen and your insurer determines the loss amount was $5,000, they will pay $4,000 for the covered claim. Deductibles aren’t applied per item, rather, per occurrence.

Wind and Hail Deductible

It has become very common for insurers to use a separate deductible specifically for wind and hail damage. Often this deductible is higher than a standard deductible or it might even be based on a percentage of the total dwelling coverage. Wind and hail claims are the most common type of claims for damage to homes, particularly to roofs. A higher deductible for wind or hail damage places more of the risk for the most common claim type on the homeowner.

Named Storm Deductible

Living near a coastline certainly has its benefits, but can also create some additional risk for homeowners and often requires a special deductible called a named storm deductible. This deductible would apply if the damage to your home was due to a named storm, such as a hurricane or a large tropical storm.

In almost all states, the named storm deductible applies per occurrence. If your home is damaged by a hurricane in August and then damaged again by another hurricane in September, you would pay a named storm deductible for the damage from each hurricane.

Named storm deductibles are usually based on a percentage of the dwelling coverage amount for your home.

Homeowners Insurance Deductible Examples

Your home insurance policy may have as many as three built-in deductibles, only one of which will apply to a claim. If your homeowner insurance policy has a land movement rider, there may be a fourth deductible that will apply only to covered claims for damage caused by land movement.

Dwelling CoverageLoss TypeLoss AmountStandard DeductibleWind and Hail Deductible (2%)Named Storm Deductible (2%)Claim Payment
$300,000Burst pipe$20,000$1,000$0$0$19,000
$300,000Tornado$20,000$0$6,000$0$14,000
$300,000Hurricane$20,000$0$0$6,000$14,000
N/AStolen laptop$1,500$1,000$0$0$5,000

Auto Insurance Deductibles

If you have full coverage on your vehicle, your car insurance policy will have a deductible for collision coverage and a separate deductible for comprehensive coverage. As with home insurance, only one deductible will apply to the claim, but the deductibles are per occurrence.

Collision Deductible

Collision deductibles usually start at $500 and go up as high as $2,500, but you can choose the amount from a list of choices. If your car is damaged in a collision and you report the claim to your own insurer, the deductible will be subtracted from your claim payment. If the car accident wasn’t your fault, your insurer will try to collect your deductible amount from the other driver’s insurer through a process called subrogation. However, you might have to wait a while to get your deductible returned and if your insurer isn’t able to collect that amount, you might not get your deductible returned at all.

Comprehensive Deductible

Fire, theft, vandalism, floods, and glass damage (not due to a collision) are all covered under comprehensive coverage. Your comprehensive deductible can range from $0 up to $2,500. Minimum deductible amounts might vary by state or by insurer. A low comprehensive deductible can help you cover mishaps like cracked windshields, which wouldn’t be covered if you chose a high deductible because the deductible would be higher than the cost of repair.

PIP or Med Pay Deductible

Depending on your state, you may have PIP or med pay for the medical coverage of your policy to cover injuries and/or related expenses caused by an automobile. These coverages have a deductible as well, which you might have to pay in addition to a collision deductible if your car was also damaged in the same incident or accident.

Read more: Benzinga's Best Car Insurance Companies or Benzinga's Best Cheap Car Insurance 

Health Insurance Deductible

In the world of health insurance and dental insurance, deductibles are also common, but with one big difference from home or auto insurance deductibles. Health insurance deductibles apply per policy period as opposed to per occurrence.

The insurer won’t pay anything until the health insurance deductible is satisfied — although there are some exceptions. Once you’ve paid enough medical expenses on your own to meet the health insurance deductible, your insurer begins to pick up the tab on health care expenses. Other deductions may apply though, such as copayments or coinsurance.

Using Deductibles to Manage Premiums

Choosing a higher deductible can be an effective way to get a lower premium. In effect, you’re self-insuring your coverage up to the deductible amount. However, you’d need to ask your agent for quotes with various deductibles. Comprehensive coverage deductibles are a good example of where choosing a higher deductible often doesn’t provide any meaningful savings. The premium savings may or may not be worth taking the additional out-of-pocket risk.

Final Thoughts

We often don’t know how much our deductibles are until we have a claim. By then, it's too late to make a change. It's always a good idea to review your policy with your agent every year or two to be sure you're properly insured and to see if there are any aspects of your policy, like deductibles, that could be structured better.

Frequently Asked Questions

Q

What are deductibles in simple terms?

A

Deductibles are a predetermined amount of money that an insured individual must pay out of their own pocket before their insurance policy starts to cover the costs. It is a way for insurance companies to share the financial burden with the policyholders and encourage responsible use of insurance services.

Q

Are deductibles good or bad?

A
Deductibles can have both positive and negative effects. They can lower insurance premiums and discourage unnecessary claims, but they can also burden individuals with frequent medical expenses and deter necessary care. The impact of deductibles depends on personal financial situation and needs. It is important to consider deductibles when choosing an insurance plan.
Q

Why do people pay deductibles?

A

People pay deductibles because it helps to share the financial responsibility of an insurance claim between the insurance company and the policyholder. By paying a deductible, individuals are essentially contributing a portion of the cost of a covered claim before their insurance coverage kicks in. This helps to discourage frivolous or unnecessary claims and encourages individuals to only file a claim when necessary. Additionally, deductibles also help to keep insurance premiums lower, as policyholders share in the costs of their claims.