by oceanriver » Sun Sep 19, 2010 06:39 am
Hello there! PLEASE read my question(s) thoroughly and very carefully? it is extremely important your answer is as clear as possible for any layman to understand, OK? Thanks very much.
1. When the deductible is automatically deducted from the TOTAL claim-amount by the insurance co., BEFORE they issue out the first check, is the client suppose to pay another (SEPARATE), same deductible-amount TO THE CONTRACTOR after the job is done? Can the contractor say we STILL have to pay the deductible, EVEN AFTER the insurance co. has ALREADY deducted it from the first check-payment and IS documented as such?
2. And/or, when the contractor takes care of the insurance-claim, in behalf of the policy-holder, does the insurance co. require the contractor to show the client met or paid the deductible, and does the insurance co. withhold the deductible from the claim- payment to he contractor?
Is the deductible added, (as a side-charge, by the contractor) to the amount for the repair-costs, and if so, does the insurance co. subtract the deductible from the contractor's bill?
Does the contractor have the right to say we STILL owe him the deductible and is he obligated to show, (on his paper-work to the insurance co.), the deductible from the client, even though the paper-work from the insurance co. itself shows, they, (the ins. co.) ALREADY retained the deductible?
To end it or summarize it very simply; Is it legal for the client to be charged the deductible TWO TIMES; one time by the insurance co. and again by the contractor...again, is it LEGAL? Hope you understood my simple, but differently-put questions? Thank you very much and best regards. M.B. El Paso, Tx.
1. When the deductible is automatically deducted from the TOTAL claim-amount by the insurance co., BEFORE they issue out the first check, is the client suppose to pay another (SEPARATE), same deductible-amount TO THE CONTRACTOR after the job is done? Can the contractor say we STILL have to pay the deductible, EVEN AFTER the insurance co. has ALREADY deducted it from the first check-payment and IS documented as such?
2. And/or, when the contractor takes care of the insurance-claim, in behalf of the policy-holder, does the insurance co. require the contractor to show the client met or paid the deductible, and does the insurance co. withhold the deductible from the claim- payment to he contractor?
Is the deductible added, (as a side-charge, by the contractor) to the amount for the repair-costs, and if so, does the insurance co. subtract the deductible from the contractor's bill?
Does the contractor have the right to say we STILL owe him the deductible and is he obligated to show, (on his paper-work to the insurance co.), the deductible from the client, even though the paper-work from the insurance co. itself shows, they, (the ins. co.) ALREADY retained the deductible?
To end it or summarize it very simply; Is it legal for the client to be charged the deductible TWO TIMES; one time by the insurance co. and again by the contractor...again, is it LEGAL? Hope you understood my simple, but differently-put questions? Thank you very much and best regards. M.B. El Paso, Tx.
Posted: Sun Sep 19, 2010 01:05 pm Post Subject:
Please read my answer carefully. It is extremely important that you understand it.
DEDUCTIBLE is the amount of a claim that is YOUR RESPONSIBILITY to pay. When the insurance company DEDUCTS the DEDUCTIBLE, where do you think that money is?
It is still in your checking or savings account waiting to be paid to the contractor who is performing the repair work.
When the contractor is billing you for the completed work, if the total loss is valued at $10,000, and if the contractor has agreed to do the work for the amount the insurance company determined the loss to be, he is agreeing to do the work for $10,000. If your DEDUCTIBLE is $500, how much do you think the insurance company will write a check to the contractor for?
Here's the math: $10,000 loss minus $500 deductible equals $9,500 paid by insurance. Homeowner pays contractor $500. $9500 + $500 = $10,000.
Everyone is happy except the homeowner who thinks he's been "billed" twice for a deductible.
NOBODY gets CHARGED for a deductible. The deductible is DEDUCTED from the claims payment. The value of the DEDUCTIBLE will have to be PAID to settle the amount owed to the contractor.
The insurance company does not RETAIN the DEDUCTIBLE, the insured "retains" the deductible -- it is the amount of the claim he has agreed to cover with his own money in exchange for a lower premium for his insurance. $0 deductible = highest premium, $500 = lower premium, $1,000 deductible = even lower premium.
So, just to summarize, to be sure you understand the concept M.B.
THE DEDUCTIBLE IS THE AMOUNT OF MONEY YOU OWE TO THE CONTRACTOR FOR DOING THE WORK.
It was not "withheld" by the insurance company, and it is not being charged by the contractor a second time. It is the BALANCE DUE for the total cost to perform the repairs.
Write the check.
Posted: Mon Sep 20, 2010 02:03 am Post Subject: Deductible
Hello there! Thanks so much for the detailed reply, I and many, many others really appreciate it very much, cause this kind of answers are what many of us need, but questions still remain. The reason I asked these questions is not because I'm trying to short-change the insurance co., not at all, ok? I do understand I have to pay the deductible out of MY own pocket, but again, the reason I have these questions is because of what the adjuster told me.
He said that, after I have the repairs done, I would have to pay the contractor the check or money I receive in the mail from the insurance co., as an initial or partial-payment from the total claim for the repairs; which I also totally understand, and will have to do. But, the adjuster ALSO said, that, if I would NOT pay the contractor the deductible out of my pocket, but just give him the money from the first initial-payment, to where the contractor’s bill would show I did NOT pay it (deductible), THEN, the insurance co. would just take it upon themselves to just deduct it from the SECOND check, which would be the recoverable amount-check, minus the deductible, if I did not pay it to the contractor. This point I also totally understand…if it was actually done that way?
The thing I do not understand about all these, and which is confusing me, and certainly to many other people out there, is, why the adjuster also said, that, if I didn't pay the deductible, along with the first check from the insurance co., to the contractor after the repairs are done, I would THEN end up paying DOUBLE the deductible-amount. He said that very plainly; that the insurance co. would deduct the deductible from the SECOND CHECK (the recoverable amount), as I stated before, BUT, that I would STILL, STILL ALSO have to pay the contractor ANOTHER same deductible-amount out of MY own pocket, which would then make it DOUBLE, and so I would end up paying up $1000 (two deductibles) instead of just $500; one from my pocket, and a second one taken out by the insurance co. from the recoverable amount? Those were his EXACT words to me, which really threw me off completely…and freaked me out!
I just find that to be very confusing, unreasonable, and unjustifiable. That’s why he even, very adamantly at that, recommended I should just go ahead and pay the contractor the deductible out of my own pocket, along with the first check which I would receive from them. I told him it was a good thing he had informed me about that cause I hadn't known that before, so I told him that made a lot of sense to me and I told him I would do just that; just pay it right away.
.
I still don't get THAT particular part where he said: I would end up paying DOUBLE the deductible. So, that's why I ask: why would YOU say the insurance co. does NOT in actuality retain the deductible? I don’t get it, for now it seems to me the adjuster, after telling me ALL that, (recommending to just pay the contractor, otherwise I would end up paying double), did not give me the opportunity to do so, cause, again, according to the paper-work, the deductible WAS INDEED ALREADY DEDUCTED, when he in turn said it would be deducted form the SECOND recoverable-check, but ONLY if I did not pay it to the contractor initially out of my own pocket.
Please bear with me; you’ll be helping millions of people out here in la la land understand this thing about the deductible for any insurance-claims they may have or are planning to file…Thank you so much.
To maybe further help you, and many others who may have the same question(s), and who may also be reading all these understand even more, let me type some numbers for you ok?
1. Let’s say the documentation received from the insurance co. shows the total claim-amount, which let's say was $10,000 dollars.
2. The next line shows the depreciation-amount, let's say that is $2,000 dollars, which would also be the recoverable amount and which would also translate into a SECOND CHECK being sent by the insurance co. to the claimant, ONLY if the work is done for the total claim-amount of $10,000, and NOT less…that is understood.
3. Now, the remainder which would be $8,000 AFTER the depreciation, and which would be the first partial-payment for the repairs, now ALSO shows a SUBTRACTED-DEDUCTIBLE of $500 (assuming the deductible is $500) from the $8,000, and so the check received in the mail would now be for $7,500 dollars instead of the $8000. The total $10,000 received, IN THE END, would be my total claim-amount of $10,000, LESS the deductible of $500; I get that.
But now, if the deductible was NOT in actuality retained by the insurance co., as you say, to where on the paper-work it clearly shows they DID INDEED retain it out of the $8000, after the depreciation, why do you say I still have that deductible in my bank account? If it SHOWS, as I've already stated and explained; the insurance co. ALREADY deducted it from the FULL claim-amount, and it PLAINLY reads on the paper-work that they DID indeed subtracted it, why is it then, that one STILL has to pay the $500 deductible to the contractor out of our own pockets, which to me seems like I would be paying it a SECOND time. It shows exactly what the adjuster said I would end up doing, but only if I didn’t pay it up- front, and again, he said if I didn’t pay it up-front, the insurance co. would subtract it from the SECOND check, not from the first one. I just don't understand that particular point, and I'm very, very sure very MANY people don't either. If it says on the insurance documents that they subtracted the deductible out of my TOTAL claim-amount, why do you say they DON’T REALLY retain the deductible?
We out here just need to hear from professionals or insurance-claims-knowledgeable persons like yourself explanations which you are very intelligently and eloquently able to give us, and which are very GREATLY appreciated, believe me.
So again, and to close, that particular part where he (adjuster) said I would end up paying DOUBLE the deductible, is what I do not understand, since they already deducted it from the first partial-payment-check, which would be from the total amount one qualifies for on the claim, and since I, myself, just like millions of other people also do, have been paying my premiums, on time, for many YEARS, I would only assume and expect the TOTAL claim-amount, less the deductible only, would be the amount we would be receiving in the form of two payments; a first-payment, to which, I would give to the contractor, and then, from out of my own pocket I would just pay the deductible MYSELF and which would also be added to the first check to the contractor, then just wait for the second check which would be the recoverable amount, then also pay that amount to the contractor to finalize and close the contract for the repairs.
My dear sir/mam, is that thing about paying DOUBLE true? AGAIN, THAT’S WHAT THE ADJUSTER TOLD ME! Can that be done, is that what’s being done by both, the insurance co. AND the contractor? Is it Legal? I welcome others to explain this questions according to how they understand this damned insurance-deductible-dilemma. If I was in a real good economical standing…like, for example: wealthy, I wouldn’t mind paying double, or even a triple deductible, cause I wouldn’t be worrying about, or looking into details like these, but since I’m not; that’s why I’m asking and need to know, as much as possible, the intricate details of this monstrosity of a double-payment-question, for those details shall dictate as to whether or not I, (as many others) will be able to fix some other thing at home which needs fixing, and which is the whole point to my question.
Thank you so very much, God Bless, and best regards to you, and all others out there who were willing to read my long inquiry, and who are able and willing to reply to it. M.B. El Paso, Tx.
Posted: Mon Sep 20, 2010 12:14 pm Post Subject:
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What is a "Deductible"??
For starters, its not something Paid. Its something Deducted, that is why its called a Deductible.
Its an pre-arranged agreement that an Insurance consumer and an Insurance company enter into.
Its an Option that is offered by an insurer to their insured.
If you the insured will allow us the insurer to "Deduct" $ xxxx.xx from the Value of your Loss Claim with us, we the insurer in return will offer you the insured an discounted price for your insurance coverage.[ Its that simple ].
A Deductible is an insurance term, and has little if anything to do with the repair side of a claim. The repair agreement is between the owner of the Property and the Repairer. It does not involve the insurance company. Repairer's are not Claims Handlers, they are Repair Professionals.
A repair estimate should be based on what YOU the owner of the Property wish to have repaired along with the method & quality YOU the owner of the Property wish to pay for. Regardless of the repair being paid out of pocket by YOU the owner of the Property, or if YOU the owner of the Property are being fully, partly, or over reimburse for the cost of the repairs requested by YOU the owner.... Be it by Grandma, Grandpa, Mom, Dad, Uncle (insert name) the Tooth Fairy, or an Insurance Co..
You the Property owner are responsible for the Payment of the _Full_ cost of the repair's you authorize the Repairer to perform.
Essentially you have two Contracts. One with the Insurer and another with the Repairer
Posted: Mon Sep 20, 2010 12:32 pm Post Subject:
.
.
.
What is a "Deductible"??
For starters, its not something Paid. Its something Deducted, that is why its called a Deductible.
Its an pre-arranged agreement that an Insurance consumer and an Insurance company enter into.
Its an Option that is offered by an insurer to their insured.
If you the insured will allow us the insurer to "Deduct" $ xxxx.xx from the Value of your Loss Claim with us, we the insurer in return will offer you the insured an discounted price for your insurance coverage.[ Its that simple ].
A Deductible is an insurance term, and has little if anything to do with the repair side of a claim. The repair agreement is between the owner of the Property and the Repairer. It does not involve the insurance company. Repairer's are not Claims Handlers, they are Repair Professionals.
A repair estimate should be based on what YOU the owner of the Property wish to have repaired along with the method & quality YOU the owner of the Property wish to pay for. Regardless of the repair being paid out of pocket by YOU the owner of the Property, or if YOU the owner of the Property are being fully, partly, or over reimburse for the cost of the repairs requested by YOU the owner.... Be it by Grandma, Grandpa, Mom, Dad, Uncle (insert name) the Tooth Fairy, or an Insurance Co..
You the Property owner are responsible for the Payment of the _Full_ cost of the repair's you authorize the Repairer to perform.
Essentially you have two Contracts. One with the Insurer and another with the Repairer
==============================================
PS,
Lakeman / Lori
Again I'm logged in and My Post didn't register as FK..! Please delete the above duplicate Post. Thanks
Posted: Tue Sep 21, 2010 01:35 am Post Subject:
I still don't get THAT particular part where he said: I would end up paying DOUBLE the deductible
I'm not sure anyone said anything like that to you, and yet it could easily be what you thought you heard. I wasn't there, so I'm not going to guess one way or the other what the reality of the communication was.
But now, if the deductible was NOT in actuality retained by the insurance co., as you say, to where on the paper-work it clearly shows they DID INDEED retain it out of the $8000, after the depreciation, why do you say I still have that deductible in my bank account?
First, a bit more explanation.
I think you are confusing the term DEDUCTIBLE and RETENTION as if they are two different things. From my side of things, I see them as essentially the same thing, but I'm pretty sure you are comparing them as if they were apples and oranges. When I teach this stuff, RETENTION is what an insured agrees he will be on the hook for in the event of a loss. DEDUCTIBLE is just another word that means the same thing. SELF-INSURE is yet another term that describes both.
A person who is exposed to a risk that could be covered by insurance, yet chooses to not be insured, is SELF-INSURED, and has decided to RETAIN 100% of the risk of loss, normally understood to be a financial measure. Insurance companies, when they issue a policy, are not so much retaining anything, as much as simply agreeing to pay your loss. They know, statistically, that your risk of loss, to them is small, even though it is 100% to you. That's what makes insurance affordable.
Doctors and lawyers sometimes form "RISK RETENTION GROUPS" where they pool their money, agreeing to cover each other's losses up to a point. The point at which the coverage starts is where each person's own retention (or deductible) ends, perhaps $5000. Then they agree to cover each other's claims up to $100,000 beyond that point. If the total claim exceeds $105,000, the group has usually purchased a STOP LOSS contract with a "retention" (or deductible) of $100,000, and that contract agrees to pay all claims above that $100,000 amount, perhaps to $1,000,000 or more. RETENTION, then, is most easily understood to mean either a DEDUCTIBLE or to be SELF-INSURED.
In a homeowner's policy, the word "retention" is usually not found (too technical), but the word DEDUCTIBLE is. And if something is deductible, it won't be included in a claims payment -- it's a number with a minus sign in front of it. The homeowner is SELF-INSURING to the point at which he feels comfortable RETAINING the first dollars of the loss, maybe $500, maybe $1000. Few homeowners carry higher deductibles than $1000, unless they are folks with multimillion dollar estates, and then they might have a $10,000 deductible in order to reduce their premium.
Now, on to your questions.
When the insurance company values a loss, and writes the claim check, they are not RETAINING anything. They are only paying what the contract entitles them to pay. If they are obligated to pay $10,000 less the deductible, then, as I think you agree, they will send a check for $9500, if the deductible is $500. That remaining $500 is (supposed to be) in your bank account waiting to be paid to the contractor to fulfill his invoice for $10,000. That's your "loss reserve" account.
That's what I meant when I first wrote about having the money in your bank account. If you instead wanted the insurance company to pay 100% of all your losses, they would charge you a much higher premium. As a result, you won't have the money in your bank account, since you paid it to the insurance company (but, then, you won't need it). I realize a $500 deductible doesn't lower your premium by $500, but the $75 or $100 annual savings can be set aside and allowed to accumulate until you have the $500 in hand, waiting.
I am a bit confused about the business of "paying a double deductible" with the second payment that you ask about. I think I have figured out the explanation, but, please correct me if I have misunderstood you.
If you have a $10,000 loss, and the insurance company says, "We'll cover $8000 minus $500, initially, and will pay the balance when the job is complete," then they will pay a total of $9500 on the claim -- same example as above. So they send you an initial check for $7500, and if you only give that amount to the contractor, he will give you a balance due invoice for $2500. But the insurance company is not going to write a check for $2500, because $7500 and $2500 equals $10,000 and they already told you the most they will pay for your loss is $9500.
They are going to write the second check for $2000, since you still have not coughed up your required $500 to the contractor, as you agreed to do when you purchased your insurance policy. They have not "charged" you a second deductible (or even "retained" a second deductible), just like they did not "charge" you a first deductible, you have yet to pay any deductible to the contractor in the first place.
If, on the other hand, you pay the contractor the $500 at the same time you hand him the insurer's check for $7500, he will give you a balance due invoice for $2000, and your insurance company will write a check for $2000, not $1500. The total they have paid will be $9500, the amount they told you they would pay.
Now, having said that, if the contractor will agree to do the job for $9500, even though he has invoiced you for $10,000 total, then you don't have to come up with the $500 out of pocket. The contractor takes the "loss" on that. Given the fact that most contractors are starving these days, economic stimulus or not, I wouldn't doubt that you could find one who would make that agreement with you.
Deductibles in health insurance work the same way, except that you normally must "satisfy" the deductible before the insurance company even begins paying claims. So in a homeowner's policy, and insurer could say, although they don't, "We will pay our share of a claim for a covered loss only after you have paid the deductible stated in the policy specifications." You don't pay the deductible . . . they don't pay the claim.
Hope this helps. If you have something you can scan and email to me, please do. That might help to clarify things. You'll find my email address on my personal page.
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