What is an insurance deductible vs out of pocket costs on a roof claim?
Short answer. The deductible is the fixed share of each covered loss you pay before insurance pays. Out of pocket is everything you end up paying, which on a roof claim can include the deductible plus non-recoverable depreciation, code items without coverage, upgrades and damage the policy excludes. Unlike health insurance, homeowners insurance has no out of pocket maximum.
Health insurance versus home insurance
- Health: a deductible, then copays or coinsurance, capped by an out of pocket maximum each year.
- Home: a deductible per claim, then the insurer pays up to the policy limits. There is no annual cap on what you might pay for things the policy does not cover.
Building your out of pocket budget for a roof
- Deductible: flat or a percentage of the dwelling limit for wind and hail.
- Non-recoverable depreciation: on actual cash value or a payment schedule.
- Code items: if you lack ordinance or law coverage.
- Upgrades: better shingles, guards, added ventilation.
- Excluded items: pre-existing rot, wear, cosmetic damage where excluded.
- Interior and contents: anything excluded or over a sublimit.
Two examples
Replacement cost policy: $15,000 roof, $2,000 deductible, no upgrades. Out of pocket: $2,000.
Actual cash value roof: same roof, $6,000 depreciation, $2,000 deductible, $800 shingle upgrade. Out of pocket: $8,800.
Lowering what you pay
- Make sure the estimate is complete and supplement missing items.
- Claim recoverable depreciation on time.
- Review roof terms at renewal and consider ordinance or law coverage.
See ACV vs RCV, code upgrades and supplements.