Comparing the Pros and Cons of 100% Coinsurance (2024)

Q: What are the risks and advantages of insuring a commercial property with 100% coinsurance?

Response 1: The advantage is a lower rate. But if the limit is less than the actual value of the property, the disadvantage is that the insured is going to be penalized on just about every claim.

Response 2: As long as the limit of liability equals the actual cash value or replacement cost, there’s no risk. The advantage is a lower premium and a happier client if there is a loss. If you don’t insure the property to the correct value, the risk is that there will be a serious penalty at the time of loss.

Response 3: Add 5% additional agreed value optional coverage. That way, at the time of a loss, 100% coinsurance will generate a 10% credit.

Response 4: Don't ever do this. Yes, you should insure at 100% total insurable value, but never use 100% coinsurance on a property. What if you’re wrong at the time of the loss, which is when the value is calculated? Don't subject the insured to such an onerous condition. Insure at 100% total insurable value and use 90% coinsurance.

Response 5: The risk is that you have no cushion if your replacement cost figures are not accurate. Yes, there is a discount on the rate, but it’s better to insure for 100% of the value and use an 80% coinsurance percentage—then you have a 20% cushion. Better yet, use agreed value and suspend coinsurance.

Response 6: The risk is that it may place a high burden on the insured, leaving no room for any variance and potentially exposing them to a coinsurance penalty. On the other hand, if you use a 100% clause in conjunction with an agreed value endorsem*nt, there is no risk except whether a sufficient amount of coverage was purchased to actually replace the property.

Response 7: The obvious risk is that at the time of loss—not application—the 100% coinsurance requirement must be met, which puts a heavy burden on the insured. The advantage is the premium savings.

Response 8: The advantage is that the rate is lower than at 90% coinsurance, or any other agreed amount. The disadvantage is that there’s no wiggle room in the property values, and it doesn’t provide the protection of an agreed amount. Basically, 100% coinsurance increases the likelihood that your client will suffer a penalty at a time of loss.

I’ve avoided 100% coinsurance for over 40 years. I’ve seen too many nasty losses and prefer to give the client better odds.

Response 9: In the case of 100% coinsurance, if a property insurance limit is lower than the value of the insured property, a proportional penalty will be assessed after a loss. A typical 80% coinsurance clause leaves more leeway for undervaluation, and thus a lower chance of a penalty in a claim situation. Insuring a property on an agreed value basis may well be a better option for some insureds as it eliminates the possibility that a coinsurance penalty will be invoked.

Response 10: I think people often elect for 100% coinsurance without considering the pros and cons. The risk of using 100% coinsurance is that at the time of the covered loss, the value of the covered property—either replacement cost or actual cash value—is greater than the limit of insurance on the property, which can occur during times of inflation in building materials.

For example, assume you set a property’s limits at $1 million with 100% coinsurance on a replacement cost basis. When the building sustains a covered $300,000 loss 11 months later, it is determined that the actual replacement cost of the building at the time of the loss is actually $1.1 million. Under the coinsurance formula—amount insured divided by the amount you should have insured, multiplied by the loss—the calculation is $1 million divided by $1.1 million, multiplied by $300,000. In this scenario, the insurer would pay $272,700 for the loss, leaving your client with a coinsurance bill to the tune of $27,300, which is obviously not good.

During times of inflationary pressure, the risk can be a real issue. We often see this phenomenon after major catastrophes, such as hurricanes and tornadoes.

The major advantage of using 100% coinsurance is lower rates. Under ISO property rules, a credit of 10% is applied to the published 80% property loss costs. It is important to remember that in the coinsurance calculation, the limit of insurance is compared to the value of the property at the time of loss, not the effective date of the policy.

Response 11: In a total loss situation, the advantage is immense.It's interesting to see people argue about deductibles on the front end and then insure buildings for 80% and 90% of their replacement cost. When they have a total loss, they are down 10-20% immediately. Then, assuming the site is not congested or obstructed, debris removal in a total loss averages 12-15% of the cost to build new. This puts the insured down 25-35% of replacement cost. If the site is congested or obstructed, debris removal may be 25-40% of replacement cost, and the policy debris removal supplement is $10,000. At this point, the insured is down 45-60%.

Then they learn about credit risk. The lender is named in the mortgagee clause and named on the check. Lenders are required to post much larger reserves on any loan with damaged collateral, so they take insurance proceeds to pay off the loan. The insured receives the difference between the loan amount and the policy limit, which is often a very modest sum, and usually not enough to remove the debris.

Insure property for 100% of replacement cost using an agreed amount endorsem*nt. When coverage is specific, always add increased debris removal coverage in anticipation of a total loss, as well.

This question was originally submitted by an agent through theVU’s Ask an Expert Service. Answers to other coverage questions are available on theVU website. If you need help accessing the website,request login information.

Comparing the Pros and Cons of 100% Coinsurance (2024)

FAQs

Is 100% coinsurance good or bad? ›

Unfortunately, if you have a 100% coinsurance, this means that you are responsible for the entire service fee. This will be paid out-of-pocket and likely does not have any eligibility for reimbursem*nt.

What does 100% property coinsurance mean? ›

The 100% coinsurance clause means you need to cover 100% of the value of your business personal property for a claim to be fully paid. If you only cover a portion of the value, the claim will not pay the full value of loss.

What are the disadvantages of coinsurance? ›

Limitations of Coinsurance:
  • Uncertain Out-of-Pocket Costs: The main limitation of coinsurance is that it makes out-of-pocket expenses unpredictable. ...
  • High Medical Costs: In cases of significant medical expenses, coinsurance can result in substantial out-of-pocket costs for the insured.
Sep 21, 2023

What are the advantages of coinsurance? ›

Overall, coinsurance can make health care services more manageable. It offers advantages like: Lowered premiums: Because you share service costs with your insurance provider, you can keep premium expenses low. You pay a smaller percentage of the total expense, which makes advanced procedures more affordable.

What is 100 coinsurance for business income? ›

Under a 100 percent coinsurance clause, the business owner must insure 100 percent of the property's value. The policy's premium costs are typically lower because the insurer doesn't take on the same risk as it would with an 80 percent policy, in which the insurer pays out 20 percent if a claim is filed.

What is a reasonable coinsurance? ›

After you meet your health insurance deductible, you share medical costs with your insurer until the end of the plan year. Your percentage of those costs is called coinsurance. Your coinsurance may be high (80% to 100%) or low (0% to 20%). Typically, it will be less than 50%.

What is property coinsurance for dummies? ›

Coinsurance is a clause used in insurance contracts by insurance companies on property insurance policies such as buildings. This clause ensures policyholders insure their property to an appropriate value and that the insurer receives a fair premium for the risk. Coinsurance is usually expressed as a percentage.

Does coinsurance apply to actual cash value? ›

If the insured purchases insurance at least equal to the coinsurance percentage (say 80 percent), the insurer pays the full value of any loss (either replacement cost or actual cash value, depending on what the insured has purchased), less the deductible, up to the limit of insurance.

Does property coinsurance apply to total loss? ›

Coinsurance as it applies to Property Insurance. Because most property losses are partial and not total losses, the average insured will take advantage of this tendency and only insure enough to cover a partial loss.

What is the issue of coinsurance? ›

The coinsurance clause in a property insurance policy requires that a home (or other physical property) be insured for a percentage of its total cash or replacement value. Usually, this percentage is 80%, but different providers may require varying percentages of coverage (90%, 70%, etc.).

Is higher coinsurance better or worse? ›

You'll generally pay less for coverage if you choose a health plan with higher coinsurance levels, such as a bronze or silver plan. The downside is that you'll pay more when you need healthcare.

Is it good to have 100% coinsurance? ›

100% coinsurance: You're responsible for the entire bill. 0% coinsurance: You aren't responsible for any part of the bill — your insurance company will pay the entire claim.

What is the effect of coinsurance? ›

The co-insurance effect is an economic theory that suggests mergers and acquisitions (M&A) decrease the risk of holding debt in any of the combined entities. Under this theory, one would expect the increased diversification caused by acquisitive activities to reduce borrowing costs for the combined entity.

Why do you have to pay coinsurance? ›

Coinsurance is a portion of the medical cost you pay after your deductible has been met. Coinsurance is a way of saying that you and your insurance carrier each pay a share of eligible costs that add up to 100 percent. The higher your coinsurance percentage, the higher your share of the cost is.

Is it better to have higher or lower coinsurance? ›

Opting for a low coinsurance health insurance plan can help alleviate the financial strain of out-of-pocket medical expenses. Compared to high coinsurance plans, low coinsurance plans typically entail lower cost-sharing responsibilities, reducing the amount you have to pay for covered healthcare services.

What does $100 after deductible mean? ›

There are plans that offer “100% after deductible,” which is essentially 0% coinsurance. This means that once your deductible is reached, your provider will pay for 100% of your medical costs without requiring any coinsurance payment.

What does 10% coinsurance mean? ›

Coinsurance is a percentage of a medical charge you pay, with the rest paid by your health insurance plan, which typically applies after your deductible has been met. For example, if you have 20% coinsurance, you pay 20% of each medical bill, and your health insurance will cover 80%.

What is a coinsurance maximum? ›

What are Coinsurance Maximums? Your total percentage cost sharing for Covered Services that you pay in a Contract Year. Your Coinsurance Maximum applies toward your Out-of-Pocket Limit.

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