Insurance Claim Payout Estimator
Estimate your net insurance claim payout after deductibles, coinsurance, and policy limits are applied.
Percentage of loss you pay after the deductible (e.g. 20 means insurer pays 80%).
Formula
Step 1 — Remaining Limit:
Remaining Limit = Policy Limit − Prior Claims Paid This Period
Step 2 — Effective Limit:
Effective Limit = min(Remaining Limit, Sub-limit) (sub-limit only if applicable)
Step 3 — Loss After Deductible:
Loss After Deductible = max(Covered Loss − Deductible, 0)
Step 4 — Insurer's Gross Share:
Insurer Gross = Loss After Deductible × (1 − Coinsurance Rate)
Step 5 — Net Payout (capped at limit):
Net Payout = min(Insurer Gross, Effective Limit)
Step 6 — Your Out-of-Pocket:
Out-of-Pocket = Deductible Portion + Coinsurance Portion + Amount Exceeding Limit
Assumptions & References
- The deductible is a flat per-occurrence deductible subtracted before coinsurance is applied (standard in most property & health policies).
- The coinsurance / co-pay rate is the percentage of the loss after the deductible that the policyholder bears (e.g., 20% in an 80/20 plan).
- The policy limit is the maximum aggregate or per-occurrence amount the insurer will pay; prior claims in the same policy period reduce available capacity.
- A sub-limit is a lower cap that applies to a specific category of loss (e.g., jewellery, flood, cyber) within the broader policy limit.
- This estimator does not account for depreciation, actual cash value vs. replacement cost, excess layers, or reinsurance arrangements.
- References: ISO Property Policy forms; NAIC Glossary of Insurance Terms; IRDA (India) Guidelines on Standard Fire & Special Perils Policy.