People buy insurance to cover losses, but how much insurance companies pay depends on the contract and the amount of the loss. With some policies, the payout is easy to determine. Life insurance pays the face value of the policy when the insured dies. Liability insurance pays legal costs and any assessed liability damages up to the policy limit. Business income insurance pays for damages and losses in income because of the damage. However, determining the payout for property losses is more complicated; how much is paid is determined by the principle of indemnity.
Probably the most basic and fundamental principle of property insurance — and why property insurance even exists — is that of indemnity. The basic purpose of insurance is to cover a loss that an insured has suffered. Indemnity is the payment of a loss by the insurer to the insured, but for no more than the actual amount of the loss. Indemnity compensates the insured for loss, but does not allow the insured to make a profit out of the loss. A moral hazard would result if the insured could profit from a loss, possibly motivating the insured to actually cause the loss to make a profit, or a morale hazard would be created, causing the insured to be complacent in preventing a loss. Insurance that causes these hazards would be against public policy, and would drive up premiums to unaffordable prices. For the same reason, the insured cannot collect from multiple insurance policies, even from different companies, for the same loss.
Actual Cash Value
In property insurance, the amount of the indemnity is typically based on the actual cash value of the loss at the time of the loss. Over the years, the courts have used 3 methods of determining actual cash value: replacement cost less depreciation; fair market value; and the broad evidence rule. Generally, the applicable rule is the one paying the least to the insured — not so insurance companies can save themselves money, but because to pay more would violate the principle of indemnification and create moral hazard.
Replacement Cost Minus Depreciation
If a 3-year old car is totally demolished, the insurance company will only pay what the car was worth at the time of loss. If it paid the full value of a new car, this would create a moral hazard by motivating some drivers to intentionally destroy the car to profit from insurance. The insurance company will determine the actual cash value by subtracting depreciation from the replacement value of the car. Replacement cost is the current price of a new item. Depreciation is the decrease in the market value of an item because of wear and tear. Note that this is different from depreciation as used in accounting and for tax purposes, because it does not depend on the purchase price of the item. Depreciation is calculated as the age of the item divided by its useful life.
|Depreciation||=||Replacement Cost||×||Age of Insured Property|
Useful Age of Property
|Actual Cash Value = Replacement Cost - Depreciation|
Thus, if a new car costs $20,000, and the depreciation of the 3-year old car is $5,000, then the insurance company will only pay $15,000 for the totally demolished car. To pay more would violate the principle of indemnification
Depreciation also applies to partial losses to realty, such as buildings and other structures on land.
Example: Calculating the Indemnification for a Partial Loss
A 10 year old building with a useful life of 40 years and a replacement cost of $120,000 suffers a partial loss of 50% due to fire. What would be the indemnification for this loss?
- Depreciation = $120,000 × 10/40 = $30,000.
- Actual Cash Value = $120,000 - $30,000 = $90,000.
- Amount of Indemnification = $90,000 × 50% = $45,000.
Fair Market Value
Sometimes, property loses value for reasons other than depreciation — in many of these cases, fair market value is used to calculate cash value. Fair market value is the price that a property would fetch in an open market. For instance, because of urban decay and higher taxes, many people do not want to live in many larger cities, which causes the property values in those cities to decline well below their replacement cost. If an insurance company paid a replacement cost minus depreciation that was higher than the fair market value of the property, then some property owners would be tempted to destroy their property to get the higher insurance value over what they would get selling it in the market.
Broad Evidence Rule
Sometimes a fair market value is difficult to determine, or there is a question as to what the fair market value is. In these cases, the courts have used other evidence in determining a value for the loss. The broad evidence rule uses all relevant factors in determining the cash value for the loss, which can include, appraisals, income generated by the property, and anything else that could potentially affect the value of the property. The factors used are what an expert would use to determine the value of a property.
Exceptions to Indemnity
Sometimes, the principle of indemnity is not easily applied or cannot be applied because of the nature of the insurable interest, because of state law, or because the insured wants greater protection than afforded by indemnification.
Valued Insurance Policy
Some things are difficult to price — antiques, paintings, heirlooms, etc. To insure these items, the insured can get a valued policy, which pays the face amount of the policy when a total loss occurs. To prevent moral hazard, the insurance company and the insured must agree what the value is before the policy is issued.
Some states have valued policy laws for real property that requires insurance companies to pay the face value of the policy if there is a total loss to the property due to a peril specified by law — which can include fire, lightning, windstorms, tornadoes, and hurricanes.
Valued policy laws were enacted to prevent disputes about the worth of the property when a total loss occurred. Many properties were overinsured by agents wanting to earn larger commissions. When a loss occurred, the insurance company would inspect the property, and if found to be worth less than its insured value, it would only pay its worth. While the valued policy laws helped to prevent such disputes, they create a moral hazard by insuring the property for more than it's worth — owners would have a lax attitude toward preventing loss, or may even cause the loss for profit. However, real estate inflation does mitigate this hazard — in fact, many properties become underinsured after a few years.
Cash Payment Policies
Some losses are difficult to measure, such as the loss of someone's life or losses suffered from disability. Insurance contracts covering these types of losses are not contracts of indemnity, but are cash payment policies, for a stipulated amount of cash is paid in the event of a loss.
Replacement Cost Insurance
Insurance is purchased to protect against major losses. However, many insureds would still have substantial losses after receiving payment from the insurance company because the typical payment will not cover the depreciated value of the property. In many of these cases, the insured must replace the property for substantially more than their insurance proceeds. This is especially true for real estate because of its location or neighborhood, or, if it is a factory or some other building used to produce goods, replacement cost may be higher because of machinery obsolescence. To remedy this situation, insurance companies offer replacement cost insurance.
Replacement cost insurance pays for the replacement value of the loss, without any deduction for depreciation. However, replacement cost insurance often has stipulations designed to lessen moral hazard. With real estate, for instance, replacement cost insurance will often require the insured to rebuild in the same place.
However, because repair costs of some old buildings constructed with costly or rare materials would exceed the building's market value, insurance companies may only pay for modern construction techniques to replace or repair old buildings to their functional equivalent, sometimes called functional replacement. A good example of this is the HO-8 homeowner's insurance policy.
The HO-8 (aka Modified Coverage Form) policy is for older homes with a replacement cost that is much higher than its market value. To prevent moral hazard, insurers will not insure a home for more than what it is worth. The HO-8 policy solves this problem by paying the cost to repair or replace damaged property, using common construction materials and methods. HO-8 provides functional replacement, which is cheaper. For instance, plaster walls may be replaced with drywall and hardwood floors could be replaced with plywood.