Select your insurance type below and enter your claim details. The calculator estimates your net payout after deductibles, depreciation, coverage limits, and co-insurance provisions are applied.
Please enter the required loss or claim amount.
The Gap Between What You're Owed and What They Offer
Insurance claims almost never pay out exactly what you expect. Deductibles reduce the gross figure. Depreciation reduces it further on actual cash value policies. Co-insurance penalties apply if you're underinsured. Policy limits cap the total. And on health claims, the interplay between deductibles, co-insurance, and out-of-pocket maximums creates a layered calculation most people can't do in their heads when they're staring at a hospital bill.
This calculator handles four claim types — home, auto, health, and life — so you can estimate what you'll actually receive before you respond to a settlement offer or pay a bill you didn't expect.
How to Use This Insurance Payout Calculator
Select the insurance type that matches your claim, then fill in the fields. Each type has its own inputs because each type applies its own set of deductions. Here's how to approach each one.
Step-by-Step for Each Claim Type
- Home / Property: enter your total loss or repair estimate, your policy's coverage limit, your deductible, and your settlement basis — replacement cost value (RCV) or actual cash value (ACV). ACV policies subtract depreciation before the deductible is applied. If you were underinsured relative to your policy's co-insurance requirement, enter the applicable penalty percentage.
- Auto: enter the repair estimate or actual cash value of a totaled vehicle, your policy limit, and your deductible. If the insurer applies betterment charges (depreciation on replaced parts in older vehicles), enter that separately. If it's a total loss and you're retaining the salvage, the salvage value is deducted from your payout.
- Health: enter the total billed amount, your annual deductible, how much of that deductible you've already met, your co-insurance percentage, your out-of-pocket maximum, and how much you've already paid toward that maximum. The calculator applies these in the correct sequence: deductible first, co-insurance after, out-of-pocket cap last.
- Life: enter the policy face value, any outstanding policy loans, and any unpaid premiums. Both are deducted from the net death benefit. Select lump sum or annuity payout. If annuity, enter the number of payment years to see the annual installment amount.
How Each Claim Type Is Calculated
Home claims start with the covered loss, capped at the policy limit. ACV policies then subtract depreciation based on the age and condition of what was lost. The deductible comes off after depreciation. Co-insurance penalties apply if your coverage-to-value ratio fell below your policy's required threshold — often 80%. Auto claims follow a similar flow: covered loss capped at the limit, then deductible and betterment deductions applied. Health claims sequence the deductible, then apply co-insurance to the remainder, then check whether the out-of-pocket maximum has been hit. Life claims are simpler: face value minus any outstanding loans and unpaid premiums equals the net death benefit.
The ACV vs. RCV Distinction Most Policyholders Miss
Replacement cost value pays the full cost to replace a damaged item with a new equivalent. Actual cash value pays replacement cost minus depreciation. On a 10-year-old roof damaged by a hailstorm, the difference between ACV and RCV can be $15,000–$30,000 on the same claim. Most standard homeowner policies default to ACV. RCV coverage costs more in premium but closes a gap that surprises a large number of claimants at exactly the worst moment. According to the Consumer Financial Protection Bureau, policyholders frequently discover the ACV/RCV distinction only after a major loss — by which point the policy can't be changed.
Example: $45,000 Roof Claim, ACV Policy, 25% Depreciation, $2,500 Deductible
Loss: $45,000. Depreciation at 25%: $11,250 subtracted. After depreciation: $33,750. Deductible: $2,500 subtracted. Net payout: $31,250. Under an RCV policy with the same deductible, the same claim would yield $42,500. That $11,250 difference is not a mistake or a dispute — it's the policy working exactly as written. Knowing your policy basis before a loss helps you make a better-informed coverage decision at renewal.
Health Insurance Payouts — Why the Math Is Layered
Health claims are the most commonly misunderstood because three separate thresholds — the deductible, the co-insurance, and the out-of-pocket maximum — interact in sequence. Most people know they have a deductible. Fewer understand that co-insurance applies only to claims above the unmet deductible balance. And many don't realize that once the out-of-pocket maximum is reached, the insurer covers 100% of subsequent in-network costs for the remainder of the plan year. Running your specific numbers through the health tab of this calculator before paying a large bill is worth the two minutes it takes.
What the Out-of-Pocket Maximum Actually Protects You From
The out-of-pocket maximum is the annual ceiling on your total cost sharing — deductibles, co-payments, and co-insurance combined. Once you hit it, you pay nothing more for covered in-network services until the plan year resets. For catastrophic or chronic conditions, reaching the out-of-pocket maximum early in the year dramatically changes your financial exposure for the rest of it. Track your year-to-date spending carefully against this number — your EOB (Explanation of Benefits) statements show accumulated totals.
Questions People Have When Filing a Claim
Why did the insurance company offer less than my repair estimate?
Several mechanisms can reduce a payout below a contractor's estimate: depreciation on ACV policies, the insurer's use of a lower preferred vendor pricing schedule, betterment deductions, deductible application, or a co-insurance penalty for underinsurance. Ask the adjuster to provide a line-by-line explanation of any reductions. You have the right to understand the calculation — and to dispute it if the depreciation schedule or pricing is inaccurate. The National Association of Insurance Commissioners provides consumer guidance on the claims process and your rights as a policyholder.
What is a co-insurance clause on a homeowner policy?
A co-insurance clause (sometimes called an insurance-to-value clause) requires your dwelling coverage to equal at least 80% of your home's replacement cost. If you're underinsured — say, your home would cost $400,000 to rebuild but you only carry $250,000 in coverage — the insurer applies a penalty formula that reduces your payout proportionally even on partial losses. The more underinsured you are, the larger the penalty. Home values and construction costs rise over time; coverage that was adequate three years ago may fall short today.
Is a life insurance death benefit taxable?
Generally no. Life insurance death benefits paid to individual beneficiaries are not subject to federal income tax. However, interest earned on death benefits held by the insurer during a deferred payout or annuity arrangement is taxable as ordinary income. Estate taxes may apply if the policy proceeds push the estate above federal or state exemption thresholds. Large policies owned by the insured (rather than an irrevocable life insurance trust) are included in the taxable estate. A tax advisor should review large policy structures.
What is betterment in an auto insurance claim?
Betterment is a deduction applied when new parts replace worn or depreciated ones on an older vehicle. If your 8-year-old car's bumper is replaced with a new bumper, the insurer may deduct a percentage of the new part's cost representing the improvement over what you had. Betterment is legal and disclosed in most policies — but the percentage is sometimes negotiable if the vehicle was well-maintained or the parts being replaced were in better-than-average condition for their age.
Can I dispute a low insurance payout?
Yes. Most policies include an appraisal or arbitration clause for property damage disputes. You can hire a public adjuster to represent your claim, obtain independent contractor estimates, and formally challenge the insurer's depreciation schedule or pricing methodology. For health claims, the appeals process is formalized — you have the right to an internal appeal and, in most cases, an independent external review of the insurer's coverage determination.
What happens if my loss exceeds my policy limit?
You absorb the difference. The insurer pays up to the policy limit; anything above that is your uncovered loss. This is why adequate coverage limits — not just having a policy — are the critical variable in insurance planning. After a total loss, the gap between your policy limit and your actual replacement cost can run into the tens of thousands on home policies and thousands more on auto policies where GAP insurance was not carried.
When does the out-of-pocket maximum reset on health insurance?
Out-of-pocket maximums reset at the beginning of each plan year — not the calendar year if your plan year runs on a different schedule. This timing is important if you have a large medical expense near the end of the plan year: you may hit your out-of-pocket maximum, then reset a few months later on January 1, meaning the same ongoing treatment starts over on cost-sharing terms. Schedule elective procedures strategically relative to your plan year if you've already had significant health spending.
Do insurance payouts affect my taxes?
It depends on the type. Property insurance payouts for actual loss (not profit over basis) are generally not taxable. If you receive more than your adjusted basis in the property, the excess may be a taxable gain — though deferral rules apply if you reinvest in similar property. Auto insurance payouts for vehicle damage are not taxable. Health insurance reimbursements are not taxable if premiums were paid with after-tax dollars. Life insurance proceeds as described above are generally income-tax-free but may have estate implications. Consult a tax professional for any large insurance payout.