Understanding Deductibles in Insurance

Insurance is a must-have for every individual or small business. Insurance offers comprehensive financial protection to safeguard your savings at the time of an emergency. However, insurance jargon can be misleading sometimes. It often raises conflict at the time of insurance pay-outs.  Hence, all users need must put effort and time into understanding the insurance plans before making any monetary commitment.

An insurance deductible is a common term that you are bound to come across in insurance. It is often considered a drawback; however, it sometimes can also be used in favor of the policyholders. So, buyers should pay special attention to the type and purpose of deductibles in their insurance policies.

What are deductibles?

A policyholder’s deductible is the amount they must pay before the insurance company begins to compensate them. In simple words, the insurance company will only pay the claim if it exceeds the deductible amount. If the holder’s policy deductible is $ 250 and the insured’s claim is $ 5,000, the insurance company is only liable to pay $ 4,750. However, if the claim is less than the deductible, the insurer is not required to pay anything. The cost of high-deductible insurance is cheaper, whereas the cost of low-deductible insurance is higher.

There are three types of deductibles that users can choose from.

  1. Voluntary deductible

Here buyers can choose the deductible amount based on their insurance needs and budget. However, it should be kept in mind that the premium amount and deductibles are inversely proportional to each other. So, the higher the deductible amount, the lower the premium and vice versa.

  • Compulsory deductible

It is a fixed amount that is deducted by the insurance company. Deductible amounts are non-negotiable under such policies.

  • Cumulative deductible

Cumulative deductible mainly applies to policies like family health insurance policies. Such policies are shared by multiple people in a family. Hence, the cumulative amount is deducted when the insurance is claimed by any of the insured persons under the given scheme.

What is the significance of deductibles in insurance?

Deductibles discourage people from filing frivolous claims or seeking needless remedies like hospitalization simply because they have insurance. High-deductible policies allow them to pay a reduced premium, which saves their money over time.

When policyholders submit claims, deductibles allow insurance companies to share the expenses with them. Companies employ deductibles for a variety of reasons, including moral hazard and financial stability.

Deductibles are frequently used in insurance policies to ensure that the provider maintains a level of financial security. A properly constructed insurance policy protects against financial loss. A deductible act as a buffer between any given minor loss and a truly catastrophic loss.

How does deductible work in insurance?

Insurance deductibles serve as a barrier to filing tiny, unnecessary claims just because coverage is available. While insurance plan premiums may be low, their deductible may be greater. This could prevent people from filing minor claims. As a result, people are only encouraged to file a claim if they have significant exposure. Because they must pay the deductible before the insurance provider will cover the remaining sum insured, any false claims are removed, and the insurer will only cover legitimate claims.

The highest cost that consumers are required to pay in a plan year is deductible. It is often confused or interlinked with an out-of-pocket maximum. The out-of-pocket maximum, in contrast to the deductible, refers to the cost-sharing agreement once the deductible has been satisfied.

Let’s look at an example in health insurance using some typical rates for visits and treatment. A $1,000 deductible insurance plan might include a $1,500 out-of-pocket limit with a 20% coinsurance rate. In that situation, the entire $85 for 11 doctor visits would be covered by the deductible. They would pay $17 per doctor visit (20 percent coinsurance) until they spend $500 in coinsurance ($1,500 – $1,000) or around 29 more office visits ($500/$17 = 29.4) after meeting their deductible. They would pay nothing further for medical care for the rest of the plan after that.

How much deductible is acceptable?

Low deductibles are beneficial when there is a fear of extensive expenses. However, high deductibles do make the premium amount manageable. In some cases, like the healthcare example used earlier, this also allows policyholders to access HSA-derived benefits.

Most deductibles of insurance plans range from $500 to $1000. The acceptable amount depends on the size of the emergency fund that policyholders have. Higher deductibles are often chosen with top-up insurance plans. These plans provide coverage above the existing insurance plan. With deductibles, policyholders can manage these policies by paying the minimum premium amounts.

What are the pros and cons of having deductibles?


  • They assist in lowering the cost of insurance. In addition, if the insured chooses voluntary deductibles, the insurance provider may provide a further discount.
  • It deters the insured from filing small claims, which helps the insured collect a No Claim Bonus (NCB), which can be used to raise the primary health insurance policy’s coverage.
  • Regardless of the applicable deductibles, the insured can obtain insurance coverage in the event of an emergency or an unexpected event.


  • More expenses will be borne by the insured, even if they do not have the financial means to pay for them. This is due to the fact that benefits under an insurance plan with a deductible are only available when the insured has paid the deductible.
  • If the deductible is larger, the insured will be responsible for paying out of pocket, which will lower the savings. In addition, if there are several emergencies, the financial burden might be enormous.
  • Policyholders have to pay deductibles every time they claim insurance during a term until a limit is reached.


Insurance deductibles favor buyers as that reduces the premium amount required for a policy. At the same time, it is also helpful for insurance companies to keep a check on fraud claims. However, if you do not want to opt for deductibles at all, there are a range of policies offered by Gonzalez insurance with no liability deductibles that might interest you. For more information, kindly connect with us at Gonzalez Insurance.