Browse Deductibles and Cost Sharing

Deductibles and Cost Sharing

Deductibles, coinsurance, copayments, and retained-loss terms.

This section focuses on the parts of a loss the insured may still need to absorb even when a policy responds.

These terms are easy to blur together because they all reduce what the insured ultimately recovers or increase what the insured has to pay. In practice, they work at different stages of the payment path: some reduce the first dollars of a covered loss, some test whether enough insurance was carried, and some delay when the insurer’s duty attaches at all.

Start With Payment Mechanics

Then Read Retained-Loss Structures

Then Read Valuation And Settlement Basis

Why This Section Matters

Many insurance disputes are really disputes about how a deductible, limit, valuation rule, or coinsurance condition changed the final payment. These pages make those mechanics explicit.

Read This Section By Question

If the reader needs the basic payment path

Start with Deductible, Policy Limit, and Coverage. Those pages explain what happens once a loss is covered and how much of that covered loss still stays with the insured.

If the reader needs to understand property underinsurance penalties

Use Coinsurance, then compare it with Actual Cash Value, Replacement Cost, and Statement of Values.

If the reader needs to compare member or insured cost-sharing structures

Read Copayment with Deductible, Coinsurance, and Self-Insured Retention.

Typical Reading Paths

If the issue is… Start here Then read
A covered claim paid less than expected because the insured kept the first layer Deductible Policy Limit, Claim
A property claim was reduced even though the limit looked high enough Coinsurance Policy Limit, Replacement Cost, Statement of Values
A benefits claim still required member payment after coverage applied Copayment Coordination of Benefits, Health and Benefits
A commercial insured kept the first layer before the insurer’s duty attached Self-Insured Retention Deductible, Commercial General Liability, Claim

In this section

  • Coinsurance
    Property-insurance condition that can reduce payment when too little insurance was carried.
  • Copayment
    Fixed member-paid amount for an eligible drug or service.
  • Deductible
    Amount the insured absorbs before the insurer pays the remaining covered loss.
  • Self-Insured Retention
    Loss amount the insured keeps before the insurer's obligation attaches.
Revised on Friday, April 24, 2026