Insurance Gap Auditor
Overview
Insurance is bought once, in a hurry, and never re-audited. Then the claim denial teaches the buyer what the policy actually said: "flood" isn't water from the sky, the roof payout was actual-cash-value on a 17-year-old roof, the jewelry sub-limit was $1,500 not the $12,000 it cost, and the e-bike isn't a "bicycle" under the policy at all.
This skill runs the audit the agent should run annually:
- Scenario engine — 15+ household risk scenarios (kitchen fire, sewer backup, sump overflow, dog bite, guest fall, trampoline, e-bike/scooter, home business equipment, teen driver, borrowed car, ring lost abroad…) each mapped to: which policy responds, what's TYPICALLY covered, what's TYPICALLY excluded or sub-limited.
- Exclusion checklist — the standard gaps in US/UK/EU personal lines, with the rider/endorsement that closes each one and typical cost bands.
- Liability sizing — umbrella limit computed from net worth + income exposure, so liability isn't a guess.
- Policy inventory — record what you actually carry; the audit output is a gap list with specific coverage amounts and rider names to request from your agent.
Educational tool: policies vary by insurer, state, and country. The output is questions and rider names, never a coverage opinion.
When to Use
- Annual insurance review (or after: moving, renovating, new pet, teen driver, home business, big purchases, inheritance)
- "What am I missing?" — the exclusion checklist for home/renters/auto
- "How much liability/umbrella do I need?" — net-worth-based sizing
- Before buying a policy: scenario-test the quotes you're comparing
- After a denial: understand which exclusion bit and what closes it
Don't use for: choosing between specific insurers, reading a specific contract's legal language (the tool encodes market-typical patterns, not your document), commercial/business policies.
Quick Start
# The scenario engine: what happens in each common loss
python3 scripts/insure_audit.py scenarios --filter fire
python3 scripts/insure_audit.py scenarios --group home
# Standard exclusion gaps + the riders that close them
python3 scripts/insure_audit.py exclusions --policy home
python3 scripts/insure_audit.py exclusions --policy auto
# Liability/umbrella sizing from finances
python3 scripts/insure_audit.py liability --net-worth 450000 --income 95000
# Record policies and run the full gap audit
python3 scripts/insure_audit.py policy add --name "Home" --type home \
--dwelling 380000 --liability 300000 --deductible 2500
python3 scripts/insure_audit.py policy add --name "Auto" --type auto \
--liability 100000 --deductible 500
python3 scripts/insure_audit.py audit --net-worth 450000
What the Scenario Engine Knows
| Scenario | Responds | Typical gap discovered |
|---|---|---|
| Kitchen fire (own home) | Home dwelling/contents | ACV roof/contents depreciation if not replacement-cost |
| Fire spreads to neighbor | Liability | Limit adequacy vs net worth |
| Flood (external water) | None — NFIP/private flood | Standard home EXCLUDES flood |
| Sewer/drain backup | Home only with rider | $5–10k backup rider often absent |
| Sump pump failure | Home only with rider | Same water-backup endorsement |
| Jewelry/furs theft | Contents with sub-limit | $1–2k sub-limit vs real value → schedule items |
| Home office equipment | Contents, sub-limited | Business property rider if > $2.5k |
| Dog bite (guest) | Liability | Breed exclusions; some states strict liability |
| Trampoline/pool | Liability | Attractive-nuisance exclusions/requirements |
| E-bike/scooter (Class 2/3) | Neither home nor auto | Needs bike/moped policy or endorsement |
| Teen driver, family car | Auto | Permissive-use rules; rate/class update |
| Loaner/borrowed car | Owner's policy first | Non-owned coverage gaps |
| Wind/hail | Home (named-peril or all-risk) | 1–2 % hurricane/wind deductible surprise |
| Earthquake | Rider only | Standard policies exclude everywhere |
| Laptop lost abroad | Travel/contents | Travel policy or HO contents off-premises limit |
The Standard Exclusion Gaps (summary)
Home/renters: flood, earthquake, sewer backup (rider ~$50–250/yr), sump overflow, scheduled-valuables sub-limits, business property, identity theft (rider), ordinance-or-law (rebuilding to new code), extended replacement cost (inflation guard on dwelling).
Auto: liability-only states' uninsured/underinsured motorist (UM/ UIM) stacking, medical payments vs PIP, rental reimbursement, loan/lease gap coverage, custom parts exclusions.
Umbrella: requires underlying limits maintained; excludes intentional acts, business liability, and typically excludes e-bikes above class.
Common Pitfalls
- "I have home insurance, so I'm covered for water." Water damage is three different things (sudden pipe burst = covered; flood = never; backup = rider). Confusing them is the #1 denial.
- Insuring the house for market value. Dwelling coverage must equal REBUILD cost (often more than market in high-land-cost areas).
- $100k liability on a $600k net worth. Your liability limit is what stands between an accident and your assets. Size it to net worth + a few years of income; umbrella is cheap ($150–400/yr per $1M).
- Forgetting the umbrella's underlying requirements. Umbrellas require auto liability at e.g. 250/500 — dropping underlying limits voids the umbrella at claim time.
- Scheduling jewelry AFTER the loss. Sub-limits apply unless items are scheduled with appraisals beforehand.
Verification Checklist
- scenarios print respond-policy, typical coverage, gap, and rider
- exclusions list rider names + typical cost bands per policy type
- liability sizing yields umbrella recommendation ≥ net worth
- audit cross-references entered policies against the gap checklist
- output always framed as questions for your agent, not legal advice
Examples
$ python3 scripts/insure_audit.py scenarios --filter backup
[SEWER BACKUP] water pushes back through drains
Responds: home policy ONLY IF water-backup endorsement present
Typical gap: rider limit $5,000-10,000 vs finished-basement loss
Ask agent: "Do I have water backup & sump overflow coverage? Limit?"
$ python3 scripts/insure_audit.py liability --net-worth 450000 --income 95000
Umbrella sizing: ~$700k-1M recommended...
Market-typical patterns for US personal lines (UK/EU notes where they differ materially). Not legal or coverage advice — the output is the question list that makes your agent specific.
