insurance-gap-auditor

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:

1. 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.
2. Exclusion checklist — the standard gaps in US/UK/EU personal lines, with the rider/endorsement that closes each one and typical cost bands.
3. Liability sizing — umbrella limit computed from net worth + income exposure, so liability isn't a guess.
4. 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

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

1. "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.
2. Insuring the house for market value. Dwelling coverage must equal REBUILD cost (often more than market in high-land-cost areas).
3. $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).
4. Forgetting the umbrella's underlying requirements. Umbrellas require auto liability at e.g. 250/500 — dropping underlying limits voids the umbrella at claim time.
5. 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.