Estimate the expected annual value of a long-term care insurance claim from a covered loss, claim probability, deductible, insurer share, and policy limit. Results separate the probability-weighted insurer payout from the amount paid in an actual modeled claim and your remaining share. This planning estimate helps compare risk retention and policy value without implying that a claim or payment is guaranteed.
The main result spreads a possible claim payment across its annual probability. The claim-year results remain important because actual experience is usually no claim or a much larger single payment.
This simplified estimate does not determine coverage. Actual payment depends on policy wording, eligibility, exclusions, valuation, waiting periods, sublimits, and claim facts.
For a $50,000 covered loss, 5% annual claim probability, $5,000 deductible, and 80% insurer share, the claim payout is $36,000 and the expected annual insurer payout is $1,800.
No. It is a probability-weighted planning average, not a prediction or guarantee for a particular year.
The deductible is subtracted from the covered loss before coinsurance and the policy limit are applied.
It caps the modeled insurer payment even when the covered loss after deductible and coinsurance would otherwise be higher.
Yes. The expected insurer payout will be zero, while the claim-year figures still show what the entered loss would mean if it occurred.
Only if your average covered loss already reflects them. Review policy definitions, waiting periods, valuation terms, and exclusions separately.
| Variable | Role in estimate |
|---|---|
| Covered loss | Loss amount before deductible and insurer share |
| Insurer share | Percentage applied after the deductible |
| Policy limit | Maximum modeled payment |