Learn more
about our commitment to your security by reading our Recommended Reimbursement Disclosure.
This outlines the role of Out of Pocket, EXP (OOPE) in calculating and communicating Recommended Reimbursement amounts for policyholders following a covered loss under their homeowner’s or renter’s insurance policy.
1. Purpose of Recommended Reimbursement
OOPE provides a Recommended Reimbursement amount as a reference point to assist insurance carriers and adjusters in evaluating policyholder-submitted expenses under Coverage D (Additional Living Expenses / Loss of Use).
This figure is calculated by comparing approved daily expenses to the policyholder’s Normal Daily Spending Before Loss, which represents typical pre-loss spending on necessary living costs.
2. Recommended Reimbursement Calculation Method
The Recommended Reimbursement is calculated using the following formula:
Approved Daily Expenses – Normal Daily Spending Before Loss = Recommended Reimbursement
This is applied per day, excluding any days without recorded or approved expenses.
The Normal Daily Spending Before Loss is typically set by the adjuster or estimated based on information provided by the policyholder.
Example:
Approved Expenses for Day = $30.00
Normal Daily Spending Before Loss = $28.88
Recommended Reimbursement = $1.12
3. OOPE's Role and Limitations
OOPE does not issue payments or make final reimbursement decisions.
All determinations regarding eligible expenses and reimbursement amounts are made solely by the adjuster and insurance carrier.
The Recommended Reimbursement provided by OOPE is non-binding, subject to carrier discretion, and should not be interpreted as a guarantee of payment.
4. Policyholder Acknowledgment
By reviewing OOPE’s Recommended Reimbursement, you acknowledge that:
The Recommended Reimbursement is based on OOPE’s internal review using carrier guidelines.
The final reimbursement outcome may differ based on your policy terms, adjuster input, or additional carrier review.
OOPE’s findings are intended to support, not replace, the claims review and approval process performed by your insurance company.
5. Questions and Support
Contact your insurance adjuster regarding final reimbursement decisions.
Reach out to OOPE at hello@teamoope.com for clarification regarding report formatting or calculations.
