BENEFIT LIMITS
A benefit limit sets an upper bound on how much the insurer will pay for any loss. Reasons for
placing a limit on the benefits include the following:
(1) The limit prevents total claim payments from exceeding the insurer’s financial
capacity.
(2) In the context of risk, an upper bound to the benefit lessens the risk assumed by the
insurer.
(3) Having different benefit limits allows the policyholder to choose appropriate coverage
at an appropriate price, since the premium will be lower for lower benefit limits.
In general, the lower the benefit limit, the lower the premium. However, in some instances the
premium differences are relatively small. For example, an increase from 1 million to 2 million
liability coverage in an auto policy would result in a very small increase in premium. This is
because losses in excess of 1 million are rare events, and the premium determined by the insurer is
based primarily on the expected value of the claim payments.
As has been implied previously, a policy may have more than one limit, and, overall, there is more
than one way to provide limits on benefits. Different limits may be set for different perils. Limits
might also be set as a percentage of total loss. For example, a health insurance policy may pay