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Ocean Point Claims Company

Reasonable and Customary Pricing

Reasonable and customary pricing is the going rate for materials and labor in a specific geographic area at the time of loss, which insurers use as the benchmark for what a repair should cost.

What the standard means

Repair costs vary by region and change over time, so a fair estimate is priced at the market rate for the work where and when the loss happened. This is called reasonable and customary pricing, sometimes usual and customary or prevailing pricing. Xactimate publishes regional price lists that update regularly, and Florida zones differ meaningfully between South Florida, the Treasure Coast, and the Panhandle. The benchmark also moves after a catastrophe, when demand surge pushes local labor and material prices up.

Where disputes arise in Florida

  • The carrier uses an outdated price list that predates a post-storm price spike
  • The carrier prices for a distant, cheaper labor market instead of the loss location
  • A contractor bids above the prevailing rate and the carrier refuses the overage

Pricing is a factual question, so the fix is evidence: current regional pricing, contractor invoices, and material quotes from the loss area.

Why it connects to fair claim handling

Systematically pricing a loss below the prevailing local rate can cross into an unfair claim settlement practice under Fla. Stat. 626.9541. Documenting the actual local market rate is what resolves the dispute and supports a full recovery.

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