AAFM Exam CWM_LEVEL_2 Topic 6 Question 87 Discussion

Actual exam question for AAFM's CWM_LEVEL_2 exam

Question #: 87
Topic #: 6

Section C (4 Mark)

Read the senario and answer to the question.

Keshav purchased a Health Insurance. The policy has a calendar-year deductible of Rs. 500 and 80:20 as coinsurance. Keshav was hospitalized with a covered illness on January 23rd 2009. This hospitalization was his first claim under the said policy for the calendar year. His covered medical expenses were Rs. 20,500. How much of this amount will the insurer pay and how much will Keshav be required to pay to the Hospital?

AThe insurer will pay Rs. 16,500 and Keshav will pay Rs. 3,500

BThe insurer will pay Rs. 20,500 and Keshav will pay Rs. Nil

CThe insurer will pay Rs. 15,500 and Keshav will pay Rs. 4,500

DThe insurer will pay Rs. 20,000 and Keshav will pay Rs. 500

Show Suggested Answer

Suggested Answer: D

by Latrice at Sep 19, 2024, 04:20 AM

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Blondell

2 months ago

But the deductible is Rs. 500, so the insurer will pay Rs. 20,000.

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Allene

2 months ago

The question is as clear as mud, but I'll go with D. It's the only one that makes sense with the given information. Gotta love these insurance questions, they really get the brain juices flowing!

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Gracia

2 months ago

I'm going with D as well. It just seems to fit with the scenario provided.

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Jenifer

2 months ago

I'm not sure about this one, but D does seem to be the most logical choice based on the information given.

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Sheldon

2 months ago

Yeah, I agree. The deductible is Rs. 500 and the coinsurance is 80:20, so D makes sense.

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Alberto

2 months ago

I think D is the correct answer too. It seems like the insurer will pay most of the expenses.

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Lucia

2 months ago

I disagree, I believe the answer is B.

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Blondell

2 months ago

I think the answer is A.

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Earnestine

3 months ago

Hmm, this is a tricky one. But I think D is the correct answer. Keshav has to pay the deductible, and the insurer will cover the rest based on the 80:20 coinsurance.

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Lisha

2 months ago

I agree with you, D is the correct answer. Keshav will pay Rs. 500 and the insurer will cover the rest.

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Myra

2 months ago

I believe A is the correct answer. The insurer will pay Rs. 16,500 and Keshav will pay Rs. 3,500.

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Erin

2 months ago

I think D is the correct answer. Keshav has to pay the deductible, and the insurer will cover the rest based on the 80:20 coinsurance.

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Martin

3 months ago

D seems like the right answer. Keshav has to pay the deductible of Rs. 500, and the insurer will cover the remaining 80% of the expenses, which is Rs. 20,000.

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Erasmo

2 months ago

Exactly, that's how the coinsurance works in this scenario.

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Rory

2 months ago

So, the insurer will pay Rs. 20,000 and Keshav will only have to pay Rs. 500.

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Dominga

2 months ago

Yes, that makes sense. The insurer will cover 80% of the expenses after the deductible.

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Vanesa

2 months ago

I think D is the correct answer. Keshav has to pay the deductible of Rs. 500.

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Cecilia

3 months ago

The policy has a calendar-year deductible of Rs. 500 and 80:20 as coinsurance. So, the insurer will pay 80% of the remaining amount after the deductible, which is Rs. 20,000.

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Felice

3 months ago

I think the correct answer is D. The insurer will pay Rs. 20,000 and Keshav will pay Rs. 500 since the deductible is Rs. 500 and the coinsurance is 80:20.

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Coral

2 months ago

Yes, the insurer will pay Rs. 20,000 and Keshav will pay Rs. 500.

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Coral

2 months ago

I think the correct answer is D.

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