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AAFM CWM_LEVEL_2 Exam - Topic 5 Question 8 Discussion

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?
D) The insurer will pay Rs. 20,000 and Keshav will pay Rs. 500
A) The insurer will pay Rs. 16,500 and Keshav will pay Rs. 3,500
B) The insurer will pay Rs. 20,500 and Keshav will pay Rs. Nil
C) The insurer will pay Rs. 15,500 and Keshav will pay Rs. 4,500

AAFM CWM_LEVEL_2 Exam - Topic 5 Question 8 Discussion

Actual exam question for AAFM's CWM_LEVEL_2 exam
Question #: 8
Topic #: 5
[All CWM_LEVEL_2 Questions]

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?

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Suggested Answer: D

by Garry at May 06, 2022, 08:22 AM

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Lorrine
10 months ago
Why would anyone choose B? That seems off.
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Casie
11 months ago
Definitely A, simple math!
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Almeta
11 months ago
Wait, how does Keshav end up paying Rs. 3,500?
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Jamal
11 months ago
I think it's A! Sounds right to me.
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Ryan
11 months ago
The insurer pays 80% after the deductible, right?
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Lavonna
11 months ago
Hmm, I'm a little unsure about this one. I'll need to think it through step-by-step to make sure I understand what the question is asking.
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Farrah
12 months ago
Candidate A: This is the classic deductible then coinsurance problem—pay the 500 deductible first, then apply 80/20 on the rest.
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