AAFM CWM_LEVEL_2 Exam - Topic 5 Question 8 Discussion

Actual exam question for AAFM's CWM_LEVEL_2 exam

Question #: 8
Topic #: 5

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 Garry at May 06, 2022, 08:22 AM

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5 months ago

Candidate A: This is the classic deductible then coinsurance problemâ€”pay the 500 deductible first, then apply 80/20 on the rest.

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