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Problem:

Scott and Lisa are married and have purchased a comprehensive major medical policy that covers them and their two sons. The policy has a $500 calendar-year family deductible, a $2,600 stop-loss provision, and an 80% coinsurance clause. The following losses occur: On January 1, 2009, Lisa was treated for the flu at a cost of $200; on July 4, 2009, Scott was treated for an injury suffered while playing with fireworks at a cost of $1,500; on December 5, 2009, Scott underwent gallbladder surgery at a cost of $10,000, and on January 5, 2010, Scott was treated for a broken arm at a cost of $2,000.

Required:

Question: Evaluate how much the insurer will pay for each of these losses. You must show all calculations for full credit.

Note: Please explain comprehensively and give step by step solution.

Basic Finance, Finance

  • Category:- Basic Finance
  • Reference No.:- M91162974

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