uestion 5 (25 marks Three months ago, Natalie was hit by a car when crossing the
ID: 126943 • Letter: U
Question
uestion 5 (25 marks Three months ago, Natalie was hit by a car when crossing the road without observing the traffic light. Her legs and arms were seriously injured. Her medical bill included the following items: . 16 days of hospitalisation at $650 per day . $29,000 surgical fees $3,500 in post-hospitalisation outpatients visits (9 times) 12 days of home nursing service totalling $13,000 AND . $9,000 physiotherapy treatment Coverage of health insurance bought by Natalie is as follows: Coverage Room and board Room and board (intensive care unit) Home nursing fees Maximum benefits per disability (HK$) Maximum limit per day: $800 per day Maximum no. of day: 120 days Maximum limit per day: $2,000 per day Maximum no. of day: 30 days Maximum limit per day: $500 per day Maximum no. of day: 35 days Lower of $12,000 or 80% of total Physiotherapy fees Pre- and post-hospitalisation outpatient visits Surgical fees S5,500 S35,000 (with $6,000 deductible) $400 per day Hospital cash Maximum no. of day: 60 days (a) What is hospital cash? (5 marks) (b) Calculate the dollar amount borne by the insurance company for each item in Natalie' medical bills. Show all working (10 marks) (c) Calculate the total dollar amount borne by Natalie for the accident. Show all working. (10 marks)Explanation / Answer
(a) Hospital Cash:
Hospital cash is the sum of the amount payable by the policyholder for each day as she taken treatment as an inpatient.
Coverage of Health insurance for Natalie is $400 per day for a maximum of 60 days.
She has been hospitalized for 16 days at a cost of $650 per day.
Total amount of Hospitalization is $650*16 =$10400.
so the insurance coverage is $400*16 = $6400.
The remaining amount is $250*16 = $4000 has to be paid from her pocket.
(b) Amount Covered by the Insurance Company from Natalie's medical Bills:
Post HospitalizationOutpatient visits
The Total dollar amount covered by the insurance company in Natalie's medical bill is 53900.
(c) The total amount was borne by Natalie for the accident:
The Total amount of Natalie's medical Bill for the accident is $64900.
The total amount covered by Insurance company for Natalie is $53900.
The total amount was borne by Natalie's for the accident is $11000.
Medical Bill Insurance Coverage Hospitalization 400*16 = $ 6400 Surgical Bills $29000Post HospitalizationOutpatient visits
$3500 Home nursing service $6000 Physiotherapy $9000 Total $53900Related Questions
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