asked 157k views
4 votes
Rose bought three policies from the same insurer. Her benefits have exceeded the max allowed by the insurer. Which of the following will happen?

A) The insurer will deny all benefits
B) Rose will be responsible for covering the excess amount
C) The insurer will evenly distribute the benefits among the three policies
D) The insurer will pay benefits up to the maximum allowed under one policy

1 Answer

5 votes

Final answer:

If Rose's benefits exceed the maximum allowed by her insurer across three policies, the insurer is likely to pay up to the maximum limit of one policy. Any excess amount would be Rose's responsibility, as deductibles, copayments, or coinsurance involve cost-sharing to prevent moral hazard.

Step-by-step explanation:

When Rose's benefits exceed the max allowed by her insurer across her three policies, the outcome D) The insurer will pay benefits up to the maximum allowed under one policy is the typical standard protocol. In cases where multiple policies are held with a single insurer, the insurance company is often responsible for paying up to the maximum limit specified but not beyond it. Any excess amount would typically become the responsibility of the policyholder. Policies often have deductibles, copayments, or coinsurance which are designed to share the cost between the insurer and insured and reduce moral hazard. Insurance companies must balance premiums with claims, administrative costs, and profits in order to sustain their operations.

answered
User AlienOnEarth
by
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