Zach Carey was a self-employed window…
Zach Carey was a self-employed window washer earning approximately $700 per week. One day, while cleaning windows on the 8th floor of the Second National Bank Building, he tripped and fell from the saffolding to the pavement below. He sustained severe multiple injuries but miraculously survived the accident. He was immediately rushed to the local hosptial for surgery. He remained there for 60 days of treatment, after which he was allowed to go home for futher recuperation. During is hospital stay, he incurred the following expenses: Surgeon: $2,500 Physician: $1,000 hosptial bill for room and board: $250 per day. nursing services: $1,200 anesthetics: $600 wheelchair rental: $100 ambulance: $150 drugs:$350 Zach has a major medical policy with Medical Benefits Corporation that has a $3,000 deductible clause, and 80% co-insurance clause, internal limits of $180 per day on hospital room and board, and $1,500 as a maximum sergical fee. The policy provides no disability income benefits.
1. Explain the policy provisions as they relate to deductibles, co-insurance- and internal limits.
2. How much should Zach recove from the insurance company? How much must he pay out of his own pocket?
3. Would any other policies have offered Zach additional protection? What about his inability to work while recovering from this injury?
4. Based on the information presented, how would you asses Zach’s health care insurance coverage? Explain.