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A contractor's workers' compensation policy has a $2,500 deductible per claim. An employee injury results in $18,750 in medical costs and lost wages. How much will the insurance company pay?

Correct Answer

A) $16,250

Insurance payment = Total costs - Deductible = $18,750 - $2,500 = $16,250. The contractor is responsible for the deductible amount, while insurance covers the remainder.

Answer Options
A
$16,250
B
$2,500
C
$21,250
D
$18,750

Why This Is the Correct Answer

With a deductible-based workers' compensation policy, the contractor pays the deductible amount out of pocket, and the insurance company covers the remaining costs. In this case, the total claim is $18,750 with a $2,500 deductible, so the insurance company pays $18,750 - $2,500 = $16,250. This is the standard calculation for any insurance claim with a deductible.

Why the Other Options Are Wrong

Option B: $2,500

This represents the total claim amount ($18,750) without subtracting the deductible. The insurance company never pays the full claim amount when there's a deductible - the contractor must pay the deductible portion first.

Option C: $21,250

This is only the deductible amount ($2,500) that the contractor pays, not what the insurance company pays. The insurance company pays the majority of the claim after the deductible is satisfied.

Memory Technique

Think 'Deductible = Contractor's Debt' - the contractor must pay the deductible amount, and insurance picks up the remaining tab.

Reference Hint

Florida Building Code - Chapter on Construction Safety and Workers' Compensation Requirements, or Business and Finance Law section covering insurance obligations

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