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.
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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