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When a child is covered by separate insurance policies through each parent, the policy of which parent is considered primary?

a) The mother's policy
b) The father's policy
c) The child's choice
d) The policy with the lower premium

User Axelfran
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1 Answer

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Final answer:

The primary insurance policy for a child with dual coverage under each parent is determined by the 'birthday rule,' not by options a, b, c, or d. An actuarially fair premium is calculated by evaluating the risk of claims and includes consideration for profit margins of the insurance company.

Step-by-step explanation:

When a child is covered by separate insurance policies through each parent, the primary insurance policy is typically the one of the parent whose birthday (month and day, not year) occurs first in the calendar year. This rule is known as the 'birthday rule' and is commonly used in coordinating benefits between the two policies. This coordination of benefits ensures that claims are submitted in an orderly fashion. Hence, none of the options a, b, c, or d are correct in the context of health insurance coordination of benefits.

The concept of an actuarially fair premium is a pricing strategy used in the insurance industry. Actuaries calculate this based on the risk profile of insured individuals to ensure that the premium covers the expected costs of claims while also allowing for the insurance company's profit margin. In the case where an insurance company cannot gain specific information, such as family cancer histories, they would likely increase the premium for the entire group to offset the greater unknown risk.

User Justin Steele
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