Medical Insurance Expert Witnesses & Co-Payments Part 2

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Medical insurance expert witnesses may opine on health insurance claims, medical insurance deductibles, and related topics. In Understanding Co-Payments, Deductibles and Co-Insurance Scott Cornelius, board member of the Independent Agents of Oklahoma City, writes:

But health insurance companies take their position as insurers very seriously and they have a method for dealing with the risk of claims. First, they underwrite applications so that they fully understand the risks presented by each individual applicant (and for group insurance they look at the experience of similar groups). Next they review the applicant’s choice of policy so they can decide what rates they need to charge based on the risks that are self-insured through flexible policy options such as deductibles, co-insurance and limits. Finally, they structure each policy with a set of pre-determined prices (also called co-payments) for different medical treatment and the service of certain providers.

All these different facets of a health insurance policy can be very confusing, but understanding the differences between co-payments, deductibles and co-insurance is probably the most difficult.

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