Ex. 2 - Interaction with Medicare
Hi there,
Was hoping someone could clarify something again for me 
Sort of an irrelevant question, but the situation is "A 70-year-old is injured by another driver in an auto accident in the course of his employment. Who pays the medical costs?"
The solution says WC but that liability insurance is the primary payer - I'm wondering how the responsibility to pay is split between WC and liability since both seem to be primary? I'm not sure if the CAS would ask this particular question but on the off chance that they do, I'd appreciate any insights! Thank you.
Comments
In this case, by law, WC is primary and Medicare is secondary, so the primary pays. However, some insurers have been known to get around this by not informing Medicare that the injury was sustained on the job. The wiki has an explanation to this effect.
https://battleacts6us.ca/wiki6us/Germani.GovtIns#Interaction_of_WC_with_Medicare
I get that Medicare is secondary - I was wondering how it would be split between the WC insurance and the auto liability insurance? Like would the auto liability be primary over WC in this case because the person was injured by someone else?
I see. In this case where there are multiple primary coverages, presumably from different insurers, I think the subrogation proceedings would determine the final split between WC and CAL. This really falls under insurance contract law, so I wouldn't expect to see this type of question in Exam 6.
Ah, gotcha, that is great to hear then. Thank you for responding so quickly!!