10Life Personal Accident Scoring Methodology

1. Overview

Accidental Death and Dismemberment Score

10Life considers the actual benefits covered, taking into account different levels of severity, including accidental death and dismemberment.

Medical Score

10Life evaluates the medical coverage based on the medical expenses of 4 common treatments for injuries, including MRI scan for bones, CT scan for brain, Tetanus Toxoid for wound and Anterior cruciate ligament surgery.

Physiotherapy Score

It is calculated based on the physiotherapy expenses that are covered by the policy.

Chinese Medical Practitioner Score

It is calculated based on the covered expenses of visiting a Chinese Medical Practitioner.

2. Score Weighting

3. Assumptions

10Life scoring model takes into account the varying personal accident insurance coverage and premium based on the age group and occupation of the insured. We assume the insured is a 35 years old normal office worker.

4. Accidental Death and Dismemberment Score Details

The Accidental Death and Dismemberment score comprises two sub-scores: the Accidental Death Score and the Dismemberment Score.

The Accidental Death Score is calculated based on the death benefits provided for the insured.

The Dismemberment Score is calculated based on the benefits provided for the insured in the cases of 19 losses, including but not limited to Loss of or Permanent Total Loss of Use of Two Limbs, Permanent Total Loss of Sight of Both Eyes, Permanent Total Loss of Hearing of both ears etc.

5. Medical Score Score Details

The Medical Score is calculated based on the medical expenses of 4 common treatments for injuries, including MRI scan for bones, CT scan for brain, Tetanus Toxoid for wound and Anterior cruciate ligament surgery.

The relevant medical expense categories and the relative proportions vary under the 4 cases studied. Using these estimated costs in each case, 10Life actuaries then refer to the benefit limits on each expense category to calculate the estimated coverage amount (to be paid by the insurer) and out of pocket expenses (to be paid by the policyholder).

Common Therapy	Estimated Medical Expense (HKD)
MRI Scan for Bones	$17,000
CT Scan for Brain	$9,000
Tetanus Toxoid for Wound	$1,900
Anterior Cruciate Ligament Surgery	$102,100

6. Physiotherapy Score Details

The Physiotherapy Score is calculated based on:

Estimated coverage for visiting physiotherapists with assumptions on the number of visits and cost per visit.

7. Chinese Medical Practitioner Score Details

The Chinese Medical Practitioner Score is calculated based on:

Estimated coverage for visiting chinese medical practitioners with assumptions on the number of visits and cost per visit.

Updated on 18 Sept, 2023

Disclaimer

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