T/508/0495, Analysis of Claims

1

The total Claim payment amount was $14.7 million. The overall summary of the data is provided below in the table:

Table 1: Overall summary of claims

The mean amount of the claim was $73457.49. Standard Deviation was 32178.49. The maximum amount of claim taken by the claimants was $228724 and minimum was $1547. The data was collected from 200 claimants who have taken claims in order to get medical support. Skewness is a measure of the symmetry in a distribution. The Skewness was 1.15 and Kurtosis value was 5.99.

2

1. a) The average age of claimants

Out of 200 claimants the average age of claimant identified was 44.5 years.

1. b) The proportion of claimants with “No Insurance”.

Table 2: The proportion of claimants with “No Insurance”.

From the above table it can be understood that out of total claimants 18 claims were No Insurance. Thus, overall proportion of the No Insurance was 9%.

3.a

An industry report suggest that the average amount of paid claims has dropped below $77500. The evidence to support this argument is provided below:

Table 3: One sample Test

From the above table it was identified that significant value is 0.077 i.e. (p > 0.05). Thus, this implied that industry report statement is true as majority of claims were under $77500. The mean amount of the claim was $73457.49. Standard Deviation was 32178.49. The maximum amount of claim taken by the claimants was $228724 and minimum was $1547.

3.b

Table 4: Number of Claims on the basis of severity

From the above table it can be understood that out of 200 claims, 26 were taken for mild case, 128 for medium and 46 for severe case.

Table 5: Confidence Interval for mean

From the table it can be understood that sample mean value is 1.59 and t value is 1.9720. As the t value is greater than significance value it can be concluded that null hypothesis is supported which means that it is true that 3 out 4 claims were taken for mild or medium severity conditions.

Table 6: Confidence Interval for proportion

The count of success rate is 0.75 and z value is 1.96 which is greater than our significance value (0.05). Thus, in this case null hypothesis is supported.

3.c

Out of 200 claimants it was identified that 121 claims made by females and 79 claims were made by males which include all severity level. For Mild or Medium claimants, the difference between the amount of claim made by female and male is provided below in the table:

From the above table, it can be understood that there is no significance association between claims taken by females and claims taken by male under mild and medium severity. Female under mild severity made 2 claims and under medium severity made 21 claims whereas males under mild severity made 4 cases and under medium severity made 13 claims. This implies that females made more cases than male and thus null hypothesis is supported which is that there is significance difference in the proportion of Mild or Medium claims by female patients as compared to that of male patients.

The value of test statistics is 1.687. From the Chi-Square test it can be understood that there is significance difference in the proportion of Mild or Medium claims by female patients as compared to that of male patients as the p-value is greater than choosen significance level (α= 0.05).

3. d

In this case two hypothesis is formulated which are

H0: The average claim when a private attorney involved is not higher.

H1: The average cliam when a private attorney involved is higher.

The abvoe t test was Two-Sample Assuming Equal Variances. The p-value is 1.66 which is greater than the significance value which (α= 0.05). Thus, it can be concluded that null hypothesis is supported in this case.

The abvoe t test was Two-Sample Assuming Unequal Variances. The p-value is 2.43 which is greater than the significance value which (α= 0.05). Thus, it can be concluded that null hypothesis is supported in this case.

Thus, from both the table it can be understood that The average claim when a private attorney involved is not higher. Hence, Null hupothesis which is H0 is supported in this case.

3.e

In this case two hypothesis is formulating which are :

H1: Private Attorney representation is higher for Severe Claims.

H2: Private Attorney representation is higher for Medium Claims

Table 7: Two-Sample Assuming Unequal Variances (Severe Condition)

Table 8: Two-Sample Assuming Unequal Variances (Medium Condition)

From the above tables it has been identified that that p value for Sever Condition was 0.081 which is greater than the p value for Medium condition which was 0.06. This implied that our first hypothesis is supported which is Private Attorney representation is higher for Severe Claims.

4.a

Table 9: Percentage of severe claim with the involvement of Specialised surgeon

From the above table it can be understood that percentage of 'Severe' claim with the involvement of an Orthopaedic surgeon (16.7 %) is lower than that of other specialist.

4.b

Table 10: Average claim of orthopedic and other surgeon

Thus, from the above table it can be understood that the average claim amount for Severe claim is higher when an Orthopaedic surgeon is involved than the other specialisation. (118944.27>61522.03 )

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References

Sachs, C.J., 2018. Malpractice Claims: It’sa Crapshoot—Time to Stop the Self-Blame and Ask Different Questions.Annals of emergency medicine,71(2), pp.165-167.

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