Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 2/5
Why do most individual medical expense policies exclude injuries arising out of the insured's employment?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Medical expense policies routinely exclude injuries that arise out of and in the course of employment because workers' compensation insurance is designed to be the primary source of benefits for occupational injuries. Excluding work-related injuries avoids duplicate coverage and premium duplication. California requires most employers to carry workers' compensation, which pays the medical costs of job injuries regardless of fault.
Why the other options are wrong
- B) Employers are generally required to provide workers' compensation for occupational injuries, not for non-occupational injuries; the exclusion targets work-related care.
- C) Medicare is for individuals 65 and older or certain disabled persons; it is not the primary payer for workplace injuries.
- D) Employers do not buy individual accident policies for all workers; the workers' compensation system fills that role.
Memory hook
Job injury, workers' comp pays first. That is why the health policy bows out of the workplace.