Q 1. Health insurance is often prone to insurance related frauds. In health insurance frauds, co-operation is required from ___________ to organize a fraud. Which are these?
Q 2. What do we mean by ?information asymmetry? under health insurance?
Q 3. A good data warehouse system should be able to provide host of information to various sectors to facilitate reporting and analysis. It should be able to: 1. Archive historical data keep periodical backups 2. Perform basic and advanced data validation 3. Provide flexibility to the user to access data from different locations
Q 4. The channels for registering complaint for personal insurance claims by the policyholders are: 1. Civil and Consumer Courts both 2. Only Consumer courts 3. Policyholder can approach Ombudsman also
Q 5. Healthcare costs are financed through various sources and methods. Which of the following option(s) is/are incorrect? 1. Commercial Health Insurance 2. Social Health Insurance 3. Government taxes and revenues 4. Contributions from individuals
Q 7. Many insurers are providing innovation to the personal accident policies. Which of the following innovation/s are being offered under the policy?
Q 8. Actuarial science is a blend of four subjects. Which of the following is not a subject to consider?
Q 9. The health insurance policy covers the cost of room charges following hospitalization. Generally, the insurers cover the room charges up to a limit of:
A) 1% of the sum insured
B) 10% of the sum insured
C) 1% of the sum insured up to a specified limit
D) 5% of the sum insured
E) 15% of the sum insured
Q 11. With respect to the rules for reference to the Ombudsman for grievance redressal, which of the following is incorrect?
Q 12. Cost sharing provisions like sub-limits on hospital cost, co-payment and deductibles reduces the amount of claim payable to the insured. Which of the following statement/s is/are true in the above context? 1. No way, the insured is getting a reduced indemnity 2. Since the benefit is reduced to the extent of deductible, insured is always a loser 3. The insured is getting the benefit of reduced liability in the form of reduction in premium
Q 13. Under group health insurance, which of the following questions are not usually asked in the proposal form?
Q 14. Imperfect market is what economists have described as health insurance for various reasons. Which of the following is not a reason for being an imperfect market?
Q 16. Regulatory actions for breaches or violations can include: 1. Issuing warnings to the insurer 2. Appoint Liquidator/ Observer/ Administrator etc. 3. Blacklisting the insured
Q 17. Which of the following is a non-stand ard age proof document?
Q 18. Uberrima Fides supports which of the following principle of insurance.
Q 19. Out of pocket medical expenses is very high in India compared to other countries. What percentage is this expenditure in India accounts for?
Q 20. Cost-sharing is a measure adapted by the insurers to reduce their cost and the insured has to share a higher spending. Which of the following is not a cost-sharing mechanism?
Q 21. What is the role of Central Council of Health? 1. It manages the finances of health programs of the State and Center 2. It acts as a link between Center and State 3. It works towards promoting coordinated and concerted action between the Center and States
Q 22. Why is health insurance sector considered as a ?BLEEDING? sector?
Q 23. Primary care can be described as _______
Q 25. In Japan, if the premium for Long life medical care plan is say 20000 Yen, what will be the contributions from general tax revenues?
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