IC27 HEALTH INSURANCE EXAM - 01
| Q1.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? |
| IRDAI |
| Policyholder |
| Only hospitals |
| Intermediaries only |
| Multiple stakeholders |
| Q2.What do we mean by ‘information asymmetry’ under health insurance? |
| The insurers have all the information about the risk is called information asymmetry |
| The insured have all the information about the risk is called information asymmetry |
| The insured is in possession of all the information about the risk & lack of such information with the insurer is called information asymmetry |
| Both insured & the insurers have all the information about the risk is called information asymmetry |
| None have all the information about the risk is called information asymmetry |
| Q3.A good data warehouse system should be able to provide a 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 |
| Only statement 1 is correct |
| Only statement 2 is correct |
| Only statement 3 is correct |
| Only statements 1 and 3 are correct |
| Statements 1, 2 & 3 are correct |
| Q4.The channels for registering complaints about personal insurance claims by the policyholders are: 1. Civil and Consumer Courts both 2. Only Consumer courts 3. Policyholders can approach Ombudsman also |
| Only 1 is correct |
| Only 2 is correct |
| Only 3 is correct |
| Only 1 and 2 are correct |
| Only 1 and 3 are correct |
| Q5.Healthcare cost is financed through various sources/ 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 |
| Statement 1 is correct; Statement 4 and 3 are incorrect |
| Only statements 1 and 2 are correct |
| Statement 2 and 4 are incorrect |
| Both 1 and 2 are incorrect |
| Only Statement 4 is incorrect & statements 1, 2, and 3 are correct. |
| Q6.Which is not a criterion for deciding reinsurance program? |
| The extent of capital ‘debit’ available from the reinsurer |
| The extent of technical support needed from reinsurers |
| Mandatory requirement for reinsurance |
| Product innovation provided for the insurance plan |
| The size and claim volatility |
| Q7.Many insurers are providing innovation to personal accident policies. Which of the following innovation/s is being offered under the policy? |
| Spouse retraining expenses |
| Cost of modification of the house or vehicle to meet the medical needs of the insured after a disabling accident |
| Coverage of adventure sports performed under the supervision of a qualified trainer |
| Accidental hospital confinement allowance |
| All of the above |
| Q8.Actuarial science is a blend of four subjects. Which of the following is not a subject to consider? |
| Statistics |
| Finance |
| Mathematics |
| Economics |
| ICD - International Classification of Diseases |
| Q9.The health insurance policy covers the cost of room charges following hospitalization. Generally, the insurers cover the room charges up to a limit of 1. 1% of the sum insured 2. 10% of the sum insured 3. 1% of the sum insured up to a specified limit |
| Only statement 1 is correct |
| Only statement 2 is correct |
| Statements 1 and 3 are correct, 2 is incorrect |
| Statements 2 and 3 are correct, 1 is incorrect |
| Statements 1 and 2 are correct, 3 is incorrect |
| Q10.Which of the following is considered to be a critical illness where lump sum payment would be given the insured can use the claim amount for any purpose? |
| Ophthalmological disease |
| Tuberculosis |
| Alzheimer’s disease |
| High blood pressure |
| Bolivian hemorrhage fever |