IC27 HEALTH INSURANCE EXAM - 06
| Q1.Which of the below options will NOT be used by an insurance company to detect fraud or as a trigger to detect fraud? |
| Not much relation between diagnosis of the ailment and the investigations done |
| Less than expected stay in hospital for treatment |
| Higher per patient average visit numbers |
| Excessive patients per doctor in a hospital |
| Expensive investigations carried out without proper justification |
| Q 2. The waiting period for mediclaim policies that are applicable for the first time the policy is taken is _ days. |
| 15 |
| 30 |
| 45 |
| 60 |
| 90 |
| Q3.____ helps in identifying the average premium (on per person basis) for both group and individual policy. |
| Earned premium analysis |
| Age distribution analysis |
| Claims probability distribution analysis |
| Group size distribution analysis |
| Written premium analysis |
| Q4.The technical head of the health system in the district is the ____. |
| Chief medical officer |
| Chief technical advisor |
| Main district Doctor |
| Health officer |
| Principal secretary |
| Q5.How does the ESIS provide its services? 1. Through its own dispensaries 2. Through its own hospitals 3. Through a network of private hospitals |
| k of private hospitals |
| Only statement 2 is correct |
| Only statement 3 is correct |
| Statements 1 and 2 are correct, 3 is incorrect |
| Statements 2 and 3 are correct, 1 is incorrect |
| Q6.When a person has cashless health cover, it minimizes the need to keep surplus ____. |
| Funds in mutual funds |
| Medicines |
| Insurance covers |
| Insurance covers |
| Liquidity |
| Q7.Which analysis shows the percentage number of claims settled on each month-end in proportion to the total number of claims paid up to the end of the year? |
| IBN |
| Claims analysis by sum insured |
| Payment duration analysis |
| Claims analysis by geographical location’s |
| Earned premium analysis |
| Q8.Which of the below options is NOT CORRECT with respect to reinsurance? |
| It is a risk transfer mechanism |
| It does not require underwriting skills |
| It is a transaction between insurance companies |
| It requires underwriting skills |
| It is insurance for insurers |
| Q9.Suresh bought a basic health insurance policy with a cover of Rs 2 lakhs. His friend who is also an insurance agent, recommended him to top up his current plan, which will cost less than taking a new insurance policy. So Suresh opted for an affordable top-up plan with a sum insured of Rs 5 lakhs and a deductible of Rs 3 lakhs. The policy benefit of Rs 5 lakhs will kick in only - |
| After reaching the limit of threshold Rs 1 lakhs |
| After reaching the limit of threshold Rs 2 lakhs |
| After reaching the limit of threshold Rs 3 lakhs |
| After reaching the limit of threshold Rs 5 lakhs |
| After reaching the limit of threshold Rs 7 lakhs |
| Q10.In which year was the General Insurance Business (Nationalisation) Act promulgated? |
| 1961 |
| 1972 |
| 1984 |
| 1987 |
| 1995 |