IC27 Mock Test Sample 13
These questions focus on core concepts of health and general insurance, including policy features, fraud detection, and regulatory aspects. Key topics include IRDAI guidelines like grace period, IBNR claims, and waiting periods. Concepts such as co-payment, data warehousing, and KYC are highlighted for operational efficiency and fraud prevention. The role of ESI and ESIS in healthcare delivery is emphasized, along with insurance product structures like floater policies. Reinsurance principles and historical milestones like the 1972 nationalization act are also covered. Overall, the set builds understanding of insurance functioning, risk management, and healthcare financing mechanisms in India.
1. What is the grace period (in days) which IRDAI has mentioned from the date of renewal with continuity in benefits?
a) 7 days
b) 15 days
c) 20 days
d) 30 days
2. Insurance contracts are different from other contracts because _____.
a) It does not result in profit for any of the parties
b) It is based on the principle of 'Utmost Good Faith'
c) It protects the assets
d) It covers uncertain losses
3. Which parameter can be used as a trigger to detect fraudulent claims?
a) Availability of post-operative histopathology reports
b) Lower per patient average medical tests
c) Costlier investigations with justification
d) Medical bills in serial order
4. IBNR claims are _____.
a) Incurred But Not Reviewed
b) Incurred But Not Reported
c) Involved But Not Responsible
d) Incurred But Not Responsible
5. When did life and non-life insurance companies arrive in modern form?
a) Early 17th century
b) Early 18th century
c) Early 19th century
d) Early 20th century
6. Strategy where employees share medical costs and premiums is called _____.
a) Deferred vesting strategy
b) Co-payment strategy
c) Deferred co-payment strategy
d) Deferred payment strategy
7. Repository of an organization’s electronically stored data is _____.
a) Data exchange
b) Data warehouse
c) Data center
d) Servers
8. Health expenditure in India (2008-09) was about ____ of GDP.
a) 2.75%
b) 2.12%
c) 3.54%
d) 4.13%
9. Fraud by medical consumable vendors is _____.
a) Hard fraud
b) Soft fraud
c) External fraud
d) Internal fraud
10. Waiting period for first-time mediclaim policy is ____ days.
a) 15
b) 30
c) 45
d) 60
11. ______ helps identify average premium per person.
a) Earned premium analysis
b) Age distribution analysis
c) Claims probability distribution analysis
d) Group size distribution analysis
12. ESI provides comprehensive care to _____.
a) Employees of industrial sector and families
b) Employees of private sector
c) All adult citizens
d) Army employees
13. Floater policy sum insured _____.
a) Has investment component
b) Is transferable
c) Is limited to 2 members
d) Can be used by any member
14. KYC helps prevent which fraud?
a) Health checkups undergone
b) Cash defalcation
c) Cash favors
d) Providing wrong address
15. Which is NOT used to detect fraud?
a) No relation between diagnosis & investigation
b) Less hospital stay than expected
c) Higher patient visit numbers
d) Excessive patients per doctor
16. Technical head of district health system is _____.
a) Chief medical officer
b) Chief technical advisor
c) Main district doctor
d) Health officer
17. How does ESIS provide services?
a) Only own dispensaries
b) Only own hospitals
c) Only private hospitals
d) Through dispensaries and hospitals
18. Cashless cover reduces need for surplus _____.
a) Mutual funds
b) Medicines
c) Insurance covers
d) Liquidity
19. General Insurance Business (Nationalisation) Act year?
a) 1961
b) 1972
c) 1984
d) 1987
20. Which is NOT correct about reinsurance?
a) Risk transfer mechanism
b) Does not require underwriting skills
c) Transaction between insurers
d) Requires underwriting skills
