IC27 Mock Test Sample 16
Health insurance involves principles like utmost good faith, indemnity, and insurable interest. Cashless facilities reduce the need for liquidity, while underwriting depends on factors like age and health status. Documentation plays a key role in claim settlement, and lack of it may lead to partial claim reductions. Different product lines include indemnity, fixed benefit, and critical illness covers. Policies vary between individual and group formats. Hospitalization indemnity plans cover actual expenses, unlike benefit-based policies which pay fixed sums. Customer confidence relies on quality control and transparency. Overall, health insurance ensures financial protection, efficient risk management, and improved access to healthcare services.
1. What could be a reason for partial reductions in claimed amount?
a) Lack of liquidity in insurance companies
b) Lack of proper documentation by insured
c) Misguided advice by TPA
d) Lack of proper documentation by hospital
2. When a person has cashless medical cover, he need not keep surplus ______.
a) Hospital list
b) Insurance covers
c) Medicines
d) Liquidity
3. Which of the following is NOT a core principle of an insurance contract?
a) Uberrima Fides
b) Indemnity
c) Benefit
d) Insurable interest
4. A score of 4.1 was received for which option related to customer feedback?
a) Call recording and quality check on telesales personnel
b) Regular assessment of hospitals
c) Customer complaints & grievance handling system
d) Online customer feedback process
5. For which type of health insurance are age and health status important underwriting factors?
a) Family
b) Individual
c) Community
d) Corporate
6. In case of misrepresentation by proposer, who has to prove it?
a) Insurance agent
b) Signatory of contract
c) Insurer
d) Insured
7. ______ depends on investment mix and economic environment.
a) Investment risk
b) Liquidity risk
c) Speculative risk
d) Insurance risk
8. What maintains customer confidence in health insurance promise?
a) Management
b) Advisory body
c) Financial control
d) Quality control
9. Which are product lines of health insurance?
a) Fixed benefit covers
b) Critical illness cover
c) Indemnity health insurance
d) All of the above
10. Select correct statements about policies:
a) Only statements 1 and 3
b) Both 1 and 2 incorrect
c) Only statement 2 correct
d) Only statements 2 and 3
11. Which organization initially offered health insurance in India?
a) General Insurance Corporation of India
b) Life Insurance Corporation of India
c) Reserve Bank of India
d) National Health Authority
12. Health insurance products in India are available for:
a) Only individuals
b) Only groups
c) Both individuals and groups
d) Government employees only
13. Total sum insured for Raghu’s three policies is:
a) Rs. 25,000
b) Rs. 50,000
c) Rs. 75,000
d) Rs. 1 lakh
14. Major development in health insurance in 2001:
a) Introduction of hospitalization indemnity products
b) Establishment of GIC
c) Introduction of CI products
d) Nationalization of insurance
15. Purpose of hospitalization indemnity products:
a) Cover critical illness
b) Cover all healthcare expenses
c) Provide fixed sum
d) Cover hospitalization expenses
16. Benefit-based insurance means:
a) No limits
b) Covers all expenses
c) Pays fixed sum
d) Excludes hospitalization
17. Raghu’s out-of-pocket expense was:
a) Rs. 0
b) Rs. 25,000
c) Rs. 50,000
d) Rs. 75,000
18. Which is NOT covered in hospitalization expenses?
a) Transplantation
b) Room charges
c) Doctor fees
d) Artificial limbs
19. Example of additional coverage item:
a) Room charges
b) Doctor fees
c) Surgery charges
d) All of the above
20. Chapter 5 mainly covers:
a) Waiting periods
b) Diseases/procedures
c) Cost-sharing
d) Benefits and coverage limits
