IC27 Mock Test Sample 16
These questions focus on key principles and features of health insurance such as insurable interest, indemnity, and utmost good faith. They highlight underwriting factors like age and health status, and emphasize documentation’s role in claim settlement. Cashless facilities reduce liquidity needs, while indemnity products cover actual hospitalization expenses. Health insurance products are available for both individuals and groups, with GIC playing an early role in India. Concepts like customer feedback, fraud prevention, and regulatory frameworks ensure transparency and trust. Differences between benefit and indemnity policies, along with coverage inclusions and exclusions, help in understanding how claims and reimbursements work in real scenarios.
1. Insurance would become a gambling transaction if there was no principle of ______.
a) Fixed returns
b) Proximate cause
c) Uberrima Fides
d) Insurable interest
e) Indemnity
2. What could be a reason for partial reduction 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 TPA
e) Lack of proper documentation by hospital
3. When a person has cashless medical cover, he need not keep surplus ______.
a) Hospital list
b) Insurance covers
c) Medicines
d) Prescriptions
e) Liquidity
4. Which of the following is NOT a core principle of insurance contract?
a) Uberrima Fides
b) Indemnity
c) Benefit
d) Insurable interest
e) Contribution
5. A score of 4.1 for customer feedback (post-sales dissonance) relates to?
a) Call recording & telesales quality checks
b) Hospital assessment
c) Grievance handling system
d) Online feedback process
e) Customer satisfaction surveys
6. For which type of health insurance are age and health status important underwriting factors?
a) Family
b) Individual
c) Community
d) Corporate
e) Group
7. In case of misrepresentation by proposer, burden of proof lies with ______.
a) Insurance agent
b) Signatory
c) Insurer
d) Insured
e) Healthcare provider
8. ______ depends on investment mix and economic environment.
a) Investment risk
b) Liquidity risk
c) Speculative risk
d) Insurance risk
e) Business risk
9. Key for maintaining confidence in health insurance promise?
a) Management
b) Advisory body
c) Financial control
d) Quality control
e) Regulation
10. Product lines of health insurance include?
a) Only 1
b) Only 2
c) Only 3
d) Only 1 and 2
e) All 1, 2 and 3
11. Select correct statements:
a) Only 1 and 3 correct
b) 1 and 2 incorrect
c) Only 2 correct
d) Only 2 and 3 correct
e) Only 1 correct
12. Which organization initially offered health insurance in India?
a) GIC
b) LIC
c) RBI
d) NHA
e) WHO
13. Health insurance products in India are available for?
a) Individuals only
b) Groups only
c) Both individuals and groups
d) Govt employees only
e) Senior citizens only
14. Total sum insured for Raghu’s family?
a) Rs 25,000
b) Rs 50,000
c) Rs 75,000
d) Rs 1 lakh
e) Rs 1.25 lakh
15. Major development in 2001 in Indian health insurance?
a) Hospitalisation indemnity products
b) Establishment of GIC
c) Critical illness products
d) Nationalization
e) Expansion of govt facilities
16. Primary purpose of hospitalisation indemnity products?
a) Critical illness cover
b) Cover all expenses
c) Fixed sum payment
d) Cover hospitalization expenses up to limit
e) Govt employee cover
17. Difference between indemnity and benefit insurance?
a) No limits
b) Covers all expenses
c) Fixed sum irrespective of expenses
d) Excludes hospitalization
e) Same basis
18. Out-of-pocket expense by Raghu?
a) Rs 0
b) Rs 25,000
c) Rs 50,000
d) Rs 75,000
e) Rs 1.25 lakh
19. Which is NOT typically covered under hospitalization?
a) Transplantation
b) Room charges
c) Doctor fees
d) Artificial limbs
e) Pacemakers
20. Example of additional coverage item?
a) Room charges
b) Doctor fees
c) Surgery charges
d) Pacemakers
e) All of the above
