IC27 Mock Test Sample 3
This set of IC27 Health Insurance questions highlights key concepts like market imperfections due to information asymmetry, adverse selection, and moral hazard. It explains insurer strategies such as cost containment and underwriting to manage risks. The questions cover government schemes like CGHS, global practices (USA, Germany), and regulatory frameworks ensuring solvency and fairness. It also focuses on customer service practices, fraud detection methods like impersonation, and claims coverage rules. Practical scenarios demonstrate reimbursement principles. Overall, it builds understanding of risk management, policy features, healthcare financing, and the role of regulation in protecting consumers and maintaining stability in the health insurance market.
1. What is one of the main reasons for the imperfections in the health insurance market, as mentioned in the passage?
a) Lack of competition among insurers
b) Information asymmetry between insurers and insured individuals
c) High pricing of insurance policies
d) Extensive government regulation
e) Overlapping coverage of insurance policies
2. What is the term used to describe the situation where a senior person is more interested in health insurance compared to a young person?
a) Adverse selection
b) Moral hazard
c) Risk pooling
d) Underwriting
e) Cost containment
3. What do health insurers use to minimize moral hazards in the context of health insurance?
a) Risk assessment tools
b) Premium discounts for seniors
c) Cost containment mechanisms
d) Underwriting guidelines
e) Government regulations
4. Why might an insurance company be more interested in providing health insurance to a young-aged person?
a) Young people are more prone to health risks
b) Young people are less interested in health insurance
c) Premiums for young people are lower
d) Young people require more medical services
e) Young people have higher incomes
5. What is demand-side moral hazard in the context of health insurance?
a) The tendency of insured individuals to use fewer health services
b) The tendency of insured individuals to make informed healthcare decisions
c) The tendency of insured individuals to accept fewer health services
d) The tendency of insured individuals to make excessive use of health services
e) The tendency of healthcare providers to provide fewer services
6. What is supply-side moral hazard in the context of health insurance?
a) The tendency of healthcare providers to offer fewer services
b) The tendency of insured individuals to avoid medical care
c) The tendency of healthcare providers to provide more expensive treatments
d) The tendency of insured individuals to underutilize services
e) The tendency of healthcare providers to restrict access
7. The benefits of which health insurance are available to Central Government employees working for civil assignments?
a) Term insurance
b) ESIS
c) CGHS
d) Travel insurance
e) Mediclaim
8. What % of the non-elderly population was covered by employment-based health benefits in the USA (2004)?
a) 47.50%
b) 50%
c) 62%
d) 76%
e) 81.50%
9. Health insurance premium is collected from employees as payroll tax in ________.
a) USA
b) Germany
c) India
d) France
e) New Zealand
10. In ___________ contracts, the Principle of Utmost Good Faith is followed.
a) Health insurance contracts
b) Purchase contracts
c) Management contracts
d) Virtual contracts
e) Service contracts
11. In the common measures taken by companies for maintaining best practices, _____ was ranked second.
a) Product brochure showing coverage and exclusions
b) Assessment of hospitals
c) Regular satisfaction survey
d) A welcome call explaining the details to the customer
e) Details on company website
12. Which option got the highest score for post-sales customer feedback measures in health insurance?
a) Call recording and quality check
b) Online customer feedback process
c) Regular customer satisfaction surveys
d) Regular assessment of hospitals
e) Customer complaints/grievance handling system
13. Which of these expenses are covered under health insurance?
- Visitors charges
- Travelling charges
- Attendant’s food expenses
a) Only 2 and 3 are covered
b) Only 1 and 3 are covered
c) Only 1 and 2 are covered
d) All three are covered
e) All three are not covered
14. Ms. Surekha purchased a Health Benefit Insurance and had hospital expenses of Rs 14000 for dengue. Coverage was Rs 20000. What amount will she receive?
a) Rs 6000
b) Rs 14000
c) Rs 20000
d) Rs 34000
e) NIL
15. __________ ministry regulates the Nutrition Support Program.
a) Ministry of Social Welfare
b) Ministry of Rural and Urban Development
c) Ministry of Labour
d) Ministry of Women and Child Development
e) Ministry of Family Welfare
16. Which regulation ensures insurers remain solvent and financial statements are true and fair?
a) Management regulations
b) Licensing and registration
c) Statutory base
d) Financial regulations
e) Product regulation
17. Mr. Shah sent another person for medical examination while buying a policy. What type of fraud is this?
a) Impersonation
b) Cash defalcation
c) Substitution
d) Non-disclosure of material facts
e) Providing wrong address
18. How is authenticity of address and presence of bogus customers checked?
a) Fraud investigations
b) Maintaining claims information
c) Training and communication
d) Making a welcome call
e) Doctor seeding
19. Why do regulators impose requirements like guaranteed issue?
a) To maintain portability
b) To standardize definitions
c) To cap waiting periods
d) To prevent arbitrary denial or cancellation
e) To protect consumer access
20. In which contracts is the Principle of Utmost Good Faith followed?
a) Health insurance contracts
b) Service contracts
c) Sales contracts
d) Real estate contracts
e) Medico-legal contracts
