IC27 Mock Test Sample 8
These questions cover key concepts of health insurance, underwriting, fraud prevention, and regulatory mechanisms. They highlight how insurers collect data through proposal forms, assess risks like credit risk, and use analytics such as claims analysis by sum insured. The importance of government data usage for policy-making and sector monitoring is emphasized. Concepts like reinsurance capacity, benefit policies, and critical illness coverage are explained. Fraud prevention measures and grievance redressal systems like State Commissions are included. The questions also address healthcare systems (UK funding, RSBY governance) and ethical principles from ancient texts, along with challenges like reinsurer withdrawal in soft market conditions.
1. Which type of hospitals in India are often restricted to the employees of large organizations and their dependents?
A) Rural hospitals
B) Specialty and teaching hospitals
C) Primary Health Centres (PHCs)
D) Hospitals and dispensaries of railways, defense, and similar large departments
2. Which document helps a company to collect details like health status, income, premium etc?
A) SAP Report
B) Sales reports
C) Proposal form
D) Medical reports
3. 'Distribution of number of claims paid and the corresponding claim amount paid for different ranges of sum insured' can be seen from which type of analysis?
A) Net Premium paid analysis
B) Claims analysis by sum insured
C) Claims probability distribution
D) Earned premium
4. With regards to Credit Risk, which of the below options is correct?
A) Risk of default by reinsurers, providers and suppliers
B) Risk of frauds and technology failure
C) Risk of concentration
D) Liquidity risk due to long-term debt
5. Data is used by Governments for ______.
A) Analyzing claim settlements
B) Analyzing sector performance
C) Formulating social schemes
D) Keeping track of market developments
6. What is/are the reason/s for Health Insurance becoming the fastest growing segment?
A) Only statement 1 is correct
B) Only statement 2 is correct
C) Only statement 3 is correct
D) Only statements 2 and 3 are correct
7. Name the measure(s) under human interface / process improvisation for fraud prevention.
A) Comprehensive claims information
B) Audits
C) Control business when fraud is not manageable
D) Vigilance, Compliance checks
8. Who listens to the appeals against the orders of any District Forum within the State?
A) State Commission
B) District Forum
C) Ombudsman
D) Nodal officer
9. A cedant has a 10-line surplus treaty with max cession 10,00,000. Maximum gross capacity?
A) 50,000
B) 1,10,00,000
C) 1,00,00,000
D) 11,00,000
10. Seema attempted suicide and incurred ₹20,000 hospital cost. How much will insurer reimburse?
A) ₹1,00,000
B) ₹20,000
C) ₹20,000 + physiotherapy
D) ₹50,000
11. Fill in the blank: Prescribing correct qualifications helps to ______.
A) Prevent mis-selling
B) Ensure renewal rights
C) Cap waiting periods
D) Protect access rights
12. Mr. Suraj had two benefit policies. What will be paid?
A) X: 16,000, Y: 24,000
B) 20,000 each
C) X: 25,000, Y: 40,000
D) X: NIL, Y: 40,000
13. Which statement is TRUE about health savings investment-linked plans?
A) Only investment happens
B) Only health coverage exists
C) Premium is split into risk and investment
D) Discourages savings
14. Under Critical Illness benefit, ______ amount is given.
A) Reasonable
B) Proportionate
C) Lump sum
D) Fixed
15. CSMBS, UCS, SSS belong to which country?
A) India
B) Bangladesh
C) Thailand
D) Japan
16. Who runs/governs the Rashtriya Swasthya Bima Yojana (RSBY)?
A) Commerce Ministry
B) Insurers
C) IRDAI
D) Government
17. How is healthcare primarily funded in the UK?
A) Commercial insurance
B) Tax funded system
C) Out-of-pocket
D) Social insurance
18. Which is NOT a key tool for underwriting?
A) Financial documents
B) Medical reports
C) Commission reports
D) Proposal form
19. Manusmrithi and Dharmasastra refer to ______ of resources and ______ them during calamities.
A) Collection, usage
B) Stocking, distributing
C) Pooling, distributing
D) Usage, collecting
20. What is the main disadvantage when a reinsurer withdraws from a treaty due to soft market?
A) Difficulty re-entering later
B) Loss of all business
C) Expensive retrocession
D) Claims not payable
