IC27 Mock Test Sample 9
These questions focus on key aspects of health insurance, public healthcare systems, and fraud prevention. They highlight the role of underwriting departments in performance benchmarking and emphasize how schemes like NRHM are centrally funded but implemented by states. Various fraud types, especially external and provider-driven frauds, are discussed along with preventive measures like fraud databases. The importance of IRDA microinsurance regulations and benefit-based policies is covered. Insights into India’s healthcare spending patterns, dominance of private sector, and drug expenses are included. The role of regulatory bodies like NPPA and global healthcare models such as NHS and social health insurance systems are also explained.
1. Which department of insurance companies use data to benchmark the performance of underwriting offices and staff members?
A) Human Resources Department
B) Finance Department
C) Underwriters Department
D) Actuaries Department
2. Which of the following statement is correct?
A) NRHM is funded by Centre and implemented through Central machinery
B) NRHM is funded by state and implemented through Central machinery
C) Public health falls under Concurrent List
D) NRHM is funded by Centre and implemented through State machinery
3. The frauds which are perpetrated by medical service providers against an insurance company or its policy holders are known as _______.
A) Medical frauds
B) Internal fraud
C) External fraud
D) Soft fraud
4. Which could be a measure under 'technology and process interface' for fraud prevention?
A) Effective judicial action
B) RAG analysis
C) Sound whistle blower policy
D) Creation of fraud database
5. In which year were the IRDA Micro Insurance regulations framed?
A) 2000
B) 2003
C) 2004
D) 2005
6. Mr. Satish bought a health insurance cover of Rs 50,000 (benefit policy). He incurred Rs 20,000 expense. What will he get?
A) Rs 20,000
B) Rs 50,000
C) Rs 70,000
D) Rs 10,000
7. What percentage of allopathic doctors in India are in the private sector?
A) 52%
B) 75%
C) 77%
D) 82%
8. What percentage of private health expenditure accounts for total health spending in India?
A) 52%
B) 75%
C) 82%
D) 77%
9. What percentage of household health expenditure is spent on drugs in India?
A) Less than 10%
B) Around 25%
C) Over 50%
D) Approximately 30%
10. Which component of government health expenditure is about one-tenth?
A) Drug procurement
B) Hospital infrastructure
C) Medical equipment
D) Healthcare workforce
11. What was the first standardized health insurance product in India?
A) HealthShield
B) HealthGuard
C) MediCare
D) Mediclaim
12. What percentage of health spending in India is by private sector?
A) 25%
B) 50%
C) 75%
D) 82%
13. Which organization regulates pharmaceutical prices in India?
A) NPPA
B) Ministry of Health
C) Drug Controllers
D) NHRA
14. What makes health insurance different from other insurances?
A) Covers health expenses
B) Involves third party (healthcare provider)
C) Government regulated
D) Lower premiums
15. Why is health insurance considered an imperfect market?
A) Not profitable
B) Covers health expenses
C) Third party involvement
D) Information asymmetry & moral hazard
16. Which scheme was introduced in 1954 for central government employees?
A) ESIS
B) CGHS
C) NRHM
D) ICDS
17. What is the primary funding source of NHS (UK)?
A) Social insurance
B) User fees
C) Taxes
D) Private insurance
18. Which method is employment-based health insurance?
A) Government funding
B) Social health insurance
C) User fees
D) Private insurance
19. Which financing guarantees basic healthcare to all residents?
A) Social insurance
B) Private insurance
C) User fees
D) Government funding
20. How is ESI Corporation financed in India?
A) Government only
B) Employers only
C) Employees only
D) Employers + Employees + Government
