IC39 Mock Test Sample 6
Insurance fraud and risk management involve regulatory oversight by IRDAI and global bodies like IAIS. Fraud includes misrepresentation, manufacturing defect claims, arson, and false accident claims. Legal frameworks like PMLA impose strict penalties, while AML tools like STR and CTR help detect suspicious financial activities. Policy wordings significantly impact claim outcomes, sometimes leading to genuine claims being rejected. Investigations must be impartial, relying on proper analysis and correlation of evidence. Technology such as AI and analytics improves fraud detection, especially in areas like livestock insurance. Various insurance policies cover operational risks, while fraud in personal accident insurance often involves intentional misrepresentation of causes.
1. Which regulatory body controls and monitors insurance business?
a) SEBI
b) IRDAI
c) RBI
d) CCI
2. Claiming manufacturing defect loss along with supplier replacement is:
a) Accidental damage
b) Wear and tear loss
c) Manufacturing defects fraud
d) Operator error
3. Impact of policy wordings on claims:
a) All claims payable
b) All claims logical
c) Genuine claims may be rejected due to gaps
d) No effect on claims
4. Life Insurance is defined in which Act?
a) Life Insurance Act 1872
b) Insurance Contracts Act 1872
c) Indian Insurance Regulation
d) Indian Contract Act 1872
5. State Insurance Fraud Bureaus are in:
a) Canada
b) Australia
c) United Kingdom
d) USA
6. Outcome of leniency in investigation:
a) Better cooperation
b) Enhanced trust
c) Financial benefit
d) Negative financial consequences
7. Penalty under Section 4 of PMLA:
a) Minimum 2 years imprisonment
b) Minimum 5 years imprisonment
c) 3 to 7 years imprisonment
d) Community service
8. Purpose of STR & CTR reports:
a) Customer complaints
b) Financial tracking
c) Tax compliance
d) Detect money laundering
9. Activities of Coalition Against Insurance Fraud:
a) Government affairs
b) Communication
c) Research
d) All a, b, c
10. Organization covering 97% of global insurance premium:
a) GIRN
b) IAIS
c) WIRA
d) IRCO
11. Clause C covers:
a) Fire or lightning damage
b) Theft
c) Flood damage
d) Earthquake damage
12. Common frauds in fire insurance:
a) Arson
b) Fake short circuit
c) Exaggeration
d) All of the above
13. Inadvertent misrepresentation is:
a) Fraudulent
b) Intentional
c) Inevitable
d) Not fraudulent
14. Advantage of statistical analytics:
a) Reduce workload
b) Improve detection accuracy
c) Simplify claims
d) Remove manual analysis
15. Why must investigation be impartial?
a) Personal opinion
b) Favor insurer
c) Faster claims
d) Fair financial outcome
16. Key factor in investigation conclusion:
a) Ignore observations
b) Single observation
c) Only witnesses
d) Correlation of observations
17. Technology in livestock insurance:
a) Biometric identification
b) Blockchain
c) Drones
d) AI databases
18. Operational phase insurance policies include:
a) Machinery breakdown
b) Boiler insurance
c) Electronic equipment
d) All of the above
19. Fraud in personal accident insurance:
a) Suicide/illness claims
b) Intoxication injuries
c) Genuine accident
d) Both a & b
20. Motor Vehicles Act 2019 (₹2.5 lakh coverage) applies to:
a) Death
b) Total disability
c) Partial disability
d) Property damage
