IC27 HEALTH INSURANCE EXAM - 01

 
Q1.Health insurance is often prone to insurance-related frauds. In health insurance frauds, co-operation is required from _____ to organize a fraud. Which are these?
   IRDAI
  Policyholder
   Only hospitals
   Intermediaries only
   Multiple stakeholders
 
Q2.What do we mean by ‘information asymmetry’ under health insurance?
   The insurers have all the information about the risk is called information asymmetry
   The insured have all the information about the risk is called information asymmetry
   The insured is in possession of all the information about the risk & lack of such information with the insurer is called information asymmetry
   Both insured & the insurers have all the information about the risk is called information asymmetry
   None have all the information about the risk is called information asymmetry
 
Q3.A good data warehouse system should be able to provide a host of information to various sectors to facilitate reporting and analysis. It should be able to: 1. Archive historical data keep periodical backups 2. Perform basic and advanced data validation 3. Provide flexibility to the user to access data from different locations
   Only statement 1 is correct
   Only statement 2 is correct
   Only statement 3 is correct
   Only statements 1 and 3 are correct
   Statements 1, 2 & 3 are correct
 
Q4.The channels for registering complaints about personal insurance claims by the policyholders are: 1. Civil and Consumer Courts both 2. Only Consumer courts 3. Policyholders can approach Ombudsman also
   Only 1 is correct
   Only 2 is correct
   Only 3 is correct
   Only 1 and 2 are correct
   Only 1 and 3 are correct
 
Q5.Healthcare cost is financed through various sources/ methods. Which of the following option(s) is/are incorrect? 1. Commercial Health Insurance 2. Social Health Insurance 3. Government taxes and revenues 4. Contributions from individuals
  Statement 1 is correct; Statement 4 and 3 are incorrect
  Only statements 1 and 2 are correct
  Statement 2 and 4 are incorrect
  Both 1 and 2 are incorrect
  Only Statement 4 is incorrect & statements 1, 2, and 3 are correct.
 
Q6.Which is not a criterion for deciding reinsurance program?
  The extent of capital ‘debit’ available from the reinsurer
   The extent of technical support needed from reinsurers
   Mandatory requirement for reinsurance
   Product innovation provided for the insurance plan
   The size and claim volatility
 
Q7.Many insurers are providing innovation to personal accident policies. Which of the following innovation/s is being offered under the policy?
   Spouse retraining expenses
   Cost of modification of the house or vehicle to meet the medical needs of the insured after a disabling accident
  Coverage of adventure sports performed under the supervision of a qualified trainer
   Accidental hospital confinement allowance
   All of the above
 
Q8.Actuarial science is a blend of four subjects. Which of the following is not a subject to consider?
   Statistics
   Finance
   Mathematics
   Economics
   ICD - International Classification of Diseases
 
Q9.The health insurance policy covers the cost of room charges following hospitalization. Generally, the insurers cover the room charges up to a limit of 1. 1% of the sum insured 2. 10% of the sum insured 3. 1% of the sum insured up to a specified limit
   Only statement 1 is correct
   Only statement 2 is correct
  Statements 1 and 3 are correct, 2 is incorrect
  Statements 2 and 3 are correct, 1 is incorrect
  Statements 1 and 2 are correct, 3 is incorrect
 
Q10.Which of the following is considered to be a critical illness where lump sum payment would be given the insured can use the claim amount for any purpose?
   Ophthalmological disease
   Tuberculosis
   Alzheimer’s disease
   High blood pressure
   Bolivian hemorrhage fever

Click Here for Answer Key