IC27 HEALTH INSURANCE EXAM – 09

Q1.____ policy is available for both indemnity and benefit basis.
 

 Term insurance

 

 Daily hospital cash benefit

 

 Personal accident

 

 Critical illness

 

 Health insurance

 

Q2.Which of the following is a feature of a Non-Medical underwriting policy?
 

 Low premiums

 

 High premiums

 

 Processing is slow

 

 There is more waiting period

 

 There are more formalities

 

Q3.What is the reason behind asking many questions instead of a simple question about an individual’s health insurance? 1. to help the customer to think about various diseases so that he can provide the necessary information 2. to record the facts in detail which forms the basis of the contract 3. to arrange for further medical examination in all cases and making the customer ready for it
 

 Only 1 and 2 are correct

 

 Only 2 is correct

 

 Only 1 and 3 are correct

 

 Only 2 and 3 are correct

 

 Only 3 is correct

 

Q4.Approximately __ are the estimated fraudulent claims in the health insurance industry.
 

 0 to 5%

 

 10 to 15%

 

 15 to 20%

 

 20 to 25%

 

 More than 50%

 

Q5.What is the group called which is involves consumers, physicians, agents, providers, etc. in making a series of false claims?
 

 Speculators in insurance

 

 Fraud rings

 

 Collusion with TPA

 

 False claims

 

 Collusion with providers

 

Q6.Who studies the data and the pattern indicated to decide on the acceptance or denial of a risk?
 

 Marketing Department

 

 Actuaries

 

 Management

 

 Finance Department

 

 Underwriters

 

Q7.What does it refer to if after doing numerical ratings, the final rating comes out to be 120?
 

As the applicant is at risk of 120%, the policy thus will not be granted to him

 

As the applicant is at extra risk of 20%, the policy thus will be priced accordingly

 

 The applicant will have to pay 120% of the standard premium rate

 

As the applicant is at a risk of 20%, the policy thus will be priced accordingly

 

As the applicant is at a reduced risk of 20%, the policy thus will also be priced accordingly

 

Q8.Factors like age, sex and race are scored to determine the level of risk in which of these method(s)? 1. Numerical rating method 2. Medical underwriting 3. Non-medical underwriting
 

 Only 1

 

 Only 2

 

 Only 3

 

 Both 1 and 2

 

 Both 1 and 3

 

Q9.With respect to the ‘best practice survey on grievance redressal’ – which of the following option(s) is/are correct? 1. These best practices are circulated amongst the insurance companies for their reference and for a rating in terms of importance 2. Was undertaken by the CII Communication and awareness working group 3. This best practice questionnaire was sent to all the General Insurance and stand-alone Health insurance companies of which only 40% responded
 

 Only statement 1 is correct

 

 Only statement 2 is correct

 

 Only statement 3 is correct

 

 Both 1 and 2 are correct

 

All 1, 2, and 3 are correct

 

Q10.While taking a medical policy, Mr. Soham conceals a serious medical condition. If this condition was known to the insurers, they would have denied or excluded it from the scope of coverage. What fraud has Mr. Soham committed?
 

 Concealment fraud

 

 Claims fraud

 

 Staging claims fraud

 

 Application fraud

 

 Eligibility fraud

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