IC27 - Health Insurance exam - 10

Explore Additional Mock Tests Here



Q 1. Which of the following is covered under Benign Brain Tumor?

Malformation of arteries of the brain

Malformation of veins of the brain

Pituitary tumors

Non-cancerous tumor in the brain

Tumors of the skull bones

Q 2. Which department oversees all the processes of the company and most comprehensively checks whether all the processes are available in an integrated manner?

Audits

Vigilance and compliance checks

Fraud investigation

Propensity modeling

Enterprise risk and internal control

Q 3. State Commission established by the state government has the financial jurisdiction of taking up the cases where the total value of the complaint is:

Up to Rs. 1 crore

Any amount of claim exceeding Rs. 20 lakhs

Up to 20 lakhs

Above 1 crore

Claim over Rs. 20 lakhs but not exceeding 1 crore

Q 4. A health insurance contract is based on the principles of contract law. It must have mutual consent in the form of 1. The proposal from the customer 2. The proposal from the insured 3. Acceptance by the insurer

Statements 1 and 2 are correct, 3 is incorrect

Statement 1 is correct, but 2 and 3 are incorrect

Statement 3 is correct, but 1 and 2 are incorrect

Statements 1 and 3 are correct, 2 is incorrect

Statement 2 is correct, but 1 and 3 are incorrect

Q 5. Which of the following is not a parameter to analyze the fraudulent claim or the fraudulent practice?

Excessive patients per doctor in the hospital

A pattern where the treating doctor, agents, and ailments are the same in many cases

Medical bills not in serial order

Medical bills in serial order

Short-term policyholders with lower sum insured

Q 6. The claim settlement paid by the insurance company comprises only the expenses admissible and _____.

predicted

settled

incurred

expenses predicted

expenses accrued

Q 7. What is the reinsurance contract called when it is proportional to the original insurance contract?

Profitable reinsurance

Non Profitable reinsurance

Excess of Loss

Stop Loss cover

Quota share reinsurance

Q 8. What is the maximum liability for all the claims made during the policy period?

Sum insured

Fixed amount

Lump sum payment

Cashless

Actual loss

Q 9. What is not under the scope of consumer protection regulation?

Granting / Cancellation of insurer's license

Product access

Portability of policy

Renewability and cancellation of policy

Product access

Q 10. _____ uses quota share / surplus structures for the Critical Illness insurance that they sell.

Non-Life Insurance Companies

Life Insurance Companies

SAHI companies

Mediclaim companies

Both Life and Non life insurance companies

Q 11. In _______ insurance contract. The premium is negotiable.

Life insurance

Individual insurance

Personal accident

Group insurance

Critical illness

Q 12. Give reasons as to why planning is required by individuals to take health insurance.

M mandatory by Government

The social requirements are quite low

Lack of awareness in India and only approximately 29% of people are insured for medical expenses.

Tax planning due to government policies

Hospitals do not treat properly to people without insurance

Q 13. Payments to the healthcare providers are made by the Government on behalf of users in _______.

Rural health schemes

Out-of-pocket payments

Commercial health insurance

Social health insurance

Social welfare organizations

Q 14. Which is the most critical step in data warehousing?

Business goal setting

Deciding requirements for business data warehouse

Collection of first-hand data

Defining the scope of data collection

Understanding of the available data

Q 15. With regards to Insurable Interest, which of the below statements is correct?

The person taking the insurance has no legally recognized relationship to the object of the insurance.

A person has the legal right to insure his health by taking a health insurance policy.

A person should not have a pecuniary interest in the asset he is going to get insured.

The reason why employers buy health insurance plans for their employees is because it's mandatory.

The greatest liability of a person is his health.



Explore Additional Mock Tests Here.