IC27 - Health Insurance exam - 6

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Q 1. _____ would help an insurance company verify whether an individual has a good insurance track record or not.

RBI

Insurance Regulators

CIBIL

An online fraud database

Banks
 
Q 2. Insurance contracts are different from other contracts because _____.

it does not result in profit for any of the parties

It is based on the principle of 'Utmost Good Faith'

It protects the assets

It covers uncertain losses

it does not result in profit for any of the parties
 
Q 3. Which factor is not considered by an insurance company while designing its annual reinsurance program?

Estimate of profit

Size of portfolio

Volatility of claims

Extent of capital credit required

Volatility of claims
 
Q 4. Which of the following parameters can be used by insurance companies as a trigger to detect fraudulent claims?

Availability of post-operative histopathology reports

Lower per-patient average medical tests

Costlier investigations with justifications

Medical bills in serial order

Availability of post-operative histopathology reports
 
Q 5.
IBNR claims are ______.

Incurred But Not Reviewed

Incurred But Not Reported

Involved But Not Responsible

Incurred But Not Responsible

Investigated But Not Reported

 
Q 6. When did the life and non-life insurance companies arrive in their modern form?

In early 17th century

In early 18th century

In early 19th century

In early 20th century

In early 21st century
 
Q 7. What is the grace period (in days) that IRDAI has mentioned from the date of renewal which should be provided with continuity in benefits?

7 days

15 days

20 days

30 days

60 days
 
Q 8. To control the costs of health care benefits for the employees, there is a strategy in which employees have to pay the cost of medical care and insurance premiums. This is classified as _______.

Deferred vesting strategy

Co-payment strategy

Deferred co-payment strategy

Deferred payment strategy

Special payment strategy
 
Q 9. What is the repository of an organization's electronically stored data, designed to facilitate reporting and analysis?

A data exchange

A data warehouse

A data center

Servers

ERP software
 
Q 10. To whom does ESI provide comprehensive medical care?

Employees of the industrial sector and their families

Employees of the private sector

All the adult citizens of the country

Army employees

General public
 
Q 11. Which of the following is true concerning the sum insured in a floater policy?

It has an investment component

It is transferable to any relative in case of need

It is limited to 2 members per year in terms of usage of the insured amount

It can be used by any member whenever required

It can be shared by the elder members
 
Q 12. The magnitude of health expenditure in India for the year 2008-09 was about _____ of the GDP at current market prices. ( As per a study commissioned by the Ministry of Health and Family Welfare )

2.75

2.12%

3.54%

4.13%

5.33%
 
Q 13. Which type of fraud is done by medical consumable vendors against an insurance company?

Hard fraud

Soft fraud

External fraud

Internal fraud

Medical fraud
 
Q 14. Which type of fraudulent activities can be prevented by KYC?

Health checkups undergone

Cash defalcation

Cash favors

Premium deposit

Provide the wrong address to claim the benefit
 
Q 15. Which of the below options will NOT be used by an insurance company to detect fraud or as a trigger to detect fraud?

Not much relation between the diagnosis of the ailment and the investigations done

Less than expected stay in hospital for treatment

Higher per-patient average visit numbers

Excessive patients per doctor in a hospital

Expensive investigations carried out without proper justification



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