IC27 - Health Insurance exam - 9
IC27 - Health Insurance exam - 9
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Q 1. Give reason(s) as to why health insurance is very important ? 1. It preserves individual savings 2. It helps in maintaining the physical fitness and health of the society 3. it provides financial access to healthcare providers in case of any illness
Only statement 1 is correct
Only statement 2 is correct
Only statement 3 is correct
Only statements 1 and 2 are correct
Only statements 1 and 3 are correct
Q 3. The critical illness products that reimburse some of the actual costs due to critical illness rather than a lump sum pay-out are priced ______ other such products.
Higher than
Lower than
Differently from
the same as
not in proportion
Q 4. In the Government's share in health expenditure, what is excluded?
The in-direct tax subsidies given to private health insurance
Cash reimbursement to patients
The direct tax subsidies given to private health insurance
Free health insurance policies to a segment of citizens
Contribution made by Govt. to the commercial insurance
Q 5. Which plan covers Personal Care costs?
Term plan
Life insurance
Disability benefit
Indemnity health insurance
Critical illness
Q 6. Concerning the 'Numerical rating method', which of the below statement is CORRECT?
Percentage assessment is made on any two components of the risk
High cost in collecting and assessing medical reports
Percentage assessment is made on each component of the risk
The key factors are - Current health status and age
Proposers have to undergo medical investigations to assess their health risk profile
Q 7. The market conduct aspects of the insurers are examined via ______.
Via financial audits
Via MIS mechanism
Via on-site inspections
Via off-site inspections
Via field inspections
Q 8. In Japan, _____ % of the population is covered under healthcare.
50
60
75
95
100
Q 9. _______ policy is available for both indemnity and benefit basis.
Term insurance
Daily hospital cash benefit
Personal accident
Critical illness
Health insurance
Q 10. 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
Q 11. 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 make 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 are correct
Q 12. 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%
Q 13. What is the group called which 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
Q 14. 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
Q 15. What does it refer to if after doing numerical ratings, the final rating comes out to be 120?
As the applicant is at a risk of 120%, the policy thus will not be granted to him.
As the applicant is at an 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
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