IC39 - Fraud Risk Management In Insurance - 3

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Q 1. Under the Inland Transit Clauses - Rail or Road, which risks are covered under Clause B?

Fire and lightning only

Breakage of bridges and collisions with carrying vehicles

Overturning of the carrying vehicle and derailment only

Accidents of nature to the carrying Railway Wagon or vehicle only

Fire, lightning, breakage of bridges, collision with or by the carrying vehicles, overturning of the carrying vehicle, and derailment or accidents of nature to the carrying Railway Wagon or vehicle

Q 2. Which types of claims are typically associated with engineering insurance?

Wear and tear losses

Manufacturing defects

Technical defects

Both a & b

Both b & c

Q 3. According to the principle of utmost good faith, when must the insured comply with this principle in a marine insurance contract?

Only at the time of entering into the contract

Throughout the contract, but not at the time of entering into it

Only during the claim settlement process

Both at the time of entering into the contract and throughout the contract

Only during the underwriting process

Q 4. Which of the following statements accurately describes the role and scope of the IRDAI database?

Collect data on fraudulent clams

Helps insurance companies to manage underwriting and claims

Keeps the data and information of perpetuated frauds

Includes and covers hospitals Nursing Home and Auto Garages

All of the above

Q 5. What is money laundering?

Money laundering refers to cleaning physical currency to remove dirt and stains.

Money laundering is the process of concealing the origins of illegally obtained money.

Money laundering is the act of legally investing large sums of money to increase its value.

Money laundering involves transferring funds between different personal bank accounts.

Money laundering is the practice of exchanging foreign currencies for domestic currency.

Q 6. Which statement is false regarding visiting the affected premise during an investigation?

Ignoring any unaffected areas.

Thoroughly examining all sections, affected or not.

Focusing only on the most affected areas.

Considering potential causes for the incident.

Conducting a comprehensive assessment.

Q 7. What is the purpose of the warranty imposed in the insurance policy that mandates proper and immediate health care for the insured animal?

To increase the policy premium

To provide additional coverage for accidental injuries

To require the insured to vaccinate the animal

To ensure the insured's compliance with animal welfare standards

To nullify the policy in case of negligence regarding the animal's health care

Q 8. What are some types of Construction phase insurance policies?

Constructors all risks insurance & Erection all risks insurance

Marine cum Erection insurance policy & Contractors plant and machinery insurance

Advanced loss of profits incidence policy & Professional liability insurance for architects

a & b

a & c

Q 9. What type of fraudulent claim involves the insured person's dependants reporting a claim to the insurance company, stating that the insured person died in an accident, despite the actual cause of death being due to sickness? They also submit fraudulent documents to support the false claim.

Accidental death misrepresentation

Sickness-related deception

Old age exaggeration scam

Suicide concealment fraud

Fictitious accident claim

Q 10. As per Section 149 of the Motor Vehicles Act, the insurance company shall initiate the settlement process upon receiving information of the accident either through the claim form or through an accident information report within what time frame?

7 days

15 days

30 days

60 days

90 days

Q 11. Which of the following actions would be considered insurance fraud?

Claiming for branded machines when actually having assembled machines.

Upgrading insurance coverage for legitimate business needs.

Providing accurate information to the insurance company during the claims process.

Reporting a genuine loss to the insurance company.

Purchasing insurance policies from a reputable provider.

Q 12. According to Section 49 of the Insurance Act 2015, what penalty can be imposed on a person who acts as an insurance agent in contravention of the provisions of this act?

Imprisonment for a term of up to 1 year

Fine up to 5,000 rupees

Fine up to 10,000 rupees

Fine up to 20,000 rupees

Suspension of insurance license

Q 13. What is a common motivation or circumstance associated with an average offender in insurance fraud cases in Australia?

Seeking financial gain

Engaging in organized criminal activities

Escaping legal consequences

Experiencing financial hardship

Engaging in organized complexities

Q 14. Identify the requisites of an effective insurance investigator: I) Impartiality and absence of prejudice II) High moral and ethical standards III) UnTimely delivery of the investigation report IV) Possession of basic knowledge of insurance principles V) Conclusion of the report with maximum evidence and avoidance of assumptions VI) Ensuring the recorded evidence in the report is legally inadmissible Select the correct options:

I, II, III

IV, V, VI

I, II, IV, V

V, VI

I, II, III, IV, V, VI

Q 15. What are "Life Insurance frauds"?

Fraudulent activities involving property claims.

Fraudulent schemes targeting medical expenses.

Deceptive practices within financial investments.

Dishonest actions related to vehicle insurance.

Deceptive acts committed to exploit life insurance policies.



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