IC39 - Fraud Risk Management In Insurance - 4

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Q 1. Which of the following statements accurately describes the definition of insurance fraud about insurance acts?

Insurance fraud is specifically defined in the Insurance Act of 1938.

Insurance fraud is specifically defined in the Insurance Laws Amendment Act of 2015.

Insurance fraud is not defined in either the Insurance Act of 1938 or the Insurance Laws Amendment Act of 2015.

Insurance fraud is defined differently in the Insurance Act of 1938 and the Insurance Laws Amendment Act of 2015.

Insurance fraud is defined in other related legislation apart from the Insurance Act of 1938 and the Insurance Laws Amendment Act of 2015.
 
Q 2. Which section of the Indian Penal Code specifically defines the term "fraudulently" and states that a person is said to do something if they do that thing with the intent to defraud, but not otherwise?

Section 23

Section 24

Section 25

Sections 23 and 24

Sections 24 and 25
 
Q 3. What type of losses are described as arising from theft or resulting from improper storage and are outside the purview of the insurance policy?

Excluded losses

Uninsurable losses

Non-compensable losses

Covered losses

Permissible losses
 
Q 4. In fake hospitalization health insurance fraud, which of the following parties may be involved in collusion?

Only insured individuals

Only insurance representatives

Only TPA (Third Party Administrator)

Only doctors and hospitals

Any combination of insured, insurance representatives, TPA, doctors, and hospitals
 
Q 5. What situation related to the apparent cause and origin of a fire may raise suspicions of fire insurance fraud?

The apparent cause and origin of the fire align with an accidental event.

The apparent cause and origin of the fire are consistent with intentional arson.

The apparent cause and origin of the fire are consistent with natural causes.

The apparent cause and origin of the fire are inconsistent with an accidental event, and there is evidence of the use of a fire accelerant.

The apparent cause and origin of the fire are inconsistent with intentional arson, and there is evidence of natural causes.
 
Q 6. In Sweden, a serious problem was identified with which issue?

Identity theft

Cybercrime

Insurance fraud

Vehicle arson

Money laundering
 
Q 7. What is a "Term Assurance" plan in the context of life insurance?

A plan that provides coverage for a specific term or period.

A plan that offers investment options and capital appreciation.

A plan designed exclusively for retirees.

A plan that provides lifelong coverage.

A plan that covers only accidental deaths.
 
Q 8. What term is used to describe fraudulent activities that are specifically targeted at manipulating, counterfeiting, or deceiving consumers about a particular product or service?

Consumer fraud

Product manipulation

Targeted deception

Product-specific frauds

Consumer exploitation
 
Q 9. In a liability policy, what is the purpose of stating the "limit of liability"?

To deny coverage for certain insured individuals.

To establish a minimum coverage amount for the insured.

To set a maximum coverage amount for each insured individual.

To provide coverage without any restrictions on liability.

To determine the premium amount for the insured.
 
Q 10. What are the benefits of the fraud analytics system in the insurance industry?

Improved customer service & Enhanced data security

includes IT Solution that will identify fraudulent claims at the claim processing stage & provide advanced detection and prevention capabilities

A centralized profiling system and helps the underwriters and claims processing officer in detecting frauds & provides extensive statistical analytics that would help the insurance in understand their portfolios

a & c

b & c
 
Q 11. Health insurance specifically designed to cover major diseases and provides a lump sum benefit for diseases like cancer, kidney ailments, and cardiac surgery is known as:

Major Medical Insurance

Comprehensive Health Coverage

Critical Illness Insurance

Chronic Disease Policy

Catastrophic Health Plan
 
Q 12. The policy issued to whom covers the legal liability as per the Motor Vehicles Act 1988 arising from the use of motor vehicles?

Registered owner of a vehicle

The driver of the vehicle

Any passenger in the vehicle

Third-party involved in an accident

Insurance agent of the vehicle
 
Q 13. What types of pandemic-related scams did scammers engage in during the COVID-19 situation?

Offering new cures and inexpensive home test kits

Providing accurate contact tracing software and vaccines

Collecting confidential information from reputable health organizations

Assisting with speeding up unemployment benefits for a fee

Collaborating with the World Health Organization or Centers for Disease Control
 
Q 14. Which Act has specific provisions for the management of corporate fraud in India?

Indian Penal Code 1860

Indian Evidence Act 1872

Indian Contract Act 1872

Indian Companies Act 2013

Indian Insurance Act 1938
 
Q 15. According to the French Federation of Insurance Companies, how many fraudulent insurance claims are recorded every year?

Thousands

Tens of thousands

Hundreds of thousands

Millions

It varies each year


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