IC27 HEALTH INSURANCE EXAM - 02
| Q 1.Ms. Surekha purchased Health Benefits Insurance. She later contracted dengue and was hospitalised for some days. The hospitalization expenses were Rs 14000. The policy had a coverage for dengue for Rs 20000. Of what amount of reimbursement will Ms. Surekha get? |
| Rs 6000 |
| Rs 14000 |
| Rs 20000 |
| Rs 34000 |
| NIL |
| Q2.___ ministry regulates the Nutrition Support Program. |
| Ministry of Social Welfare |
| Ministry of rural and urban development |
| Ministry of labor |
| Ministry of women and child development |
| Ministry of family welfare |
| Q3.Name the regulation which ensures that the insurance companies stay solvent and their accounting statements are true and fair. |
| Management regulations |
| Licensing and registration |
| Statutory base |
| Financial regulations |
| Product regulation |
| Q 4.While completing the process of buying a medical health policy, Mr. Shah sent Mr. Mehta in his place for medical examination. What type of fraud has been committed? |
| Impersonation |
| Cash defalcation |
| Substitution |
| Disclosure of material information at the medical stage |
| Provide the erroneous address to claim benefit |
| Q5.How is the authenticity of the address and for the presence of any bogus customers done? |
| By doing fraud investigations |
| By keeping comprehensive claims information |
| By training and communications |
| By making a Welcome call |
| Doctor seeding |
| Q6.What is the reason for which the regulators can impose requirements like guaranteed issues or variants thereof for some or all products in the market? |
| To maintain portability across insurers |
| To maintain st and audition of definitions and terms |
| To put caps on waiting periods and cost-sharing provisions |
| To ensure that insurers cannot arbitrarily decline renewals or cancel policies |
| To protect the access right of consumers |
| Q7.Prakash has a health insurance policy and also a personal accident policy. What main section(s) of the insurance market do these products normally fall into? |
| Life insurance in both cases |
| Non-life insurance in both cases |
| Non-life insurance for health and life insurance for personal accident |
| Life insurance for health and non-life insurance for personal accident |
| Life insurance for health and non-life insurance for personal accident or life insurance in both cases |
| Q8.When a third party is involved in health insurance it makes the process complex. Why ? 1. The third party decides the type of health services used by an individual i.e. insured 2. The insured decides how much of the services can be used 3. It is the insurer who decides the cost of services |
| Only statement 1 is correct |
| Only statement 2 is correct |
| Only statement 3 is correct |
| Statement 1 and 3 are correct, 2 is incorrect |
| \Statement 1 and 2 are correct, 3 is incorrect |
| Q9.Under a Stop Loss treaty, the limit and retention are generally expressed as a percentage of ___. |
| Gross premium income |
| Gross profit margin |
| Net premium income |
| Gross net retained premium income |
| Gross net written premium income |
| Q10.In which of the below contracts is the Principle of Utmost Good faith followed? |
| Health insurance contracts |
| Service contracts |
| Sales contracts |
| Real estate contracts |
| Medico-legal contracts |