IC27 HEALTH INSURANCE EXAM - 03
| Q1.NSSO refers to: |
| National Sample Survey Officer |
| National Small Survey Office |
| National Sample Survey Office |
| National Saving Survey Office |
| National Sample Saving Office |
| Q2.The Central Government Health Scheme (CGHS) was introduced in ___. |
| 2010 |
| 1956 |
| 1954 |
| 1973 |
| 1938 |
| Q3.The health insurance risks are not discrete. They often overlap and interplay. Which of the following statement is true which can justify means to manage health insurance risks? 1. Active involvement of the top management along with regulatory oversight 2. An independent regulator would be more effective 3. Active involvement of every employee along with regulatory oversight |
| Only statement 1 is correct |
| Only statement 2 is correct |
| Only statement 3 is correct |
| Only statements 1 and 2 are correct |
| Statements 1, 2 & 3 are correct |
| Q4.Insurance Ombudsman is a grievance redressal mechanism whose jurisdiction is __. |
| All insurance-related complaints can be filed with Ombudsman |
| Only general insurance-related complaints can be filed with Ombudsman |
| Only life insurance related complaints can be filed with Ombudsman |
| Complaints related to personal insurance claims for value up to 20 lakhs can be filed with Ombudsman |
| It is the final authority & no appeal can be filed against the order of the Ombudsman |
| Q5.Since Critical (CI) illness is also covered under hospitalization policy, why should an insured opt for a stand-alone CI policy? 1. Some stand-alone policies do not cover CI 2. Substantial components of CI may not be covered under the hospitalization policy (long-term nursing care) 3. Critical illnesses is very frequent thus are excluded under all hospitalization policies |
| Only statement 1 is correct 2 3 are incorrect |
| Statement 2 & 3 are correct but statement 1 is incorrect |
| Only statement 2 is correct |
| Only statement 2 is incorrect |
| None of the statements are correct |
| Q6.Health insurance is offering various new/innovative products which were not heard of earlier. Which of the following is not a new/innovative product? |
| High-deductible hospital cover |
| The daily cash benefit cover |
| Disease management cover |
| Physician fee for in-patient treatment |
| OPD |
| Q7.One of the most significant developments in recent years towards the public health financing system in India which reduced the gap between the healthcare available in urban-rural areas has been ___. |
| Establishment of Employees State Insurance Scheme (ESIS) |
| Establishment of Central Govt. Health Scheme (CGHS) |
| Establishment of National Rural Health Mission (NHRM) |
| Establishment of Universal Coverage Scheme (UGC |
| None of the above |
| Q8.The accident policy of Mr. Sanjay was expiring on 31.05.17. He met with an accident on 1.06.17 and was discharged on 5.06.17. What percentage of claims will be accepted by the company out of the total hospitalization expenses? |
| 100% |
| 50% |
| 25% |
| 10% |
| NIL |
| Q9.In order to help the customers have a proper understanding of the implications of the clauses in health insurance policies, IRDAI took which of the following measure for standardization? |
| For easy comparison, fix parameters in all policies in the exactly the same way |
| Similar benefits in policies with similar premiums |
| Ensure that the names of the products are not misleading and similar to its competitors’ products |
| Prescribe a standard wording for some of the clauses relating to insurance |
| Updated comparative charts to be displayed on the IRDAI website |
| Q10.In which way does reinsurance provide a method for insurance companies to diversify their risks? |
| By contributing a part of the premium received from customers to a reinsurance company and receiving the corresponding claims incurred from the reinsurance company |
| By claiming a part of the premium received from customers to a reinsurance company and receiving the corresponding claims incurred from the reinsurance company |
| By contributing full premium received from customers to a reinsurance company and receiving the corresponding claims incurred from the reinsurance company |
| By contributing 50% of the premium received from customers to a reinsurance company and receiving the corresponding claims incurred from the reinsurance company |
| By contributing a part of the premium received from customers to a reinsurance company and receiving half the corresponding claims incurred from the reinsurance company |