IC27 HEALTH INSURANCE EXAM - 05
| Q1.Which of the following countries of the world has introduced or provides insurance for the elderly ‘Medicare Medicaid’ for the poor but there are growing concerns over the sustainability? |
| USA |
| Japan |
| Germany |
| Chile |
| India |
| Q2.There are certain regulator tools with regard to licensing and registration. Which of the following is not in its domain? |
| Validate the management background |
| Validate the proposer background |
| Validate the integrity of the management |
| Checkup the financial strength of management |
| Checkup business plans of the insurers |
| Q3.What is the measure(s) under technology and process interface for fraud prevention? |
| Doctor seeding |
| Training & communication |
| Creation of fraud database |
| Propensity modeling |
| Creation of consumer awareness |
| Q4.Which data analysis can help an actuary to calculate the expected cost of claims for policies with various sum-insured amounts? |
| Written premium |
| Claims analysis by age band s |
| Claims analysis by geographic location |
| Claims probability distribution |
| Earned premium |
| Q5.Which of the following statement/s is/are correct with regard to the most important factors to be considered while pricing a health insurance product? 1. The cost of paying benefits 2. Profit margin 3. Administrative cost |
| Only statement 1 is correct |
| Only statement 2 is correct |
| Statements 1 and 3 are correct, 2 is incorrect |
| Statements 2 and 3 are correct, 1 is incorrect |
| Statements 1 and 2 are correct, 3 is incorrect |
| Q6.Which is INCORRECT with respect to the cashless facility in health insurance? |
| It is provided in-network hospitals only |
| The insured is required to settle the hospitalization expenses at the time of discharge from the hospital |
| Under emergency cashless claims, the insured meets with a sudden accident that requires immediate hospitalization |
| Under planned cashless claims, the insured is aware of the hospitalization 2-3 days in advance |
| None of the above |
| Q7.A data warehouse is a __ of an organization's electronically stored data. |
| Section |
| Technique |
| Depository |
| Repository |
| Component |
| Q8.What is the main role of an actuary in the claim reserving process? |
| To set aside a reserve for the claims reported |
| To calculate the future claims payments |
| To estimate the IBNR claims reserves |
| To estimate the earned premiums reserves |
| Component |
| Q9.What common perception often motivates customers to exaggerate their claims? |
| The insurance company pays less than what you claim even if it is a true loss assessment |
| The insurance company pays less than what you claim even if it is improper loss assessment |
| The insurance company pays more than what you claim even if it is a true loss assessment |
| The insurance company pays more than what you claim even if it is an improper loss assessment |
| The insurance company pays less than what you claim even if it is improper loss assessment |
| Q10.The primary function of the ICD-10 coding system is to ____. |
| deliver data to decision-makers through report writing and query tools |
| provide codes to classify diseases |
| integrate the data collected from insurers into logical subject areas |
| aggregate analysis of all health insurance data |
| integrate the data collected from insurers into logical subject areas |