IC27 HEALTH INSURANCE EXAM - 09

Q1.____ policy is available for both indemnity and benefit basis.
   Term insurance
   Daily hospital cash benefit
   Personal accident
   Critical illness
   Health insurance
 
Q2.Which of the following is a feature of a Non-Medical underwriting policy?
   Low premiums
   High premiums
   Processing is slow
   There is more waiting period
   There are more formalities
 
Q3.What is the reason behind asking many questions instead of a simple question about an individual’s health insurance? 1. to help the customer to think about various diseases so that he can provide the necessary information 2. to record the facts in detail which forms the basis of the contract 3. to arrange for further medical examination in all cases and making the customer ready for it
   Only 1 and 2 are correct
   Only 2 is correct
   Only 1 and 3 are correct
   Only 2 and 3 are correct
   Only 3 is correct
 
Q4.Approximately __ are the estimated fraudulent claims in the health insurance industry.
   0 to 5%
   10 to 15%
   15 to 20%
   20 to 25%
   More than 50%
 
Q5.What is the group called which is involves consumers, physicians, agents, providers, etc. in making a series of false claims?
   Speculators in insurance
   Fraud rings
   Collusion with TPA
   False claims
   Collusion with providers
 
Q6.Who studies the data and the pattern indicated to decide on the acceptance or denial of a risk?
   Marketing Department
   Actuaries
   Management
   Finance Department
   Underwriters
 
Q7.What does it refer to if after doing numerical ratings, the final rating comes out to be 120?
  As the applicant is at risk of 120%, the policy thus will not be granted to him
  As the applicant is at extra risk of 20%, the policy thus will be priced accordingly
   The applicant will have to pay 120% of the standard premium rate
  As the applicant is at a risk of 20%, the policy thus will be priced accordingly
  As the applicant is at a reduced risk of 20%, the policy thus will also be priced accordingly
 
Q8.Factors like age, sex and race are scored to determine the level of risk in which of these method(s)? 1. Numerical rating method 2. Medical underwriting 3. Non-medical underwriting
   Only 1
   Only 2
   Only 3
   Both 1 and 2
   Both 1 and 3
 
Q9.With respect to the 'best practice survey on grievance redressal' - which of the following option(s) is/are correct? 1. These best practices are circulated amongst the insurance companies for their reference and for a rating in terms of importance 2. Was undertaken by the CII Communication and awareness working group 3. This best practice questionnaire was sent to all the General Insurance and stand-alone Health insurance companies of which only 40% responded
   Only statement 1 is correct
   Only statement 2 is correct
   Only statement 3 is correct
   Both 1 and 2 are correct
  All 1, 2, and 3 are correct
 
Q10.While taking a medical policy, Mr. Soham conceals a serious medical condition. If this condition was known to the insurers, they would have denied or excluded it from the scope of coverage. What fraud has Mr. Soham committed?
   Concealment fraud
   Claims fraud
   Staging claims fraud
   Application fraud
   Eligibility fraud

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