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 |