IC27 HEALTH INSURANCE EXAM - 15
| Q1.Which of the below is the ODD ONE in customer complaints submitted to the insurance Ombudsman relating to a grievance against the insurer? |
| Dispute with regard to the premium paid in terms of the policy |
| Delay in settlement of claims beyond six months |
| Any repudiation of claims by the insurance companies |
| Dispute on the legal construction of the policy wordings where such dispute relates to claim |
| Non-issuance of any insurance document to customers after receipt of premium |
| Q2.___ provides free medical services to all citizens as a guarantee by its Government. |
| India |
| Germany |
| UK |
| USA |
| Denmark |
| Q3.The contribution to the health care system in France is through : |
| Contribution = Employee + General Taxes |
| Contribution = Employer + General Taxes |
| Contribution = Employee + Employer + General Taxes |
| Contribution = Employee + Employer |
| Contribution = Employee + Employer + Private Funds |
| Q4.In which type of policy are the details of the family asked? |
| Group insurance |
| Corporate insurance |
| Term insurance |
| Community policy |
| Floater policy |
| Q5.In ___ cover, the reinsurer undertakes to pay for medical insurance claims beyond the stop loss trigger, and may or may not offer administration services up to the stop-loss limit. |
| Term Policy |
| Employee Stop Loss |
| White Labeling |
| Group Insurance |
| Critical Illness |
| Q6.Identify the correct formula with regard to the Disposal Ratio. |
| Claims rejected / claims reported |
| Claims paid + Outstand ing at the end – Outstand ing at beginning / Claims reported |
| Proposals rejected / Proposals received |
| Policies issued / Policies received |
| Claims settled / Claims reported |
| Q7.To facilitate monitoring the individual, small group, and large group blocks of business separately, one can use - |
| Written premium |
| Earned premium |
| Age distribution |
| Group size distribution |
| Claims analysis |
| Q8.When the insurance company looks beyond what the customers are asking and tries to anticipate and fulfill the customer’s unexpressed needs, this is known as ___. |
| Empathy |
| Reliability |
| Responsiveness |
| Proactiveness |
| Assurance |
| Q9.Which of these statements is/are CORRECT? 1. Solvency ratio is calculated as 'Required Solvency Margin' to 'Available Solvency Margin' 2. The ‘Required Solvency Margin’ is based on mathematical reserves and sum at risk and assets of the policy holder’s fund 3. 'Available solvency margin' means the excess of the value of assets over the value of liabilities and other liabilities of policyholders fund and shareholders’ funds |
| Only 1 is correct |
| Only 2 is correct |
| Only 3 is correct |
| Only 1 and 2 are correct |
| All 1, 2, and 3 are correct |
| Q10.Under the Consumer Protection Act, which has a three-tier system of redressal of complaints, the District forum is the lowest agency in the hierarchy having pecuniary jurisdiction of ___. |
| Up to Rs 5 lakhs |
| Up to Rs 10 lakhs |
| Up to Rs 15 lakhs |
| Up to Rs 20 lakhs |
| Up to Rs 25 lakhs |