IC27 HEALTH INSURANCE EXAM - 17

Q1.In the case of Pre-Policy medical tests, the amount reimbursed by the insurance company to the insured is ___.
   50% of the expenses
   60% of the expenses
   25% of the expenses
   100% of the expenses
   NIL
 
Q2.What does a Quote Engine help in? 1. It helps in tracking the customer's portfolio and transactions over a period of time 2. It helps in maintaining control of the underwriting authority for each iteration of quote 3. It provides ease of changing the rules for arriving at the quote, which would be cumbersome in a policy administration system
   Only 1
   Only 2
   Only 3
   1 and 2
   2 and 3
 
Q3.A best practice questionnaire was sent to all the General insurance and stand-alone Health Insurance companies. The survey result was - 1. An adequate training facility for agents is seen to have the highest importance 2. This was followed by the use of technology for efficiencies in the distribution of health insurance 3. Customer awareness during the sales process was also given importance
   1 and 2 are correct
   2 and 3 are correct
   Only 1 is correct
   Only 3 is correct
  All 1, 2, and 3 are correct
 
Q 4.Which of these helps insurance companies to identify the current trend of claims?
   OLAP analysis
   Data mining
   Analysis
  ALL
  Datamart
 
Q5.Which of these statement(s) is/are correct? 1. Management Information Systems (MIS) and Analytics help detect frauds as they trigger off frequent claims from a particular customer or a hospital. 2. Insurance companies need to constantly update the triggers. 3. Insurance companies need to monitor follow-up action for curbing fraud.
   Only 1
   Only 2 and 3
   Only 1 and 2
   Only 1 and 3
   All 1, 2 and 3
 
Q6.Offsite monitoring is done at ____.
   Insurers office
   Insureds office
   TPA’s office
   Regulators office
  Nowhere
 
Q7.Rakesh was admitted to a hospital as he suffered some injuries in an accident. As the injuries were minor, he was discharged the same day. Identify, which type of cover will cover such type of expenses?
   Outpatient coverage
  Top-up plans
   Disease management cover
   Personal accident cover
   Daily cash cover
 
Q8.Under Long Term Care (LTC) plan, the Immediate Needs plans are purchased by ____ when the insured is requiring long-term care.
   Credit
   Deferred payments
   Immediate Full payments
  Lump-Sum payments
   Through SIP payments
 
Q9Mr. Smith is unemployed and is a citizen of Germany. In which way does he receive health insurance cover?
   Mr. Smith will not be covered as he is unable to pay any premium
  Mr. Smith will be at the mercy of health care providers
   Private players can offer Mr. Smith a 50% premium offer for the same amount of risk cover
   Mr. Smith will have to wait for his retirement pension funds
  Mr. Smith will continue as a member of the sickness fund and his contributions will be paid by federal/local Government
 
Q10.There are two reinsurers - A and B. They are frequently co-reinsurers on the same liability excess of loss treaties. Identify the most likely reason that reinsurer A would NOT want to write a liability quota share retrocession for reinsurer B?
   Because it would be in breach of terms of business agreements
   Because it can retrocede the cession
   Because there would be a conflict of interest
   Because its exposure to any one single claim could be significantly increased
   Because it cannot retrocede the cession

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