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 |