Questions and Answers
Which statement regarding group health insurance is correct?
Primary care can be described as:
Statement 1 is true and statement 2 is false.
True
Which of the following refers to a hospital/health care provider enlisted by an insurer to provide medical services to an insured on payment by a cashless facility?
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Which documents are not required for Permanent Total Disability claim?
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Risk transfer through risk pooling is called __________.
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What is underwriting in insurance?
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Match the risk reduction measures with their descriptions:
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The duration of cover for pre-hospitalization expenses would typically vary from insurer to insurer, but the most common cover is for ________ pre-hospitalization.
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Gender is a factor that affects the morbidity of an individual.
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Match the following documents with their description:
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Health insurance is designed to handle which of the following risks?
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Which of the below group would not be eligible for a group health insurance policy?
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Who cannot be covered under a family floater policy?
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As per IRDA regulations issued in February 2013, what is the grace period allowed beyond the expiry date of the policy, for renewal?
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Identify the form of insurance that is depicted in the following scenario: Patient pays the health provider and is subsequently reimbursed by the health insurance company.
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Moral hazard by health insurance companies can result in:
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Which of the below elements promote trust?
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Active listening involves paying attention to the speaker, giving an occasional nod and smile, and providing feedback.
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Expand the term IGMS.
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_____ is reflected in the caring attitude and individualized attention provided to customers.
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Match the following: A pair of jeans - ஜீன்ஸ் ஒரு தாடி
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What is the main purpose of insurance?
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Which of the following statements is correct with regards to the territorial jurisdiction of the Insurance Ombudsman?
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What is the origin of modern insurance business?
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What is meant by 'risk retention' in the context of insurance?
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How is the complaint to be launched with an insurance ombudsman?
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Insurance prevents loss of asset.
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What is the time limit for approaching an Insurance Ombudsman?
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Out of 400 houses, each valued at Rs. 20,000, on an average 4 houses get burnt every year resulting in a combined loss of Rs. 80,000. What should be the annual contribution of each house owner to make good this loss?
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Which among the following is not a pre-requisite for launching a complaint with the Ombudsman?
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Which of the following statements is true?
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Why do insurers arrange for survey and inspection of the property before acceptance of a risk?
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Which of the following options best describes the process of insurance?
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What is meant by customer lifetime value?
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In a customer's mind, there are two types of feelings and related emotions that arise with each service failure on the part of the insurance company. These feelings are:
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What does not go on to make a healthy relationship?
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Which among the following is not an element of active listening?
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Insurance is a tangible good.
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Study Notes
Overview of IC-38 Question Bank
- The IC-38 exam consists of 50 questions to be attempted in 1 hour
- For all correct answers, candidates obtain 50 marks
- There is no negative marking for wrong answers
- Candidates must 'mouse-click' the appropriate answer option on the computer screen
- Candidates can make changes to their answers before clicking 'Submit'
- After 1 hour, candidates cannot attempt any more questions or check their answers
- Candidates will receive a score card/result sheet immediately after submitting the exam
- Candidates are provided a backup sheet in case of power or system failure
- Candidates can only ask the Test Administrator questions before the exam starts
Section 3: Health Insurance (10 questions)
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Health insurance covers risks related to mortality, morbidity and medical expenses
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Group health insurance policies cannot cover unrelated individuals formed to avail coverage
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Family floater policies cannot cover parents-in-law or maternal uncles
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As per IRDA, the grace period for renewing a lapsed policy is 30 days
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Indemnity is the form of health insurance where the insured is reimbursed for expenses
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Moral hazard by insurers can lead to adverse selection and abuse of coverage
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Primary care refers to the first point of contact for people seeking healthcare
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Network providers are hospitals/clinics enlisted by insurers for cashless treatment
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Underwriting is the process of risk selection and pricing for insurance policies
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Pre-hospitalization cover is typically for 30 days prior to hospital admission### Insurance Policy Terms and Modifications
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Insurance policies can have certain terms and conditions that need to be modified at the time of issuance
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This modification is done through an endorsement
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Other methods of modifying policy terms include:
- Warranty
- Alteration
- Modifications are not possible in some cases
Provisioning for Insurance Claims
- The amount set aside in the insurer's books to account for all pending claims is known as provisioning or reserving
- This is done based on the status and expected payouts of the various claims
Grace Period for Health Insurance Renewal
- As per IRDA guidelines, individual health insurance policies are allowed a 30-day grace period for renewal
Health Insurance Coverage
- Health insurance deals with both morbidity (illness/disease) and mortality (death)
- It covers hospitalization expenses as well as pre and post-hospitalization expenses
Group Health Insurance
- In group health insurance, any individual in the group could potentially anti-select against the insurer
- Group health insurance provides coverage only to employer-employee groups
Hospitalization Expenses Policy Coverage
- Hospitalization expenses policy covers:
- Hospitalization expenses
- Pre and post-hospitalization expenses
- It may also provide a lump-sum payment to family upon the insured's death
Documents for Permanent Disability Claim
- Documents not required for permanent total disability claim include:
- Fitness certificate from treating doctor
- Proof of performing normal duties
Renewal Notice Requirements
- As per regulations, insurers are legally required to send a renewal notice to the insured 30 days before the policy expiry
Health Insurance Entry Age
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The minimum and maximum entry age for a health insurance policy is 18-80 years### Insurance Regulatory Terminology
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Insurance is a method of sharing losses of a 'few' by 'many'
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Insurers inspect and survey property before accepting risk to assess the level of risk
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The insurance process involves sharing the losses of a few by many
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Customer lifetime value refers to the total economic benefits that can be achieved by building a long-term relationship with the customer
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Active listening involves paying attention to the speaker, providing feedback, and giving occasional nods and smiles
Consumer Grievance Redressal
- District Forum handles consumer disputes up to Rs. 20 lakhs
- State Commission handles consumer disputes between Rs. 20 lakhs and Rs. 100 lakhs
- Charging above the Maximum Retail Price (MRP) can form a basis for a valid consumer complaint
- Shopkeeper not advising on the best product in a category cannot form the basis for a valid consumer complaint
- The most appropriate option for a customer to lodge an insurance policy related complaint is the Integrated Grievance Management System (IGMS)
Ethical Behavior in Insurance
- Ethical behavior helps build trust between the insurance agent and the insurer
- Ethical behavior is expected not just from top management but from all insurance agents
- Unethical behavior while selling insurance is not impossible, but it is necessary to maintain ethical standards
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Practice questions for candidates preparing for an exam, available in English and Tamil.