Insurance Agents (HEALTH) Question Bank - English

Sr.No Question Body Alternative 1 Alternative 2 Alternative 3 Alternative 4 Correct

Alternative
1 Life Insurance Corporation of India(LIC) was set up Life Insurance Corporation Act, 1956 The Insurance Act, 1938 Life Insurance Companies Act, 1912 Indian Insurance Companies Act, 1928 1
under which of the following acts?
2 Which of the following social security scheme is a PMVVY PMFBY PMJAY PMSBY 3
Health Insurance plan?
3 In the olden days, Chinese traders used to keep their Chinese boats were small and they The Chinese Government mandated that Chinese traders placed their goods in Chinese traders placed their goods in
goods in different boats while sailing through carried heavy goods goods should be distributed among multiple boats because it provided multiple boats because it was cheap
treacherous waters. Analyse why? multiple shipping companies so that insurance against total loss 3
there is equal distribution of business

4 What is the cost of risk directly proportional to? Probability and impact of the loss Impact of the loss alone Probability of loss and object of Impact of loss and the object of
1
insurance insurance
5 Which of the below statement is incorrect? Under mutuality, the funds of various Mutuality is also known as pooling Under mutuality we have funds flow Mutuality provides protection against
individuals are combined from one source to many the economic loss arising as a result of
one’s untimely death. This loss is
shouldered and addressed through
3
having a fund that pools the
contributions of many who have entered
into the life insurance contract
when are
6 The earliest type of modern insurance was in the Spain France Germany Italy
form of protection by business guilds or societies in
4
Europe especially _________ in the 14th century.

7 In terms of Breach of Utmost Good Faith, which of Concealment is Intentional Non- Concealment is Innocent Non-Disclosure Fraudulence is Intentional Hiding existence of a disease is
2
the following is not correct Disclosure Misrepresentation intentional Non-Disclosure
8 Explain difference between peril and hazard. Peril is the cause of loss and hazard is Peril is the direct cause of loss while Hazard is the direct cause of loss while Peril is probability of loss while hazard is
the consequence of that loss hazard increases/decreases the peril increases/decreases the probability related to impact of loss 2
probability of loss of loss
9 The IRDA was established in the year __________ 1999 2000 2002 2003
2
under the IRDA Act, 1999.
10 Losses caused by an earthquake are ______ Critical Collaborative Corollary Common 1
11 Who is protected under the In-Contestability Clause Insurer Insured Insurance Agent Insurance Broker
included under a Life Assurance Policy? 2

12 Who among the Following, is Likely to be Exposed to Medical-Professional Tourist-Guide Demolition-Experts Marketing-Executive, Who is regularly on
Accidental Hazard, in His or Her Occupation? Choose the Field.
3
the Most Appropriate Option.

13 Which priciple of insurance implies if the same Contribution Uberrima fides Subrogation Proximate cause 1
property is insured with more than one insurance
company
14 ____________________is a corollary principle of Insurable Interest Uberrima fides Subrogation Proximate cause 3
Indemnity
15 Who among the Following, is Likely to be Exposed to Yoga-Instructor Film-Stunt-Artist Dancer in a Night-Club Person, Exposed to Mining Dust
Health-Hazard, in His or Her Occupation? 4
 Insurance Agents (HEALTH) Question Bank - English
16 Why Do, Insurers need Material Information? For Documentation Purposes. Decide on the Risk- Acceptance, and the To Comply with the Regulatory To Improve the Customer-Service.
Terms and Conditions, Associated. Requirements. 2

17 Compare: Gambling and Insurance. Gambling and Insurance, Both, are the Gambling has No Insurable Interest Insurance has Only Profitable Outcomes, Gambling is Legally Enforceable, but,
Same. involved, but Insurance does have. while, Gambling could result in Losses. Insurance is Not. 2

18 Select a Scenario, that showcases the Principle of Timely Payment of Premium. Disclosing All Material Information on Faking All Material Information on the Disclosing All Irrelevant Information on
Uberrima Fides. the Insurance Proposal- Form. Insurance Proposal- Form. the Insurance Proposal- Form. 2

19 Label the Interest, that the Insured has, in the Speculative Interest Wager Interest Insurable Interest Indemnity Interest
Subject-Matter of Life Assurance. Choose the Most 3
Appropriate Option.
20 Expections stated under Section 59 of the Insurance No risk to be assumed unless premium is Insurance cannot be sold on credit basis Accepting premiums in instalment in None of the above 3
Rules 1939 for advance payment of premium. received in advance in India respect of Sickness Insurance, Group
Personal Accident Insurance, Medical
Benefits Insurance and Hospitalisation
Insurance Schemes subject to certain
conditions
21 Examine the conditions mentioned below and tell us I only II only III only I and III
which is not a valid condition for returning a policy
during the free look period.
I: Option must be exercised within 15 days of 3
receiving the policy document
II: Communication has to be in writing
III: Communication can be verbal or written
22 Section 45 (Indisputability Clause) of Insurance Act, One Year Three Years Five Years Seven Years
protects the Insured, from Rejection of Claim, by the
Insurer; provided the Policy has completed --. 2
Choose the Most Appropriate Option.

23 As per the Suicide Clause, if the Life-Assured Dies, as Nothing Premium, Paid by the Life-Assured. (2 × Premium), Paid by the Life-Assured. Full Face-Amount of the Policy.
a Result of Suicide, After 3 Years of the Issue of
4
Policy, What Does the Beneficiary Receive as the
Claim?
24 What Does, First Premium Receipt (F.P.R.), signify? Free-Look Period has ended. It is the Evidence, that the Policy- Policy cannot be cancelled, Now. Policy has acquired a Certain Cash-Value.
2
Contract has begun.
25 Identify the Document, that evidences a Contract, Proposal-Form Claim-Form Nomination-Form Policy-Document
between the Insurer and the Insured. 4

26 Which One of the Following Statements, is In- Under this Method, Underwriters assign Under this Method, Underwriters assign Under this Method, the Total Number of Under this Method, if the Extra-Mortality-
Correct, with Regard to Numerical Rating Method of the Positive Rating-Points for All the Positive Points for Any Positive or Points, so assigned, will decide How Rating (E.M.R.) is Very High, Insurance
2
Underwriting? Negative or Adverse Factors. Favourable Factors. Much Extra- Mortality-Rating (E.M.R.), it may even be declined.
has been given.
27 Which One of the Following Statements, is In- Under this Method, Subjective This Method is especially used in Case of In this Method, the Company may seek In this Method, the Underwriter assign
Correct, with Regard to Judgement Method of Judgement is used. Complex Cases. Expert Opinion of Medical Doctor. Positive or Negative Rating-Points to the 4
Underwriting? Adverse Factors.
 Insurance Agents (HEALTH) Question Bank - English
28 Mr. Vimal is a 32-Years' Old, Healthy, Non-Smoker, Risk will be Accepted at Ordinary Rates. Risk will be Accepted With an Extra, Over Risk will be Accepted, With a Lien on Risk will be Accepted, With a Restrictive
Teetotaller Individual; Who applies for Life the Tabular Rate of Premium. Sum- Assured. Clause.
Assurance from ABC Limited Insurance Company.
1
Which One of the Following Statements, will Hold
True, with Regard to Risk-Acceptance by the
Insurance Company?
29 If, Mr. Brijesh, a 40-Years' Old Individual, is perceived Risk will be Accepted at Ordinary Rates. Risk will be Accepted at Lower Rates. Risk will be Accepted With an Extra, Over Risk will be Declined.
as a 'Sub-Standard Risk', by the Insurance Company, the Tabular Rate of Premium.
then, Which One of the Following Statements, will
3
Hold True, with Regard to Risk-Acceptance by the
Insurance Company?

30 What is meant by 'Risk-Classification'? Choose the The Process, in which, Individual Lives The Tendency of People, Who suspect or The Process of Evaluating Each Proposal The Process, in which, the Applicants,
Most Appropriate Option. are Categorised and Assigned to know that, their Chance of Experiencing for Life- Assurance in Terms of the Who are Exposed to Similar Degrees of
Different Risk-Classes, Depending on the a Loss is High, to seek-out the Insurance, Degree of Risk, it represents; and then Risk, are Placed in the Same Premium-
1
Degree of Risks, they Pose. Eagerly; and to gain in the Process. Deciding: Whether or Not to Grant the Class.
Insurance, and on What Terms.

31 On payment of claim, the life insurance policy- Can be reinstated on payment of pro- Stands cancelled Automatically terminates Continues till the end of the policy 3
rata premium period
32 On payment of claim, the individual fidelity Can be reinstated on payment of pro- Stands cancelled Automatically terminates Continues till the end of the policy 3
guarantee policy- rata premium period
33 Arbitrators appoint ________________who presides A President A Chairman An Umpire A Judge 3
the meeting.
34 Dispute relating to question of liability are to be Arbitration Communication Litigation Understanding 3
settled through __________________.
35 Mr. Nimesh bought a 20-Years' Unit-Linked Surrender-Value will be paid. Premiums paid will be Returned, After Lower of Sum-Assured or Fund-Value, Higher of Sum-Assured or Fund-Value,
Insurance Plan (U.L.I.P.). In the Event: Mr. Nimesh Deducting the Dues. will be paid. will be paid.
4
dies, Within the Policy-Term, Which of the Following,
will be paid?
36 In Case of Presumption of Death of Life-Assured, Death-Certificate from Municipal Decree from a Competent Court. Employer's Certificate Inquest-Report
Which One of the Following Documents, needs to be Corporation.
2
submitted, by the Nominee?

37 Mr. Brijesh purchased a 20-Years' Unit-Linked Surrender-Value Premiums, After Deducting the Dues. Lower of Sum-Assured or Fund-Value. Higher of Sum-Assured or Fund-Value.
Insurance-Plan (U.L.I.P.), from ABC Insurance
Company. If Mr. Brijesh Dies, Before the Maturity of
4
the Policy, then Insurance Company will have to pay -
-.

38 Which One of the Following Claims, can be Payable, Death-Claim Maturity-Claim Survival-Benefit Surrender-Value
1
Only to the Assignee or Nominee?
39 Which One of the Following Documents, needs to be Inquest Report Death-Certificate Post-Mortem Report First Information Report (F.I.R.)
submitted, by the Nominee, in the Event of Natural
Death of the Life-Assured? Choose the Most 2
Appropriate Option.
 Insurance Agents (HEALTH) Question Bank - English
40 Which of the below statement/statements is/are A&B A&C Only C All of them 2
true with regard to a proposal form?
A) The proposal form can be filled in by the proposer
in written or electronic format.
B) The proposal form contains the details of
imsurance cover, warranties, terms and conditions.
C) The insurer can decide whether to accept or reject
the proposal for insurance based on the information
in proposal form.

41 Declaration of the proposer in the proposal form Legal Duty, Common Law Principle Contractual Duty, Common Law Principle Common Law Principle, Contractual Duty Common Law Principle, Legal Duty 3
converts _____________________________of
Utmost Good Faith to
__________________________ of Utmost Good
Faith.
42 You are an insurance agent. Mr. Mahesh has Concentrate on completing the sale and Report suspicious transaction along with Blackmail Mr. Mahesh and try to get Keep mum about the transaction
approached you as a customer to buy some securing commission all the information you have about Mr. some monetary benefits out of him
insurance. You hear from friends that Mr. Mahesh is Mahesh
2
involved in sale of pirated goods and all the resultant
cash is invested in buying life insurance. What should
you do?
43 Important information that a prospectus discloses Only I I and II II and III I, II and III
includes:
I. Any incentives to reward policyholders for early
entry
1
II. Any incentives to reward policyholders for
continued renewals
III. Any incentives to reward policyholders for
favourable claims experience
44 If Complex Language is used to word a Certain Policy- In Favour of the Insured. In Favour of the Insurer. The Policy will be declared as Void, and The Policy will be declared as Void, and
Document, and it has given Rise to an Ambiguity, the Insurer will be asked to Return the the Insurer will be asked to Return the
1
How Will it generally be construed? Premium, With Interest, to the Insured. Premium, to the Insured, Without Any
Interest.
45 Which of the Following, is Not a Part of a Standard Policy Schedule Standard Provisions Policy-Specific Provisions Policy Forfeiture Provisions
4
Policy-Document?
46 Gives us, an Example of a Standard Policy-Provision. A Clause, Precluding the Death Due to Suicide Clause A Clause, Precluding Certain Illnesses. A Clause, Granting Certain Privileges to
Pregnancy, for a Lady, Who is Expecting the Policy-Holder.
2
at the Time of Writing the Contract.

47 Potential Value means- The value of premiums that is arrived at Future premiums that may be expected The value of premiums that could be Future premiums that is expected to be 3
by persuading the customer to buy to be received if existing business is derived by persuading the customer to received if existing business is retained
additional products retained buy additional products

48 Elements of Trust are A&B A, B & C A, C & D A, B & D 4

A) Communication,
B) Attraction,
C) Belief,
D) Presence
49 ____________ is the most important step in sales Interview Prospecting Handling objections Closing the sale 2
process.
 Insurance Agents (HEALTH) Question Bank - English
50 An agent need not recommend insurance in certain Where the prospect is interested in When the risk involved is non-insurable. Where the risk involved can be managed All of the above 3
situations. One of the situation can be- reducing the cost of handling the risk. by means other than insurance.

51 When is a cover note issued to proposer? When the underwriting process is When the negotiations for insurance are When the underwriting process is When the negotiations for insurance are 3
complete and policy is issued in progress and policy document is complete and policy not is issued in progress and policy document is
prepared issued
52 During which period, insurance policy can be Coverage period Free Look Period Waiting Period Grace Period 2
returned and refund of premium obtained?
53 If the policy is being purchased electronically, it is Help the customer to open e-Insutance Help the customer to register for e- Help the customer to open e-vault for Help the customer to generate e- 1
agent's duty to- Account through registered insurance Insurance Policy with OTP through Insurance Policy through registered Insurance Policy through registered
repository registered insurance repository insurance repository insurance repository
54 The customer has choice to continue with same Term Insurance Policy Motor Third Party Policy Endowment Policy Unit Linked Insurance Policy 2
insurer or to switch to another insurance company in
following kind of policies:
55 Which of the following is not a contributor towards Historical Present Potential Speculated
4
Customer Lifetime value
56 Which of the following is NOT an example of non Signaling okay with a hand gesture Gesturing in an empty room Wearing jewelry Raising your voice
2
verbal communication?
57 The ability to perform the promised service Tangible Reliability Assurance Responsiveness
dependably and accurately, can be termed as 2
_________
58 The knowledge, competence and courtesy of service Reliability Assurance Responsiveness Tangible
providers and their ability to convey trust and
2
confidence, can be termed as _________

59 Select the Correct Statement, with Regard to Grace- The Standard Length of The Standard Length of The Standard Length of The Standard Length of
Period. Choose the Most Appropriate Option. the Grace-Period is 1 Month or 31 Days. the Grace-Period is One Quarter. the Grace-Period is One Week. the Grace-Period is One Fort-Night. 1

60 No one else in the insurance company has ownership of responsibility towards duty towards role in resolving 1
_____________ the client's problems as much as an
agent does.
61 In case where the complaint of a customer is not Insurance Grievance Redressal Grievance Redressal Officer Consumer Complaints Registration Integrated Grievance Management 4
satisfatorily resolved, the complaint may be raised Mechanism System System
with-
62 IGMS stands for- Insurance Grievance Management Integrated Grievance Management IRDAI Grievance Management System Initial Grievance Management System 2
System System
63 Defect means- Imperfection in the quality of product / deficiency in the nature of product / inadequacy in the manner of All of the above 4
service service performance of the product
64 Consumer dispute redressal agencies are not National level District level City level State level 3
established at-
65 District Commission has the powers of High Court Supreme Court of India Small Causes Court Civil Court 4
________________.
66 Appeals against orders passed by State Consumer High Court State Commission Civil Court National Commission 4
Disputes Redressal Commission are accepted for
hearing at ______________.
67 Which Consumer dispute redressal agency is State Commission National Commission District Commission Both District & State Commission 2
established by the Central Government?
68 A complaint can be filed with the Consumer Dispute The advocate The agent authorised by the consumer The Consumer or his authorised agent Only the consumer 3
Redressal Agencies by-
 Insurance Agents (HEALTH) Question Bank - English
69 The Ombudsman passes an award to insured within 2 months 15 days 3 months 1 month 3
_________ from the date of receipt of all the
requirements from the insured and insurer.

70 Consumer protection Act. comprises of_________ One-tier Three-tier Two-tier Four-tier

2
quasi-judicial machinery
71 Which of the following statement is incorrect with No one else other than the complainant There is no fee for filing a complaint with The complaint can be filed personally or No advocate is necessary for the
regard to process of filing a complaint with a himself / herself can file a complaint State Commission or National can even be sent by post purpose of filing a complaint
1
Consumer Court? with the State or National Commission Commission

72 If a policyholder wishes to file a complaint against Where the value of goods/services and Where the value of goods/services and Where the value of goods/services and Where the value of goods/services and
any insurance company directly with State compensation claimed is up to Rs 20 compensation claimed exceeds Rs. 20 compensation claimed exceeds Rs.100 compensation claimed exceeds Rs. 10
2
Commission, then in which of the following cases can lakh lakh but does not exceed Rs. 100 lakh. lakh. crores
he / she do so?
73 Which of the following statement is incorrect with This redressal authority has original, It entertains appeals from the National It has original jurisdiction to entertain No fees is charged to file a complaint
regard to the State Commission? appellate and supervisory jurisdiction Commission complaints where the value of with state commission
goods/service and compensation, if any
2
claimed exceeds Rs. 1Crore but does not
exceed Rs. 10 Crore

74 Which of the following rules is incorrect with regards The Award should be more than Rs. 50 The Award should be made within a The insurer shall comply with the Award If the insured does not intimate in
to the Award that can be passed by the lakh period of 3 months from the date of and send a written intimation to the writing the acceptance of such Award,
Ombudsman? receipt of complaint Ombudsman within 15 days of the the insurer may not implement the 1
receipt of such acceptance letter Award

75 In case of rejection of application, the applicant is 25 days of receiving the application 30 days of receiving the application 21 days of receiving the application 14 days of receiving the application 3
communicated the reasons for the rejection in
writing within -
76 The insurer is required to communicate his final 25 days 15 days 30 days 20 days 2
decision on the review application made by applicant
within ____________.
77 Whom can the aggrieved insurance agent appeal to Designated Official Appellate Authority Appellate Official Appellate Officer 4
in case of cancellation of appointment?

78 An aggrieved agent can appeal within 45 days, 30 days 30 days, 20 days 25 days, 30 days 20 days, 15 days 1
_______________ and the officer will give the
decision within _______________.
79 The applicant who passes the Insurance Agency Six months 24 months 12 months 36 months 3
Examination is issued a pass certificate by the
examination body. The validity of this certificate is
_____________ within which the applicant can apply
for the appointment as an agent with any insurer for
the first time.
80 What as per the code of conduct mentioned in the Demand / receive share of benefit from Inducing the prospect to omit a material Soliciting or procuring insurance Issuing insurance advertisement 2
IRDAI (Appointment of Agents) Regulations, 2016, insurer fact in the proposal form business without setting up a registered
the insurance agents are prohibited from - office

81 An agent's appointment can be cancelled / Discloses material facts in the Violates terms of policy Fails to retain the clients on renewal of Furnishes wrong / false information 4
suspended if he - application the policy
 Insurance Agents (HEALTH) Question Bank - English
82 When is the name of blacklisted agent removed from When the agent resigns from his When the suspension against the agent When the agent submits his written oath When the agent surrenders his 2
the black list? appointment as agent by the insurer is revoked by the authority to the authority regarding strictly appointment as agent by the insurer
adhering to the code of conduct in
future
83 Which of the below Act has provisions for monitoring IRDA Act, 1999 Deposit Insurance and Credit Guarantee Public Liability Insurance Act, 1991 The Insurance Act, 1938 and subsequent
and control of operations of insurance companies? Corporation Act, 1961 amendment 4

84 Which One of the Following Bodies, can issue the Finance Ministry Government of India Life Insurance Corporation (L.I.C.) of Insurance Regulatory and Development
License to work as Individual Agents, in India? India and General Insurance Corporation Authority of India (I.R.D.A.I.) 4
(G.I.C.) of India, Jointly.
85 Insurance Agents, who hold the Licence to act as Brokers Corporate Agents Third-Party Administrators (T.P.A.s) Composite Insurance Agents
Agents for Both: Life Insurer, General Insurer, Health
4
Insurer, and Each of the Two Mono-Line Insurers, are
called --.
86 Minimum Academic Qualification of a Sepcified Class 10 Class 12 Graduate Post-Graduate
Person 2
is --.
87 An Applicant, seeking an Appointment as an I-A, Designated Official A.I-A, Appellate Officer I-B, Designated Official I-B, Appellate Officer
Insurance
Agent of an Insurer, shall submit an Application in 1
Form: --, to the --- of the Insurer.

88 Which of the following factors are mostly in the Social factors Genetic factors Environmental factors Lifestyle factors 4
control of an individual for maintaining good
health
89 Which diseases are spread due to bad hygiene Cancer and AIDS Hypertension and diabetes Influenza and chickenpox None of the above 3
and environmental sanitation
90 Does a country's social and economic progress No, there is no relationship between Yes, there is a direct relationship The relationship is indirect The relationship is uncertain 2
depend on the health of its people the two between the two
91 What is the main aim of healthcare services To create more jobs for healthcare To promote, maintain, monitor or To make healthcare facilities To make healthcare services difficult 2
providers restore health of people expensive to access
92 Which of the following statements is true Healthcare facilities should be based Healthcare facilities should be based Healthcare facilities should be based Healthcare facilities should be based 1
regarding the setting up of healthcare facilities on the probability of the incidence of on the frequency of less severe on the availability of nearest railway on the investment capacity of
more severe illnesses like Hepatitis B illnesses like cold and cough station healthcare providers

93 Which of the following statements is true They are provided by primary care They are only available to inpatients They are the first point of contact for They include ambulance facilities and 4
regarding secondary healthcare services physicians patients within a health system diagnostic services

94 Which healthcare provider would Mr. Sagar A specialist at a hospital A primary healthcare provider A dentist A pharmacist 2
most likely visit first if he is feeling sick
95 Which of the following defines primary Healthcare services provided by Healthcare services provided by Specialized consultative healthcare Ambulance services and pathology 1
healthcare doctors, nurses and small clinics medical specialists services
96 Which health insurance scheme aims to provide Central Government Health Scheme Employees’ State Insurance Scheme Commercial Health Insurance None of the above 1
comprehensive medical care to central
government employees and their families
 Insurance Agents (HEALTH) Question Bank - English
97 Which section of the Income Tax Act allows Section 80 B Section 80 C Section 80 E Section 80 D 4
individuals to deduct premiums paid towards
Health Insurance from taxable income

98 Which type of health insurance policy is allowed Any health insurance policy Only policies provided by the Only policies provided by life insurers Only policies provided by non-life 1
to be deducted from taxable income under Government insurers
Section 80 D of the Income Tax Act

99 Which of the following statements is true about The first standardised health The Central Government Health Employees’ State Insurance Scheme Health insurance in India began with 3
the development of health insurance in India insurance product for individuals and Scheme (CGHS) was introduced for (ESIS) provides comprehensive health the introduction of commercial
their families in India was introduced blue-collar workers employed in the services through a network of its own health insurance by non-life insurers
in 2001 by private players in the formal private sector dispensaries and hospitals for blue- in 1986
insurance sector collar workers employed in the
formal private sector

100 Which of the following is not a type of private Solo practitioners Diagnostic laboratories Corporate hospitals Government clinics 4
health care provider in India
101 The following intermediary facilitates carrying Insurance Broker Third Party Administrator Surveyor and Loss Assessor Reinsurance Broker 2
out of pre-insurance medical examinations in
connection with underwriting of the health
insurance policies

102 All the statements given below related to Employees’ This scheme was introduced for central ESIC (Employees State Insurance All workers earning wages up to Rs. Employee and employer contribute
State Insurance Scheme are true EXCEPT: government employees and provides Corporation) is the implementing agency 15,000 are covered under the 1.75% and 4.75% of pay roll respectively;
comprehensive health services through contributory scheme state governments contribute 12.5% of 1
a network of its own dispensaries and the medical expenses
hospitals
103 All the statements given below related to Central The Central Government Health Scheme The CGHS is only for the central It aims to provide comprehensive The services are provided through
Government Health Scheme are true EXCEPT: (CGHS), which was introduced in 1954 government employees including medical care to employees and their CGHS’s own dispensaries, polyclinics and
3
pensioner and their family member families and is fully funded by the empanelled private hospitals.
working in civilian jobs employer (central government)
104 All the options given below are lifestyle factors that Exercising Eating within limits Safe drinking water Avoiding worry
determine the health of any individual EXCEPT: 3

105 Which of the following is an example of Influenza Malaria Dengue Asbestosis

communicable disease caused due to environmental 1
factors like bad hygiene?
106 Which of the following is an example of Chickenpox Malaria Dengue Asbestosis
communicable disease caused due to environmental 1
factors like bad hygiene?
107 What type of information is included in the PAN Number Personal bank details Detailed information on diseases Details of any other insurance with 3
medical questionnaire required in case of such as Diabetes, Hypertension, other insurer
adverse medical history in the proposal form Chest pain or Coronary Insufficiency
or Myocardial Infarction

108 What information does the insurer consider Details of the insured Details of the subject matter Previous history of insurance and All of the above 4
when deciding to accept a proposal claim experience
 Insurance Agents (HEALTH) Question Bank - English
109 What does UIN in Health Insurance Stand for The unique identification number of The unique identification number of The unique identification number of The unique identification number of 3
the policy document the insurer the product the policyholder
110 What is a condition in an insurance contract It is a provision in the contract that It is a provision in the contract that
It is an optional provision that may or It is a provision in the contract that 4
can be changed at any time outlines the rights of the policyholder
may not be included in the forms the basis of the agreement
agreement.
111 Which of the following statements about A breach of condition makes the A breach of condition makes the They are not important in They are optional provisions in an 2
conditions in an insurance policy is true policy voidable at the option of the policy voidable at the option of the determining the basis of the insurance contract
insured insurer agreement
112 What is an endorsement in insurance policy A document attached to the policy A document that specifies the A document that sets out changes or A document that provides additional 3
that covers all perils and exclusions standard terms and conditions of the amendments to the policy coverage to the policy
policy
113 Identify the true statement Only I is true Only II is true Both I and II are true Both I and II are false
I. Critical illness policies are usually available for
persons in the age group of 21 years to 65 years.
1
II. The sum insured offered under these policies is
quite low.

114 Which of the following is an example of package Only I I and II II and III I,II and III
policy?
I. Health plus life combi product 3
II. Shopkeepers policy
III. Householder's policy
115 What is the free look in period for health insurance 15 days 20 days 30 days 45 days
1
policies
116 A Life Assurance Company paid the Treatment Costs Survival-Benefit Payments Surrender-Value Rider-Benefit Conditional Assignment
to the Insured, During the Event of Hospitalisation of
the Insured, During the Policy-Term. This is an 3
Example of
--.
117 Ms. Kavita purchases a Critical Illness (C.I.) Rider, Claim will be ascertained, as per the Claim will be ascertained, based on the Claim will occur, when the Policy-Holder Claims will be ascertained, based on the
along with, a Term Assurance Plan, from ABC Conditions, stipulated in the Policy. Dates, which are determined, at the decides to cancel the Contract. Medical and Other Records, provided by
Insurance Company. How Will, the Company Beginning of the Contract, it-self. the Policy-Holder, in Support of Her
4
ascertain the Claim for the Critical Illness (C.I.) Rider? Claim.
Choose the Most Appropriate Option.

118 What are the two broad categories of health Home care covers and personal Indemnity covers and hospital cash Dental covers and critical illness Out-patient covers and travel covers 2
insurance products accident covers (fixed benefit) covers covers
119 Which category of health insurance products Indemnity covers Home care covers Personal accident covers Hospital cash (fixed benefit) covers 1
constitutes the bulk of the health insurance

120 What is the other name for Fixed benefit covers Out-patient covers Travel covers Dental covers Hospital cash 4

121 Which of the following is true regarding long Premium for such products shall Premium for such products shall Premium for such products shall Premium for such products shall 3
term health products offered by Life Insurance remain unchanged for at least a remain unchanged for at least a remain unchanged for at least a remain unchanged for at least a
Companies period of every block of four years period of every block of two years period of every block of three years period of every block of five years

122 What is the minimum size of a Group for which 3 5 9 7 4

Group Health Insurance Policy can be issued
 Insurance Agents (HEALTH) Question Bank - English
123 What is the maximum tenure for Credit Linked 5 years 1 year 2 years 3 years 1
Group Personal Accident policies offered by
General Insurers and Health Insurers

124 What is the provision in case an insured has The insurance companies will split Each insurance company will make The insured must choose one policy The insured must provide proof of 2
taken health policies from multiple insurance the claim payment evenly claim payments independently to use for all claim payments which policy they want to use for
companies that provide fixed benefits according to their policy's terms and each claim
conditions
125 What is the purpose of IRDA Guidelines on To provide more confusion among To make it difficult for customers to To remove the confusion among To limit the number of health 3
Standardization in health insurance insurers and customers compare products and take a insurers, service providers, TPAs, and insurance providers in the market
considered decision hospitals
126 What types of insurance products do the IRDA All insurance product All health insurance products, All health insurance products, All general and health insurance 4
guidelines on standardization in Health including PA and Domestic/Overseas excluding group policies products, excluding PA and
Insurance apply to travel Domestic/Overseas travel -
Indemnity based health products
Offered by general / health insurers

127 What is the purpose of a Hospitalization To only provide coverage for To indemnify the policyholder by To provide coverage for all medical To exclude expenses related to 2
indemnity policy expenses before and after covering expenses during expenses hospitalization
hospitalization hospitalization
128 What is the minimum prescribed period of 24 hours 12 hours 36 hours 48 hours 1
hospitalization after which the policy provisions
come into force
129 Which of the following procedures are covered Dental procedures Eye surgeries Cosmetic surgeries None of the above 2
under the policy
130 Which of the following statements is true about The policy does not cover infants The policy does not cover Sr.Citizen The policy does not cover expenses The policy covers only inpatient 4
the indemnity based Mediclaim policy related to hospitalization hospitalization expenses

131 What are Post hospitalization expenses Expenses incurred during Expenses incurred after Expenses incurred before Expenses not covered by insurance 2
hospitalization hospitalization hospitalization
132 What is the duration of cover for Pre and Post 60 days pre and 30 days post 90 days pre and 30 days post 30 days pre and 90 days post 30 days pre and 60 days post 4
hospitalization expenses hospitalization hospitalization hospitalization hospitalization
133 What is a family floater policy Only the individual can be covered Only the dependent family members A policy that offers a single sum None of the above 3
under this policy can be covered under this policy insured which floats over the entire
family
134 In a family floater policy, how is the premium Based on the age of the oldest Based on the age of the youngest Based on the sum insured chosen for None of the above 1
calculated member of the family member of the family each individual insured
135 Why do insurance companies collect details of To charge improper premiums To exclude coverage for any future To provide free treatment for such To decide on accepting the proposal 4
pre-existing diseases diseases diseases for insurance
136 What is a pre-existing disease Any disease suffered by an insured Any disease suffered by an insured Any disease suffered by an insured Any disease suffered by an insured 2
person within 12 months prior to person within 48 months prior to person within 24 months prior to person within 36 months prior to
commencement of the policy commencement of the policy commencement of the policy commencement of the policy

137 What is disease-specific capping in health A limit on the premium charged for A limit on the number of claims that A limit on the amount of coverage A limit on the number of diseases 3
insurance policies covering certain diseases can be made for a particular disease provided for specific diseases that can be covered under a policy
 Insurance Agents (HEALTH) Question Bank - English
138 What is co-payment in health insurance The portion of the claim amount that A separate policy taken by the The percentage of the premium paid The amount deducted from the Sum 1
the policyholder/insured has to bear policyholder to cover specific by the policyholder/insured Insured after every claim
diseases
139 Which of the following is a cost-sharing Waiting period Coverage for Day care procedure Deductible/ Excess Pre-policy check-up cost 3
provision in a health insurance policy
140 Who bears the cost of a pre-policy medical check- Prospective client Insurer Government Healthcare provider 2
up in a health insurance policy
141 What is a top-up cover in health insurance A policy that covers only pre-existing A policy that covers only day-care A policy that provides cover for high A policy that covers only accidents 3
conditions procedures sums insured over and above a
specified amount
142 What is the entry age for Elderly health 50 years 55 years 60 years 65 years 3
insurance plans
143 What is the claim amount in a fixed benefit A fixed sum irrespective of the The amount spent by the insured for A variable amount based on the No claim amount is given 1
insurance plan amount spent by the insured for the the named treatment severity of the ailment
named treatment
144 What is the proof required to process a claim in Detailed bills and invoices of the Proof of Hospitalization and coverage Doctor's prescriptions and medical None of the above 2
a fixed benefit insurance plan treatment of ailment under the policy reports

145 What is a critical illness policy A policy that provides daily cash A policy that provides a fixed sum on A policy that covers treatment costs A policy that covers only pre-existing 2
benefit to the insured person during diagnosis of certain named critical for minor illnesses conditions
hospitalization illness
146 What is the waiting period for Corona Kavach 90 days 30 days 15 days 60 days 3
and Corona Rakshak
147 What is the maximum sum insured option Rs. 1 lakh Rs. 2.5 lakh Rs. 2 lakh Rs. 1.5 lakh 2
available under Corona Rakshak
148 What is the lump sum benefit payable under the 50% of the sum insured 75% of the sum insured 100% of the sum insured 125% of the sum insured 3
standard policy for vector-borne diseases on
positive diagnosis requiring hospitalization for a
minimum of 72 hours
149 What do Health plus Life Combo Products offer Life insurance cover only Health insurance cover only Both life and health insurance covers None of the above 3

150 What is the aim of Micro-insurance products? To aim for the protection of high- To aim for the protection of low- To aim for the protection of middle- To aim for the protection of people 2
income people from urban sectors. income people from rural and income people from semi-urban from developed sectors.
informal sectors. sectors.
151 Which of the following policies was launched by Ayushman Bharat Scheme Rashtriya Swasthya Bima Yojana Jan Arogya Bima Policy Bima Kavach Yojana 2
the Government to provide health insurance (RSBY)
coverage for the below poverty line (BPL)
families in association with insurance
companies?
152 What is the Sum Insured amount for Rashtriya Rs. 5,00,000 Rs. 1,00,000 Rs. 50,000 Rs. 30,000 4
Swasthya Bima Yojana (RSBY)?
153 Which of the following schemes was launched to Ayushman Bharat Scheme Money Back Scheme Endowment Scheme Bima Kavach Yojana 1
achieve the vision of Universal Health Coverage
(UHC)?
154 What is the premium amount for Pradhan Rs. 10/- per annum per member Rs. 12/- per annum per member Rs. 15/- per annum per member Rs. 20/- per annum per member 2
Mantri Suraksha Bima Yojana (PMSBY)
 Insurance Agents (HEALTH) Question Bank - English
155 What is the maximum sum insured provided for Rs. 1 Lakh Rs. 3 Lakh Rs. 5 Lakh Rs. 2 Lakh 4
death under Pradhan Mantri Suraksha Bima
Yojana (PMSBY)
156 Who can avail an Overseas Travel Insurance Only Indian citizens travelling abroad Only Indian citizens travelling abroad Indian citizens travelling abroad for Only employees of Indian employers 3
policy for holiday for business business, holiday or studies and sent on contracts abroad
employees of Indian employers sent
on contracts abroad

157 What is the most common form of group health Individual policy Group policy taken by employers Personal policy Family policy 2
insurance covering employees
158 Identify the true statement Only I is true Only II is true Both I and II are true Both I and II are false
I. Health plus life combi products are jointly designed
by the two insurers and marketed through the
distribution channels of both insurers 1
II. For health plus life combi products, the claims are
handled by the insurers jointly

159 What are the benefit payout provided under 'Critical Actual medical expenses incurred due to A fixed sum per day for the period of Payout on occurrence of a pre-defined All of the above
Illness cover'? hospitalization hospitalization critical illness like heart attack, stroke, 3
cancer etc
160 Hospital daily cash policy provides towards benefits: Only I I and II II and III I,II and III
I. Incidental expenses
II. Expenses not payable under the indemnity policy
2
III. Expenses non payable under Co-pay

161 ABC Insurance Company assumes a high interest rate Premium charged will be higher Premium charged will be lower Premium charged will remain unchanged Premium charged will fluctuate wildly
in their premium calculations. This mean that: 2

162 Which of the following health insurance products is Indemnity cover Fixed benefits cover Critical Illness cover All of the above
a fixed benefit plan for payout on occurrence of a
3
pre-defined critical illness like heart attack, stroke,
cancer etc.?
163 Why is underwriting necessary To create a large pool of risks for the To prevent the insurance company To accept all risks, regardless of To offer insurance at the lowest 2
insurance company from becoming insolvent premiums possible premium
164 Which factor affects morbidity rates in health Financial status Gender Marital status Educational qualification 2
insurance
165 What is moral hazard in health insurance The physical hazards associated with The cost associated with a health risk The deliberate intention of taking The risk assessment and pricing done 3
a health risk insurance just to collect a claim by the underwriter
166 Which of the following statements is true about It can prove costly to the insurance It refers to the physical hazards of a It has no impact on the insurance It can be beneficial to the insurance 1
moral hazard in health insurance company health risk company company
167 Insurers charge lower premiums for which of the Standard risks Substandard risks Preferred risks Declined risks 3
following risk types
168 Who plays a critical role in primary underwriting Underwriter Agent or Company representative Policyholder Insurance broker 2
 Insurance Agents (HEALTH) Question Bank - English
169 Before issuing a policy, the specific consent of The insurance company The regulator The policyholder The insurance agent 3
the policyholder for any underwriting loading
charged over and above the premium must be
obtained. This regulation is for the benefit of

170 When can porting be done Anytime during the policy period Only at the time of policy issuance Only after a break in the policy Only at the time of policy renewal 4

171 Who should the insured make a request for The new insurer The old insurer IRDAI Any insurance agent 2
porting to
172 What is the consequence of breach or Increase in premium Policy becomes void Decrease in premium Policy remains unaffected 2
concealment of information by the insured in
insurance
173 When are financial documents usually asked for Only in high sum assured coverage When there is a mismatch between Both (B) and (C) None of the above 4
in insurance stated income/occupation and
coverage sought

174 What is the purpose of medical underwriting in To determine the premium amount To determine whether to offer To determine the number of family To determine the type of hospital 2
health insurance coverage or not members to be covered where the insured can be admitted

175 What are the different categories of risk into Accept risk at standard rates, extra Accept risk at an extra premium Postpone the cover for a stipulated All of the above 4
which the underwriter can classify a proposal premium, or decline the cover period/ term

176 In which cities are the premiums for certain Small towns and villages Tourist destinations Metros and 'A Class' cities Industrial hubs 3
products higher due to higher claims cost
177 Which of the following non-employer groups can Employer welfare associations Customers of a particular business Borrowers of a bank All of the above 4
be offered group health insurance where insurance is offered as an add-
on benefit
178 What is the main cover under Overseas Travel Life cover Home insurance Health cover Vehicle insurance 3
Insurance policies
179 Which risk group does a person working in Risk group I Risk group II Risk group III None of the above 3
underground mines belong to
180 What is the general age limit for the working 5-70 18-70 30-70 50-70 2
population in employer-employee groups

181 From the below given age proof documents, identify School certificate Identity card in case of defence Ration card Certificate of baptism
the one which is classified as non-standard by personnel 3
insurance companies.
182 Out of following underwriting methods the process Medical underwriting Non medical underwriting Numerical rating method Group insurance
of underwriting is speedy but the premiums may be 1
relatively higher except
183 Group insurance is underwritten mainly on Law of Uberrima fides Law of Insurable interest Law of averages Law of mutual benefit
3
_________________.
184 Which One of the Following Statements, is In- A Specified Amount is Paid, as per the The Illness should have been covered in Critical Illness (C.I.) Rider is an Example The Life Assurance Policy Contract
Correct, with Regard to Critical Illness (C.I.) Rider? Policy- Terms, in the Event of Diagnosis the List of Critical Illnesses, specified by of the Claims, that may occur, during the Terminates, After the Rider-Payments
4
Choose the Most Appropriate Option. of a Critical Illness. the Insurance Company. Policy- Term. are Made.
 Insurance Agents (HEALTH) Question Bank - English
185 Third-Party Administrators (T.P.A.s) are Regulated, Life Insurance Council and General Insurance Regulatory and Development Insurance Brokers Association of India Finance Ministry
by Which of the Following Bodies? Insurance Council, Jointly. Authority of India 2
(I.R.D.A.I.)
186 What is the true test of an insurer's performance The colour of the insurance The number of employees the The claims paying ability of the Location of Company office premises 3
in insurance? company's logo insurance company has insurance company
187 Who is the first stakeholder and receiver of the The insurance agent who sold the The person who processes the The insurance company's The customer who buys the 4
claim? policy insurance claim shareholders insurance policy
188 Which of the following statements is true Claims can only be serviced by the Claims can only be serviced by Third Claims can be serviced by either the Claims can only be serviced by 3
regarding Health insurance claim servicing? insurance company itself. Party Administrators (TPAs). insurance company or TPAs providers/hospitals.
authorized by the insurance
company.
189 What happens from the time a health claim is The claim is rejected immediately The payment is made without any The claim goes through a set of well- The insurer/TPA ignores the claim 3
made known to the insurer/TPA to the time the verification defined steps
payment is made as per the policy terms?

190 What is claim intimation in the insurance claim The final stage of the claim process The process of investigating a claim The act of informing the insurance The process of determining the 3
process? company of a planned or emergency amount to be paid for a claim
hospitalization
191 Which of the following statements is true Claim intimation is not mandatory Claim intimation is required before Claim intimation is required within claim intimation is required before 4
regarding claim intimation in health insurance? 48 hours of hospitalization in case of 48 hours of hospitalization in case of hospitalization in case of planned
an emergency an emergency admission, and within 24 hours of
hospitalization in case of an
emergency.
192 How is claim intimation to Insurer / TPA possible Only Through telegrams Only Through fax Through Mobile Apps/ call centres/ Only Through postal mail 3
according to the statement? internet/ e-mail
193 What happens after a company or TPA receives The claim is immediately approved The documents are ignored The details are matched for accuracy The claimant is asked to provide 3
an intimation about Mr. X's claim? and a reference number is generated more documents

194 Which of the following is true regarding the Claims are accepted without any Claims are scrutinized for Claims are only scrutinized for Claims are scrutinized for sum 2
scrutiny of claims for final settlement on a scrutiny or verification of documents. admissibility, sum assured, admissibility, but not for sum assured, but not for admissibility,
reimbursement basis? deductibles, and sub-limits. assured, deductibles, and sub-limits. deductibles, and sub-limits.

195 What action is taken by the company in case the Pre-authorization of likely The claim is directly processed The hospital is contacted for more The claim is rejected 1
intimation is for a planned surgery under the expenditure is given to the hospital information
Cash-less scheme?
196 Which of the following alternative modes of Unani Siddha Homeopathy All of the above 4
treatment may be covered by health insurance
policies, but may have sub-limits?
197 What is the recent directive of IRDAI regarding Insurers are not allowed to cover Telemedicine is allowed only for non- Telemedicine is allowed wherever Policyholders are required to visit 3
telemedicine in medical insurance policies? telemedicine in their policies. coronavirus-related medical regular medical consultation is the hospital for all medical
consultations. allowed. consultations.
198 Which of the following is NOT a factor that Sum insured available for the Deductible amount Balance sum insured available under Sub-limits 2
decides the claim amount payable? member under the policy the policy for the member after
taking into account any claim made
already
 Insurance Agents (HEALTH) Question Bank - English
199 What are Reasonable and Customary Charges? Charges that are higher than the Charges for services or supplies that Charges that are decided solely by Charges for services or supplies that 4
prevailing charges in the are unique to a particular provider the insurer are consistent with the prevailing
geographical area charges in the geographical area for
identical or similar services

200 What has been standardized under IRDAI Health Sum insured available for the Balance sum insured available under Non-payable items in health Deductible amount 3
Insurance Standardization Guidelines? member under the policy the policy for the member after insurance
taking into account any claim made
already
201 How are payments made for a payable claim By cheque or bank transfer By cash only Only by cheque By transferring the claim money to 1
amount? the insurance company's account

202 Which of the following is not a possible reason No active treatment; admission is Illness treated is excluded under the Hospitalization is more than 24 hours The cause of illness is abuse of 3
for denial of health insurance claims? only for investigation purpose policy alcohol or drugs

203 What percentage of submitted health claims are 5% to 10% 10% to 15% 15% to 20% 20% to 25% 2
usually denied?
204 What is the time frame within which 30 days from the date of receipt of 60 days from the date of receipt of 90 days from the date of receipt of 120 days from the date of receipt of 3
investigations for suspect claims should be claim intimation claim intimation claim intimation claim intimation
completed?
205 Within how many days of completing the 30 days 15 days 60 days 90 days 1
investigation should a claim be settled?
206 What are some examples of frauds committed in Impersonation Fabrication of documents Inflation of expenses All of the above 4
health insurance?
207 What options are available for customers if their IRDAI The Consumer Commissions Insurance Ombudsman All of the above 4
claim is denied?
208 What is the first step for a customer covered The customer approaches the The customer approaches the The customer pays the hospital The customer contacts the TPA 2
under health insurance to avail the cashless treating doctor for admission hospital’s insurance desk with charges in advance directly
facility? insurance details
209 Who takes the decision on whether the cashless The hospital The patient The TPA The insurer 3
authorization could be provided or not?

210 What does the hospital do when the patient is Check the amount of credit in the Request the patient to pay the entire Ask the patient to undergo further Transfer the patient to another 1
ready for discharge? account of the patient approved by treatment charges in cash treatment hospital
the TPA against the actual treatmnet
charges covered by Insurance

211 What is the purpose of reserving in the context To make provisions for all claims in To hold claim amounts until To ensure that policyholders pay To estimate the profits that the 1
of insurance companies? the books of the insurer based on the payments are due their premiums on time insurer will earn from investments
status of the claims
212 What does the TPA do after studying the Approves the cashless authorization Takes a decision on whether cashless Rejects the cashless authorization None of the above 2
information provided in the cashless without delay authorization could be provided and, immediately
authorization form? if so, for how much amount

213 What should mr.X do if he doesn't have his He should contact the hospital He should contact the TPA through a He should wait until they have their He should pay for the treatment out 2
insurance details with him? 24 hour helpline insurance details of pocket
 Insurance Agents (HEALTH) Question Bank - English
214 What should Mr.X do if the hospital suggested He should choose another hospital in He should contact the TPA to check He should pay for the treatment out He should contact the consulting 2
by his doctor is not in the TPA network? the network of the TPA for options where cashless facility is of pocket doctor for further advice
available
215 When should a customer inform the TPA about After the patient is discharged Before the patient is admitted to the At the time of filling the pre- In advance of the discharge and 4
the discharge? hospital authorization form request the hospital to send to the
TPA any additional approval that may
be required
216 What is the most important document required Investigation report Consolidated and detailed bills Receipt for payment Discharge summary 4
to process a health insurance claim?

217 What is the purpose of investigation reports in To provide a summary of the To provide a break-up of the bills To assist in comparing the diagnosis To verify the identity of the patient 3
health insurance claims? patient's condition and treatment
218 What is the purpose of the claim form in health To provide a summary of the To request processing of the claim To provide a break-up of the bills To assist in comparing the diagnosis 2
insurance claims? patient's condition and treatment
219 Which of the following is an expectation from Providing legal advice to customers Delivering groceries to customers Servicing customers in the event of a Performing home repairs for 3
insurance agents/brokers in addition to selling claim customers
policies?

220 Which document may be required for accident Consolidated and detailed bills Identity proof Dialysis/Chemotherapy/Physiotherap FIR or Medico-legal certificate 4
claims? y charts
221 What is the purpose of having a membership To obtain discounts on medical To receive reimbursement for To avail cashless facility for To receive medical advice and 3
with the TPA? treatment at hospitals. medical expenses not covered by the hospitalization or treatment covered consultation from a team of
policy. by the policy, and to process claims healthcare professionals.
when required.
222 What document does the TPA issue to the Medical report Discharge summary Pre-authorization or Letter of Prescription for medication 3
hospital for cashless treatment? Guarantee
223 What is claims investigation about? Determining the validity of the claim Assessing the credibility of the Verifying the authenticity of the Calculating the premium to be 1
and finding out the real cause and claimant's occupation claimant's identity documents charged for the policy
extent of the loss
224 What documents are required for name and Birth certificate and rental Passport and bank statement Aadhar card and credit card PAN card and telephone bill 4
address verification for AML (Anti-money agreement statement
laundering) purposes?
225 What is the role of assistance companies in They process claims on behalf of They provide assistance to customers They offer tie-up arrangements with They provide legal assistance to 2
overseas claims? insurance companies in case of contingencies covered hospitals for cashless treatment customers during claims process
under the policy

226 Which of the following is NOT a service provided Medical service provider referrals Interpreter Referral Delivery of Essential Medicines Rental car booking 4
by assistance companies during overseas travel
insurance claims?
227 What is the fee charged by assistance companies It varies depending on agreement It is a fixed amount for all customers It is determined by the insurance There is no fee charged for the 1
for their services? with the particular insurance of the insurance company company and is the same for all services provided by assistance
company, benefits covered etc. assistance companies companies
228 Which of the following steps is necessary for Submit a written request to the Visit any hospital of choice Intimate the call centre and proceed None of the above 3
hospitalization in case of a travel insurance insurance company to a specified hospital with a valid
claim? travel insurance policy
 Insurance Agents (HEALTH) Question Bank - English
229 How do hospitals verify the validity of an The hospitals do not verify the The hospitals contacts the assistance The hospitals call the insured's family The hospitals relies on the insured's 2
overseas travel insurance policy? validity of the policy before companies/ insurers on the call or friends to confirm the policy word that they have a valid policy.
treatment centre numbers to check the validity details
of the policy and verify coverages.

230 Which type of claim payment is made in foreign Cashless claims Reimbursement claims Both cashless and reimbursement None of the above 1
currency? claims
231 What is the currency conversion rate used while The rate as on date of loss The rate as on date of filing the claim The rate as on the date of discharge The rate as on the date of admission 1
processing reimbursement claims? from the hospital to the hospital
232 What currency is used for payments for British Pound (GBP) Indian Rupee (INR) United States Dollar (USD) Euro (EUR) 2
admissible claims in reimbursement claims for
overseas travel insurance?
233 Which document is required to certify the Birth certificate Passport Permanent disability certificate from Driving license 3
disability of an insured individual? a civil surgeon or equivalent
competent doctors
234 For a claim to be processed, which of the following Only I and II Only I and IV I, II and III I, II, III and IV
are most important documents?
I. Documentary evidence of illness
3
II. Payment made to the hospital
III. Further advice for treatment
IV. Payment proofs for implants
235 Which of the following statement/s is / are correct Only I Only II Both I and II Neither I nor II
with regards to 'claim processing and payment
services' provided by a TPA?
I. TPAs normally receive advance money from the
insurer for claim settlement. The TPA is expected to
keep an account of the monies and provide periodic
1
reconciliation of the amounts received from the
insurance company
II. The money can be used for purposes of payment
of approved claims and providing other services to
the customers

236 Hospital-Admission-Intimation can be made to an Fax Calling the Call-Centre E-Mail Any of the Above.
Insurance Company, through, Which of the Following 4
Channels?
237 For a Health Insurance Claim to be Processed, Which Only, I and II. Only, I and IV. I, II, and IV. I, II, III, and IV.
of the Following, are the Most Important
Documents?
I. Documentary Evidence of Illness. 4
II. Treatment-Provided.
III. In-Patient Duration.
IV. Investigation-Reports.
 Insurance Agents (HEALTH) Question Bank - English
238 Identify the True Statement: Only Statement-I is True. Only Statement-II is True. Both: Statement-I and Statement-II, are Both: Statement-I and Statement-II, are
I. Morbidity increases due to Various Adverse True. False.
Factors, such as, Being Over-Weight or Under-
Weight, Personal History of Certain Past and Present
3
Diseases or Ailments.
II. Morbidity decreases due to Certain Favourable
Factors, like, Lower Age, a Healthy Life-Style, etc.