IC-38 Model Question Paper Model Test Paper 4 Version1.1.

_CO_30thJune2017

1. IRDAI Regulations stipulate the Turnaround times (TAT) for various services that an insurance
company has to render to the consumer which are part of -
a. IRDAI (Protection of Policyholders Interests Regulations) 1999
b. IRDAI (Protection of Policyholders Interests Regulations) 2000
c. IRDAI (Protection of Policyholders Interests Regulations) 2001
d. IRDAI (Protection of Policyholders Interests Regulations) 2002
e. IRDAI (Protection of Policyholders Interests Regulations) 2004
2. IGMS refers to -
a. Internal Grievance Management System
b. Integrated Grievance Management System
c. International Grievance Management System
d. Indian Grievance Management System
e. None of the above
3. Integrated Grievance Management System is launched by -
a. IRDAI
b. Central Government
c. State Government
d. The Insurance Act , 1938
e. The Consumer Protection Act, 1986
4. .......................acts as a central repository of Insurance Grievance data and as a tool for monitoring
grievance redress 'in the industry.
a. IGMS
b. IMGS
c. MIGS
d. GIMS
5. IGMS tracks complaints and the time taken for their redressal. The complaints can be registered at which
of the following URL -
a. http://www.policyholder.gov.in/ Integreted_Grievance_Managementaspx
b. http://www.IRDAI.gov.in/ Integreted_Grievance_Management.aspx
c. http://www.IGMS.gov.in/ Integreted_Grievance_Management.aspx
d. http://www.MHA.gov.in/ Integreted_Grievance_Management.aspx
e. http://www.insurancegrievance.gov.in/ Integreted_Grievance_Management.aspx
6. While granting registration to corporate agent, which of the following aspects are considered by IRDAI
a. Does not suffer from a disqualification as specified under section 42D of the act
b. Has the necessary infrastructure
c. Has not been refused license in the past
d. Has completed mandatory training and passed the exam
e. All are considered

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IC-38 Model Question Paper Model Test Paper 4 Version1.1._CO_30thJune2017

7. Specified persons of corporate agents must fulfill which of the following criteria
a. Minimum class 12th pass
b. Undergone 50 hours of training
c. Corporate agent must have valid certificate of registration
d. Specified person can apply through principal officer of the corporate agent
e. All above
8. Identify the incorrect statement
a. A specified person of a corporate agent may switch over to any other corporate agent by applying
to IRDAI through new agent, along with no objection certificate from previous corporate agent
b. If the old corporate agent does not issue a no objection certificate within 30 days, it shall be
deemed that corporate agent has no objection to his switching over
c. The license for corporate agent is valid for three years
d. Corporate agent must apply within 30 days before expiry of registration
e. If the application for renewal reaches later than 30 days but before expiry of license, then license
may be renewed by paying a fine of Rs. 1 lakh
9. Identify the incorrect statement
a. Authority may accept renewal application after expiry if sufficient reasons are offered in writing
and a fine of Rs. 750 plus taxes is paid
b. A corporate agent is permitted to submit the application for renewal of registration 90 days prior
to expiry of registration
c. No application for renewal shall be rejected unless the applicant has been given a reasonable
opportunity of being heard
d. Appeal against order of authority can be filed with Securities Appellate Tribunal
e. Refusal to grant licenses shall be intimated within 60 days
10. Identify the incorrect statements
a. After termination of license corporate agent must provide services in respect of contract already
entered into
b. Corporate agent must provide services up to completion of services or expiry of six-month after
ceasing of license
c. Corporate agent can undertake multilevel marketing
d. Corporate agents take adequate steps for redress of grievances within 14 days
e. Corporate agent must maintain separate books of accounts for corporate agency business
11. When a person who is able to dominate the will of the another, uses her position to obtain an undue
advantage over the other is known as
a. Coercion
b. Fraud
c. Undue influence
d. Mistake

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IC-38 Model Question Paper Model Test Paper 4 Version1.1._CO_30thJune2017

12. When a person induces another to act on a false belief that is caused by a representation he or she does
not believe to be true. They state is referred as
a. Coercion
b. Fraud
c. Undue influence
d. Mistake
13. Error in one's knowledge or belief or interpretation of a thing is referred to as
a. Coercion
b. Fraud
c. Undue influence
d. Mistake
14. Which of the following are not the element in a valid insurance contract?
a. Offer and acceptance
b. Capacity to contract
c. Consideration
d. Coercion
15. Moral hazard refers to:
a. Dishonesty by an individual
b. Honesty in an individual
c. Hazard in the property
d. Hazard of the risk
16. Which of the following are not social related trends
a. Large population
b. Increase in urbanisation
C. Health issues in rural areas
d. Sedentary lifestyle
17. Which of the following are not related to life expectancy?
a. Expected number of years that a child will survive
b. Does not address the issue of living quality life
c. Sedentary lifestyle
d. Creation of infrastructure for geriatric diseases
18. Health Insurance in India formally began with the inception of the Employees' State Insurance Scheme,
introduced vide the ESI Act of ……..
a. 1942
b. 1945
c. 1948
d. 1950
e. 1955
19. The ESI scheme was introduced for…………
a. Govt employees only
b. Blue collared workers of formal private sector
c. White collared officers
d. Army, defence, police personnels
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IC-38 Model Question Paper Model Test Paper 4 Version1.1._CO_30thJune2017

e. Senior citizens only

20. What are the features of ESI scheme?
a. This scheme was introduced for blue-collar workers of formal private sector
b. It provides comprehensive health services through a network of its own dispensaries and
hospitals.
c. It is also supplemented by services purchased from Authorized Medical Attendants and private
hospitals.
d. The scheme is largely financed through a contribution from employers and employees, which is
supplemented by the Central and State governments.
e. All of these
21. In personal lines of insurance the objective of proposal form is to get information about
a. Proposer's health
b. Way of life and habits
c. Pre-existing health conditions
d. Medical history, hereditary traits
e. All above
22. The onus of proof can rest with the……….. in respect of any information not so recorded, where the
insurer claims that proposer has suppressed any material, information or provided any false information for
granting of insurance cover
a. Insurer
b. Insured
c. Agent
d. Broker
23. Insurance company has the duty to record all information received, ………..which the agent has to
keep In mind by way of follow-up
a. Physically
b. Orally
c. Casually
d. By written
24. The intermediary like insurance agent, broker has the responsibility towards
a. Insurer
b. Insured
c. Both
d.None
25. ………states that an insurer or its agent or other intermediary shall provide all material information in
respect of proposed cover to the prospect to enable the prospect to decide on the best cover that would be in
his interest
a. IRDA act
b. Insurance act
c. Insurance regulation
d. IRDA regulation

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IC-38 Model Question Paper Model Test Paper 4 Version1.1._CO_30thJune2017

26. In which type of policy coverage is provided for whole family under a single sum insured, which floats
over the entire family
a. Top up
b. Individual coverage
c. Family floater
d. Family coverage
27. Which of the following are not the examples of sublimits and disease-specific capping
a. Exclusion of cataract
b. Room rent restricted to one percent of sum insured
c. ICU charges 2% of sum insured
d. Accidental hospitalisation
28. A............ is a cost sharing requirement under health insurance policy that provides that the
policyholders will bear a specified percentage of the admissible claim amount
a. Self payment
b. Part payment
c. Co payment
d. Deductible
29. ___________ is the cost sharing requirement under health insurance policy that provides that the
insurer will not be liable for a specified amount in case of. indemnity policies
a. Self payment
b. Part payment
c. Co payment
d. Deductible
30. Find the incorrect statement
a. A deductible does not reduce the sum insured
b. Deductible, maybe on per year/per life or per event
c. Deductible may specify given number of days/hours where it will apply
d. None are incorrect
31. Certain occupations have extra risk to accidents or exposures like:
a. drivers
b. blasters
c. X ray machine operators
d. miners
e. all of these
32. How does past illness affect morbidity?
a. If it has any possibility of causing increased debility.
b. If it has any possibility of impairment.
c. If it has a chance of recurring.
d. all of these
e. none of these

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IC-38 Model Question Paper Model Test Paper 4 Version1.1._CO_30thJune2017

33. Basic principles of underwriting are ________ .

a. Utmost good faith
b. Insurable interest
c. Indemnity
d. Contribution
e. All of these
34. In Indian health insurance market, the key medical underwriting factors for assessment of insurability
are _________
a. current health status
b. age
c. gender
d. occupation
e. all of these
35. In any forms of insurance, there is a legal attire interwoven with:
a. several principles of insurance
b. specific laws on insurance
c. judicial pronouncements
d. a, b and c all true
e. b and c are true
36. Which of the following is not true for Intimation?
a. Claim intimation is the first instance of contact between the customer and the claims team.
b. The customer has to inform the claim team before availing hospitalization. Claim v
cannot be filed after hospitalization.
c. Recently, insurers have started insisting on the intimation of claim as soon as practicable.
d. The timely availability of information about hospitalization helps the insurer /TPA to verify
that the hospitalization of the customer is genuine and there is no impersonation or fraud and
sometimes, to negotiate the charges.
e. All of the above are true.
37. What is registration in Claim Process?
a. Registration of a claim is the process of entering the claim in the system and creating a reference
number using which the claim can be traced any time.
b. A claim Number is generated which can be numeric or alpha-numeric based on the system and
processes.
c. Registration and generation of a reference number is usually done once the claim intimation is
received and matched.
d. At the time of intimation / registration, the exact claim amount is initiated.
e. All of the above except d
38. What are the most important requirements in verification of documents?
a. The documentary evidence of the illness
b. Treatment provided
c. In -patient duration
d. Investigation reports
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IC-38 Model Question Paper Model Test Paper 4 Version1.1._CO_30thJune2017

e. All of the above.

39. How can one capture the billing information? The standard practice is to classify the treatment charges
into:
a. Room, board and nursing expenses including registration and service charges
b. Charges for ICU and any intensive care operations
c. Ambulance charges
d. Medicines and drugs
e. All of the above
40. Which of the following is not included in the Cardiac packages of Hospitalisation?
a. Angiogram
b. Angioplasty
c. Additional charges angioplasty
d. CABG
e. Bypass surgery
41. Which of the following relates to the Indian Insurance Company?
a. The aggregate holding of equity shares by foreign investors do not exceed 42% of the
paid up equity capital.
b. The aggregate of equity shares by foreign investors do not exceed 49% of the paid up
quity capital.
c. These include portfolio investors.
d. Only a and c
e. Only b and c
42. What does reinsurance means?
a. Insurance of part of one insurer’s risk by another insurer who accepts the risk for
a mutually acceptable premium.
b. Insurance a group of individuals.
c. Insuring an insurance company wholly.
d. Only a and b
e. None of the above.
43. Currently, how many life insurance companies are operating in India?
a. 20
b. 25
c. 24
d. 30
e. 14
44. Which of the following relates to Life Insurance Industry?
a. LIC of India is a Public sector company
b. There are 23 life insurance companies in the private sector.
c. The Postal department, under the Government of India, also transacts life insurance business via
Postal Life Insurance, but a exempt from the purview of the regulator.
d. All of the above
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IC-38 Model Question Paper Model Test Paper 4 Version1.1._CO_30thJune2017

e. Only b and c

45. Which among the following is the regulator for the insurance industry in India?
a. Insurance Authority of India
b. Insurance Regulatory and Development Authority of India.
c. Life Insurance Corporation of India.
d. General Insurance Corporation of India.
e. General Insurance Council of India.
46. Identify the scenario where a debate on the need for insurance is not required.
a. Property insurance
b. Business liability insurance
c. Motor insurance for third party liability
d. Fire insurance
e. Health insurance.
47. ………… has significant role in selling and servicing.
a. Word of mouth publicity (good/bad)
b. Written letter
c. Email
d. SMS
e. Documented proof
48. IRDAI has launched.........which acts as a central repository of Insurance grievance data and as a tool
for monitoring grievance redress in the Industry.
a. IDMS
b. DOCM
c. IMGS
d. IGMS
e.OGRS
49. This Act was passed "to provide for better protection of the interest of consumers and to make
provision for the establishment of consumer councils and other authorities for the settlement of consumer's
disputes. Which Act is referred here?
a. The Insurance Act 1938
b. Consumer Protection Act, 1986
c. The IRDA Act 1999
d. LIC Act 1956
e. None of the above
50. Consumer disputes can be addressed in:
a. District forum
b. State commission
c. National commission
d. District commission
e. All of the above excepted

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