H05 Health Insurance Claims MCQs

Welcome to our comprehensive collection of Multiple Choice Questions (MCQs) on H05 Health Insurance Claims, a fundamental topic in the field of IC38 Life Insurance Agent Exam. Whether you're preparing for competitive exams, honing your problem-solving skills, or simply looking to enhance your abilities in this field, our H05 Health Insurance Claims MCQs are designed to help you grasp the core concepts and excel in solving problems.

In this section, you'll find a wide range of H05 Health Insurance Claims mcq questions that explore various aspects of H05 Health Insurance Claims problems. Each MCQ is crafted to challenge your understanding of H05 Health Insurance Claims principles, enabling you to refine your problem-solving techniques. Whether you're a student aiming to ace IC38 Life Insurance Agent Exam tests, a job seeker preparing for interviews, or someone simply interested in sharpening their skills, our H05 Health Insurance Claims MCQs are your pathway to success in mastering this essential IC38 Life Insurance Agent Exam topic.

Note: Each of the following question comes with multiple answer choices. Select the most appropriate option and test your understanding of H05 Health Insurance Claims. You can click on an option to test your knowledge before viewing the solution for a MCQ. Happy learning!

So, are you ready to put your H05 Health Insurance Claims knowledge to the test? Let's get started with our carefully curated MCQs!

H05 Health Insurance Claims MCQs | Page 4 of 6

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Q31.
What do insured persons need to carry to relate them to the policy and TPA in health insurance?

a.

A copy of the policy document

b.

Proof of residence

c.

An Identity Card

d.

A health certificate

Discuss
Answer: (c).An Identity Card Explanation:Insured persons need to carry an Identity Card to relate them to the policy and TPA in health insurance.
Q32.
What does TPA issue to the hospital based on the information provided for requesting the cashless facility?

a.

Pre-authorization or a Letter of Guarantee

b.

Claim form

c.

Reimbursement request

d.

Premium receipt

Discuss
Answer: (a).Pre-authorization or a Letter of Guarantee Explanation:TPA issues a pre-authorization or a Letter of Guarantee to the hospital based on the information provided for requesting the cashless facility.
Q33.
Besides claims servicing, what additional function do TPAs typically have in health insurance?

a.

Setting premium rates

b.

Sales and distribution of insurance policies

c.

Customer relationship and contact management

d.

Risk assessment for underwriting

Discuss
Answer: (c).Customer relationship and contact management Explanation:TPAs typically have the additional function of customer relationship and contact management in health insurance.
Q34.
What should be looked into upon receiving a claim notification in Personal Accident insurance?

a.

The claimant's financial status

b.

The claimant's criminal record

c.

The validity of the policy and premium payment

d.

The claimant's medical history

Discuss
Answer: (c).The validity of the policy and premium payment Explanation:Upon receiving a claim notification in Personal Accident insurance, one should look into the validity of the policy and premium payment.
Q35.
What is the primary purpose of claims investigation in Personal Accident insurance?

a.

To determine the claimant's financial status

b.

To verify the claimant's criminal record

c.

To confirm the cause and extent of the loss

d.

To assess the claimant's medical history

Discuss
Answer: (c).To confirm the cause and extent of the loss Explanation:The primary purpose of claims investigation in Personal Accident insurance is to confirm the cause and extent of the loss.
Q36.
What are some examples of possible fraud in Personal Accident claims?

a.

Accurate reporting of the loss details

b.

Exaggeration in the temporary total disability (TTD) period

c.

Reporting illnesses as accidents

d.

Promptly submitting all required documents

Discuss
Answer: (b).Exaggeration in the temporary total disability (TTD) period Explanation:Possible fraud in Personal Accident claims includes exaggeration in the TTD period and reporting illnesses as accidents.
Q37.
Which document is important for the settlement of Personal Accident death claims?

a.

Personal Accident claim form

b.

First Information Report

c.

Anti-money laundering documents

d.

Discharge voucher

Discuss
Answer: (d).Discharge voucher Explanation:The discharge voucher is important for the settlement of Personal Accident death claims.
Q38.
What should be included in the claim documentation for Personal Accident insurance?

a.

Claimant's bank statement

b.

Treating doctor's signature

c.

Leave certificate from the employer

d.

All of the above

Discuss
Answer: (d).All of the above Explanation:The claim documentation for Personal Accident insurance should include claimant's bank statement, treating doctor's signature, and leave certificate from the employer.
Q39.
What is the role of assistance companies in overseas travel insurance claims?

a.

They provide medical services only

b.

They offer assistance services during travel

c.

They handle legal aspects of claims

d.

They sell travel insurance policies

Discuss
Answer: (b).They offer assistance services during travel Explanation:Assistance companies in overseas travel insurance claims offer assistance services during travel.
Q40.
Which of the following services are typically provided by assistance companies for overseas travel insurance?

a.

Monitoring of medical condition during and after hospitalization

b.

Pre-trip information services and visa requirements

c.

Financial emergency assistance

d.

All of the above

Discuss
Answer: (d).All of the above Explanation:Assistance companies for overseas travel insurance typically provide services like monitoring of medical condition during and after hospitalization, pre-trip information services and visa requirements, and financial emergency assistance.
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