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 6 of 6

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Q51.
Which type of insurance policies are most susceptible to fraud claims?

a.

Life insurance policies

b.

Auto insurance policies

c.

Hospitalization indemnity policies

d.

Travel insurance policies

Discuss
Answer: (c).Hospitalization indemnity policies Explanation:Frauds occur mostly in hospitalization indemnity policies.
Q52.
How does a Third Party Administrator (TPA) typically get remunerated for the services it provides?

a.

By receiving a percentage of the insurance premium

b.

By getting paid directly by the insured individuals

c.

In the form of fees

d.

Through commissions from hospitals

Discuss
Answer: (c).In the form of fees Explanation:The TPA typically gets remunerated in the form of fees for the services it provides to the insurer.
Q53.
Which of the following document is maintained at the hospital detailing all treatment done to an in-patient?

a.

Investigation report

b.

Discharge summary

c.

Case paper

d.

Hospital registration certificate

Discuss
Answer: (b).Discharge summary Explanation:The document maintained at the hospital detailing all treatment done to an in-patient is the "Discharge summary." This summary contains comprehensive information about the patient's condition, diagnosis, treatment, and other relevant details during the hospitalization period. It is crucial for processing health insurance claims.
Q54.
The amount of provision made for all claims in the books of the insurer based on the status of the claims is known as ________.

a.

Pooling

b.

Accounting

c.

Reserving

d.

Investing

Discuss
Answer: (c).Reserving Explanation:In the context of insurance, "reserving" refers to the amount of provision made for all claims in the books of the insurer based on the status of the claims. It involves setting aside funds to cover expected claim payments and is an important financial aspect of insurance operations.
Q55.
Which of the following documents are not required to be submitted for Permanent Total Disability claim?

a.

Duly completed Personal Accident claim form signed by the claimant.

b.

Copy of Insurance Policy.

c.

Permanent disability certificate from a civil surgeon or any equivalent competent doctors certifying the disability of the insured.

d.

Fitness certificate from the treating doctor certifying that the insured is fit to perform his normal duties.

Discuss
Answer: (d).Fitness certificate from the treating doctor certifying that the insured is fit to perform his normal duties. Explanation:In the case of a Permanent Total Disability claim, a fitness certificate from the treating doctor certifying that the insured is fit to perform his normal duties is not required. The other documents mentioned, such as the claim form, copy of the insurance policy, and the permanent disability certificate, are essential for processing such claims.
Q56.
Most hospitals accept Guarantee of Payments from all international insurance companies once the insured provides them with a valid __________ Insurance policy.

a.

Legal Liability

b.

Corona Rakshak

c.

Overseas Travel

d.

Endowment

Discuss
Answer: (c).Overseas Travel Explanation:Most hospitals accept Guarantee of Payments from all international insurance companies once the insured provides them with a valid "Overseas Travel" insurance policy. This type of insurance policy provides coverage for medical and non-medical expenses during overseas travel, and hospitals rely on it to ensure payment for services provided to international travelers.
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