NEW
Font size
Worksheetslevel 2- BG
Total questions: 15
Worksheet time: 8mins
Co-payment is
Co-payment is cost sharing requirement
Co-payment reduces the Sum Insured
Co-payment is applicable on Sum Insured
All of the above
Sub limit is a
Sub limit restricts the insured to claim upto the Sum insured
Limit that exists within the main limit
Sublimit is applicable on Room rent, ICU or any disease specifically mentioned in policy
None of the above
All of the above
Pre-policy checkup can lead to
Acceptance of risk without restriction
Risk Loading/ Exclusion of coverage
Decline/ Deferment for specified period
All of the above
Provision in a health insurance policy that eliminates coverage for certain medical services is
Exclusion
Waiting period
Non- Payable
None of the above
Identify which statement is correct for Individual policy:
All members covered in policy have individual sum Insured
All members covered in policy have one sum Insured
They cannot be covered in one policy
None of the above
Family Floater means all members of the family have one sum insured and can claim up to the limit of Sum insured
True
False
Family members listed below are considered as dependents
Legally married spouse of the policy holder as long as he/she continues to be married to the Policy Holder
Policy holder's children if they are unmarried, still financially dependent on him and have not established their own independent households
Policy Holder's natural parents or parents that have legally adopted him
All of the above
Indemnity policy pays
Policy which guarantees a lump sum payment
Payment is not dependent on the loss amount
Pay the sum insured that is agreed when buying the policy
All of the above
None of the above
Pre hospitalization is medical expense incurred after the insured person is discharged from the hospital
True
False
If no claim has been made under the Policy and the Policy is renewed without any break, cumulative bonus to the next Policy Year will be added automatically increasing the Sum Insured for the next Policy Year
True
False
Who is a TPA
TPA is Third Party Administrator
TPA is an Independent organization that processes insurance claims for the Insurance Company.
The risk of loss remains with the Insurance Company, and not with the TPA
All of the above
Hospital must comply with all minimum criteria as mentioned below
It must have at least 10 inpatient beds in those towns having a population of less than 10, 00,000 and 15 inpatient beds in all other places.
Qualified Medical practitioner & nursing staff under its employment round the clock.
Fully equipped operation theatre of its own where surgical procedures are carried out.
Daily records of patients which are made accessible to the insurance company's authorized personnel.
All of the above
A cost-sharing requirement under a health insurance policy that implies that the insurer will only pay if the amount exceeds the specified amount is called as
Contribution
Co-payment
Deductible
Sublimit
Find the odd man out
Surgical kit
Eye Kit
Eye Drape
Bandage, Sterile Injections, syringes
In a retail policy tonsillectomy is covered after a waiting period of
30 days
1 year
2 years
4 years
