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English Mock Test Chapter 8

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Question 1
What is the full form of ASHA?
A
Accredited Social Health Activist
B
Association of Social Health Activities
C
Association of super Health Activities
D
None of the above
Question 2
Which of the below features will be checked in a medical examiner’s report?
A
Height, weight and blood pressure
B
Emotional behavior of the proposer
C
Social status
D
Truthfulness
Question 3
_________ refers to a hospital/health care provider enlisted by an insurer to provide medical services to an insured on payment by a cashless facility.
A
Network provider
B
Day care centre
C
Third Party Administrator
D
Domiciliary
Question 4
With the advancement of technology and medical science many complicated surgical procedures have been simplified and do not require more than a day's stay in the hospital or less than 24 hours at times; for e.g., lithotripsy, cataract etc. The Centre where such procedures are carried out is known as _____________________.
A
Network provider
B
Day care centre
C
Third Party Administrator
D
Domiciliary
Question 5
_____________________ :It means any person who is licensed under the IRDA (Third Party Administrators - Health Services) Regulations, 2001 by the Authority, and is engaged, for a fee or remuneration by an insurance company, for the purposes of providing health services.
A
Network provider
B
Day care centre
C
Third Party Administrator
D
Domiciliary
Question 6
____________________________ : Certain insurance products offer domiciliary hospitalization benefits. This generally refers to medical treatment for a period exceeding three days for such illness/ injury which in the normal course would require treatment at the hospital/ nursing home, but was actually taken whilst confined at home in India under any of the following circumstances namely:ü                 The condition of the patient is such that he/ she cannot be removed to the hospital / nursing home ü The patient cannot be removed to hospital/ nursing home for lack of accommodation therein
A
Network provider
B
Day care centre
C
Third Party Administrator
D
Domiciliary Hospitalization
Question 7
Which of the below is condition for Domiciliary Hospitalization benefit?
A
The condition of the patient is such that he/ she cannot be removed to the hospital / nursing home
B
The patient cannot be removed to hospital/ nursing home for lack of accommodation therein
C
All of the above
D
None of the above
Question 8
Which of the below group would not be eligible for a group health insurance policy?
A
Group of unrelated individuals formed for the purpose of availing group health insurance
B
Employees of a company
C
Professional association members
D
Credit card holders of an organization
Question 9
Which of the below statement is not correct regarding cashless claim?
A
The insurer directly pays to the network hospital
B
The TPA directly pays to the network hospital.
C
The patient should admitted in a network hospital.
D
The patient can admitted in any hospital.
Question 10
Which of the below statement is correct with regards to a policy returned by a policyholder during the free look period?
A
The insurance company will refund 100% of the premium
B
The insurance company will refund 50% of the premium
C
The insurance company will refund the premium after adjusting for proportionate risk premium for the period on cover, medical examination expenses and stamp duty charges
D
The insurance company will forfeit the entire premium
Question 11
Health Insurance business can be done by
A
Stand alone Health Insurance companies
B
Non life or General Insurance companies
C
Life Insurance Companies
D
Both A&B
Question 12
The claim process of Health Insurance
A
Cashless facility
B
Claims reimbursement
C
Both of the above
D
None of the above
Question 13
IN off duty cover____________
A
If cover is required only for the restricted hours, when the employee is at work and / or at official duty, the reduced premium say a reduced percentage of the appropriate premium may be charged.
B
If cover is required not only for the restricted hours, when the employee is not at work and / or not at official duty, the reduced premium say a reduced percentage of the appropriate premium may be charged.
C
If cover is required only for the restricted hours, when the employee is not at work and / or not at official duty, the reduced premium say a reduced percentage of the appropriate premium may be charged.
D
All the above
Question 14
Who is the beneficiary in a Group Health Insurance Scheme for a group of employees of a company?
A
The employees
B
The Employer
C
Both the above
D
All The above
Question 15
The expenses covered under health insurance usually include:
A
Cost of room / bed
B
Boarding expenses
C
Nursing expenses
D
All the above
Question 16
The expenses covered under health insurance usually include:
A
Cost of room / bed
B
Boarding expenses
C
Nursing expenses
D
All the above
Question 17
The expenses covered under health insurance usually include:
A
Cost of room / bed
B
Boarding expenses
C
Doctor’s fees
D
All the above
Question 18
The expenses covered under health insurance usually include:
A
Diagnostic tests
B
Boarding expenses
C
Doctor’s fees
D
All the above
Question 19
The expenses covered under health insurance usually include:
A
Diagnostic tests
B
Operation theatre charges
C
Doctor’s fees
D
All the above
Question 20
The expenses covered under health insurance usually include:
A
Expenses related to surgical appliances and the like
B
Operation theatre charges
C
Doctor’s fees
D
All the above
Question 21
_____________________: Insured who undergoes treatment after getting admitted in the hospital
A
Inpatient
B
Outpatient
C
Day care centre
D
Portability
Question 22
_____________________: Insured who undergoes treatment without getting admission/staying in the hospital
A
Inpatient
B
Outpatient
C
Day care centre
D
Portability
Question 23
_____________________________ :It is the right accorded to an individual health insurance policyholder (including family cover), to transfer the credit gained for pre-existing conditions and time bound exclusions, from one insurer to another insurer or from one plan to another plan of the same insurer, provided the previous policy has been maintained without any break. Moving between policies of the same company itself has been excluded.
A
Inpatient
B
Outpatient
C
Day care centre
D
Portability
Question 24
_____________________________ : It means any person who has completed sixty or more years of age as on the date of commencement or renewal of a health insurance policy.
A
Inpatient
B
Outpatient
C
Senior citizen
D
Pre-existing conditions
Question 25
_____________________________ : These refer to manifestation or occurrence of illness/injury for which treatment was required during a pre-determined time. These can be covered after a certain waiting period.
A
Inpatient
B
Outpatient
C
Day care centre
D
Pre-existing conditions
Question 26
_____________________ :is another version of a health insurance policy. Here, the sum insured floats among the family members. Family floaters usually cover husband, wife and two children. Some policies cover more than two children, parents and parents in law as well. The coverage for the entire family is limited to the sum insured opted for. The total premium payable for family floater policies is less than the total premium payable for non-floater policies where separate sums insured are applicable for each family member.
A
Family floater policy
B
Outpatient
C
Day care centre
D
Pre-existing conditions
Question 27
Which of the below is a criteria for a hospital establishment?
A
Has qualified nursing staff under its employment round the clock
B
Has at least 10 in-patient beds in towns having a population of less than 10,00,000
C
at least 15 in-patient beds in all other places
D
All the above
Question 28
Which of the below is a criteria for a hospital establishment?
A
Has qualified nursing staff under its employment round the clock
B
Has at least 11 in-patient beds in towns having a population of less than 10,00,000
C
at least 20 in-patient beds in all other places
D
All the above
Question 29
Which of the below is a criteria for a hospital establishment?
A
Has qualified medical practitioner(s) in charge round the clock
B
Has at least 10 in-patient beds in towns having a population of less than 10,00,000
C
at least 15 in-patient beds in all other places
D
All the above
Question 30
Which of the below is a criteria for a hospital establishment?
A
Has qualified medical practitioner(s) in charge round the clock
B
Has at least 11 in-patient beds in towns having a population of less than 10,00,000
C
at least 20 in-patient beds in all other places
D
All the above
Question 31
Which of the below is a criteria for a hospital establishment?
A
Has a fully equipped operation theatre of its own where surgical procedures are carried out
B
Has at least 10 in-patient beds in towns having a population of less than 10,00,000
C
at least 15 in-patient beds in all other places
D
All the above
Question 32
Which of the below is a criteria for a hospital establishment?
A
Has a fully equipped operation theatre of its own where surgical procedures are carried out
B
Has at least 11 in-patient beds in towns having a population of less than 10,00,000
C
at least 20 in-patient beds in all other places
D
All the above
Question 33
Which of the below is a criteria for a hospital establishment?
A
Maintains daily records of patients and makes these accessible to the insurance company’s authorized personnel
B
Has at least 10 in-patient beds in towns having a population of less than 10,00,000
C
at least 15 in-patient beds in all other places
D
All the above
Question 34
Which of the below is a criteria for a hospital establishment?
A
Maintains daily records of patients and makes these accessible to the insurance company’s authorized personnel
B
Has at least 11 in-patient beds in towns having a population of less than 10,00,000
C
at least 20 in-patient beds in all other places
D
All the above
Question 35
Which of the below is a prerequisite for getting a cashless facility?
A
The insured has to approach a network hospital and get the treatment done
B
The card issued either by the insurer or by a third party administrator has to be presented to the network hospital
C
Either based on the smart card or after getting pre-authorization from the insurer or from the TPA, the hospital would give admission
D
All the above
Question 36
Which of the below is a pre- requisite for getting a cashless facility?
A
The insured has to approach a network hospital and get the treatment done
B
The card issued either by the insurer or by a third party administrator has to be presented to the network hospital
C
Some insurance companies are required to be notified 48 hours before hospitalization.
D
All the above
Question 37
Which of the below is a pre- requisite for getting a cashless facility?
A
The insured has to approach a network hospital and get the treatment done
B
The insurer / TPA will process the cashless settlement after verification of policy details
C
Some insurance companies are required to be notified 48 hours before hospitalization.
D
All the above
Question 38
Which of the below is not a pre- requisite for getting a cashless facility?
A
The insured has to approach any hospital and get the treatment done
B
The insurer / TPA will process the cashless settlement after verification of policy details
C
Some insurance companies are required to be notified 48 hours before hospitalization.
D
All the above
Question 39
Which of the below is common exclusion for a health insurance policy?
A
Pre existing diseases (for a waiting period)
B
Weight control programs/ supplies/ services
C
Cost of spectacles / contact lances/ hearing aids etc.
D
All the above
Question 40
Which of the below is common exclusion for a health insurance policy?
A
Pre existing diseases (for a waiting period)
B
Hormone Replacement
C
Home visit charges
D
All the above
Question 41
Which of the below is common exclusion for a health insurance policy?
A
Infertility/ sub fertility/ Assisted conception procedure
B
Obesity (including morbid obesity) treatment
C
psychiatric & psychosomatic disorder
D
All the above
Question 42
Which of the below is common exclusion for a health insurance policy?
A
Infertility/ sub fertility/ Assisted conception procedure
B
Treatment of sexually transmitted disease
C
Corrective surgery for refractive error
D
All the above
Question 43
Which of the below is common exclusion for a health insurance policy?
A
donor screening charges
B
Treatment of sexually transmitted disease
C
Corrective surgery for refractive error
D
All the above
Question 44
Which of the below is the full form of PPN?
A
Policy provider network
B
Permanent provider network
C
Proffered provider network
D
Proffered policy network
Question 45
Which of the below is the full form of ESIS?
A
Employees' State Insurance Scheme
B
Employers' State Insurance Scheme
C
Employees' Social Insurance Scheme
D
Employers' Social Insurance Scheme
Question 46
CGHS was introduced in ______________________________
A
1951
B
1954
C
1952
D
1950
Question 47
As per IRDA insurer should bear at least ________________ of pre policy health checkup expenses.
A
100%
B
80%
C
70%
D
50%
Question 48
Critical illness policy can be sold  ___________________________________.
A
As a standalone policy
B
As an add on cover to few health policies
C
As an add on cover in some Life Insurance Policies.
D
All the above
Question 49
which of the following diseases can commonly be covered in critical illness?
A
Cancers or specified severity.
B
Acute myocardial infarction.
C
Coronary artery surgery.
D
All the above
Question 50
which of the following diseases can commonly be covered in critical illness?
A
Multiple Sclerosis
B
Heart valve replacement
C
Renal Failure
D
All the above
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