Health - Questionnaire-2022 For Promotional Exam by RR

Health Questionnaire: Version 5 (1-303):- 08th March 2022
HEALTH INSURANCE QUESTIONNAIRE-2022

1. Which amongst the below listed type of covers can be enlisted amongst the definition of " general
micro-insurance product" with maximum amount of cover,term of cover and maximum/minimum age
as defined under IRDAI (Micro Insurance) Regulations,2015 amended upto 19th May 2015?
1. Any health insurance contract, any contract covering the belongings, such as, hut, livestock or tools
or instruments or any personal accident contract, either on individual or group basis
2. Maximum Tenure being 3 year
3. Health Cover upto 2.5 Lacs
4. Cover for belongings maximum upto 1 Lacs per asset/cover
5. Maximum tenure being 1 year
6. Minimum/Maximum Age being 18 years/65 Years, wherever involved
7. Minimum/Maximum Age being Product specific, wherever involved.
Choose the correct option:

a. 1, 2 and 3 are correct
b. 1, 3 and 6 are correct
c. 1, 2, 3, 4 and 6 are correct
d. 1, 3, 4, 5 and 7 are correct
e. All the above are correct
2. Pick out the correct option on the maximum amount of sum insured and term of cover offered under a
general micro-insurance product issued to cover dwelling and contents, or livestock or tools or
implements or other names assets or crop insurance against all perils?
a. Rs. 2,50,000 Per Asset/Cover

b. Rs. 2,00,000 Per Asset/Cover
c. Rs. 1,00,000 Per Asset/Cover
d. Rs. 5,00,000 Per Asset/Cover
e. Any of the limits given above
3. Amongst the below listed options, tick the correct tenure (Minimum/Maximum) for which a general
microinsurance health contract can be issued as per IRDAI (Micro Insurance) Regulations,2015?
a. Minimum 1 Year/ Maximum 3 Year

b. Minimum 9.5 Months/ Maximum 1 Year
c. Minimum 1 Year/Maximum 1 Year
d. Minimum 3.5 Months/Maximum 5 Year
e. Any of the above options
4. What is the maximum amount of sum insured/cover given/offered under a Health Insurance contract
(Individual) falling under the definition of General Microinsurance product?
a. Rs. 5,00,000
b. Rs. 2,50,000
c. Rs. 1,00,000
d. Rs. 2,00,000
e. Rs. 50,000
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Rajnish Ranga, Dy. Manager, Health Dept, HO-OICL

5. What is the maximum amount of sum insured/cover given/offered under a Health Insurance contract
(Family/Group) falling under the definition of General Microinsurance product?
a. Rs. 1,00,000
b. Rs. 2,50,000
c. Rs. 2,00,000
d. Rs. 5,00,000
e. Rs. 50,000
6. According to the IRDAI (Micro Insurance) Regulations,2015, what should be the minimum and
maximum age of the proposer/dependents to get coverage under a health insurance contract?
a. 18 Years and 79 Years

b. No Age Bar on Coverage
c. 18 Years and 65 Years
d. Product Specific
e. 3 Months and 65 Years
7. What is the maximum amount of sum insured/cover given/offered under a Personal Accident
(Family/Group) falling under the definition of General Microinsurance product?
a. Rs. 1,00,000
b. Rs. 2,50,000
c. Rs. 5,00,000
d. Rs. 10,00,000
e. Rs. 2,00,000
8. What is the maximum amount of sum insured/cover given/offered under a Personal Accident
(Individual) falling under the definition of General Microinsurance product?
a. Rs. 5,00,000
b. Rs. 2,00,000
c. Rs. 1,00,000
d. Rs. 10,00,000
e. All the above Sum Insured could be offered
9. Tick the correct tenure (Minimum/Maximum) for which a general microinsurance Personal Accident
contract can be issued as per IRDAI (Micro Insurance) Regulations,2015?
a. Minimum 9.5 Months/ Maximum 1 Year

b. Minimum 3 Years/ Maximum 3 Years
c. Minimum 1 Year/ Maximum 3 Years
d. Minimum 1 Year/ Maximum 1 Year
e. No Capping of Policy tenure
10. Please pick out the correct option of premium amount upto which General Insurance policies issued to
Micro, Small and Medium Enterprises as classified in Section (7) of Micro, Small and Medium
Enterprises Development (MSMED) Act, 2006 under various lines of General insurance business will
also be qualified as general micro insurance business?
a. Upto Rs. 5,000 premium p.a. per MSM Enterprise

b. Upto Rs. 25,000 premium p.a. per MSM Enterprise
c. Upto Rs. 10,000 premium p.a. per MSM Enterprise
d. Upto Rs. 50,000 premium p.a. per MSM Enterprise
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11. Which amongst the below listed entities or individuals could be appointed as Micro Insurance Agents
in accordance to IRDAI (Micro Insurance) Regulations,2015?
1. A Non-Government Organization (NGO)

2. A Self-Help Group (SHG)
3. A Micro-Finance Institution (MFI)
4. RBI Regulated NBFC – MFIs
5. District Co-operative Banks/Regional Rural Banks/Urban Co-operative banks licensed by RBI and
Eligible as per extant norms
6. Primary Agriculture Cooperative Societies
7. Insurance Marketing Firm (IMF)
Choose the correct option from above:
a. Only 1, 2, 3 are correct

b. Only 1, 3, 5 and 7 are correct
c. Only 1, 2, 3 and 5 are correct
d. 1, 2, 3, 4, 5 and 6 are correct
12. Which amongst the below statement(s) is/are correct in accordance to IRDAI (Micro Insurance)
Regulations,2015?
(1) An insurer carrying on life insurance business may offer life micro insurance products as also
general micro-insurance products.
(2) An insurer carrying on general insurance business may offer general micro insurance products as
also life micro-insurance products.
a. Only 1 is correct
b. 1 and 2 both are correct
c. Both are incorrect
d. Only 2 is correct
e. No such option exist in the regulations.
13. The deed of agreement executed by Insurers in accordance to IRDAI (Micro Insurance)
Regulations,2015 with micro-insurance agents, specifically authorize them to perform one or more of
the following additional functions.
Pick out the correct funtions?
1. Collection of Proposal form
2. Collection of Self-Declaration from the proposer that he/she is in good health
3. Underwriting of an Insurance Proposal
4. Collection and remittance of premium
5. Distribution of policy documents
6. Assistance in the settlement of claims.
7. Assistance in final payment of claims.
8. Ensuring nomination to be made by the insured
a. Only 1, 2, 3 and 5 are correct

b. Only 1, 2, 4, 6, 7 and 8 are correct
c. Only 1, 2, 4, 5, 6 and 8 are correct
d. All the above are correct
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e. None of the above is correct

14. Choose the mandated procedure of filing of Micro Insurance products with the authority,that every
insurer is subjected to?
a. Use and File
b. File and Use
c. No filing for Micro-Insurance product is required
d. Any of the above (a) or (b)
e. None of the above
15. "Every micro-insurance product which is cleared by the Authority for the purpose of micro-insurance
shall prominently carry the caption “Micro-Insurance Product”.
Please state whether the guideline is true or false?
a. True
b. False
16. Which amongst the two statements is incorrect in accordance to the underwriting guidelines
mentioned in IRDAI (Micro Insurance) Regulations,2015?
1. No insurer shall authorize any micro-insurance agent or any other outsider to underwrite any
insurance proposal for the purpose of granting insurance cover.
2. An insurer may authorize any micro-insurance agent or any other outsider to underwrite any
insurance proposal for the purpose of granting insurance cover subject to its Board approved
underwriting policy.
b. 1 is incorrect and 2 is correct
c. Both 1 and 2 are correct
e. Both are incorrect
17. Pick out the correct option on maximum renumeration/commission which a micro-insurance agent may
be paid i.e. remuneration for all the functions rendered in regulation 5 of IRDAI (Micro Insurance)
Regulations,2015 and including commission, by an insurer for General Insurance Business?
a. 10% of the premium

b. 12.5% of the premium
c. 15% of the premium
d. 17.5% of the premium
18. In accordance to the obligations specified to Rural and Social Sectors, which amongst the two below
noted statement(s) is/are correct?
(1) All micro-insurance policies may be reckoned for the purposes of fulfilment of social obligations by
an insurer pursuant to the provisions of the Act.
(2) Where a micro-insurance policy is issued in a rural area and falls under the definition of social
sector, such policy may be reckoned for both under rural and social obligations separately.
b. 1 is correct but 2 is incorrect
c. 2 is correct but 1 is incorrect
d. Both the statements are correct
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e. None of the two statements is correct

19. According to the IRDAI (Expenses of Management of Insurers transacting General or Health
Insurance business) Regulations,2016 Dated: 27th April 2016, please tick the correct percentage of
the allowable expenses under Health Retail segment as part of the total gross premium of the insurer
written in India?
a. 15% for first 400 Crores & 17.50% for the Balance
b. 37.50% for first 400 Crores & 32.50% for the Balance
c. 30% for first 400 Crores & 32% for the Balance
d. 25.75% for first 400 Crores & 30.50% for the Balance
e. 17.50% for first 400 Crores & 22.50% for the Balance
20. In accordance to IRDAI (Expenses of Management of Insurers transacting General or Health

the allowable expenses under Health Group/Corporate segment as part of the total gross premium of
the insurer written in India?
a. 17.50% for first 250 Crores & 22.50% for the Balance
c. 35% for first 250 Crores & 27.50% for the Balance
d. 37.50% for first 250 Crores & 20.50% for the Balance
e. 50% for first 250 Crores & 23.50% for the Balance
the allowable expenses under Health Government Scheme as part of the total gross premium of the
insurer written in India?
a. 10% for first 200 Crores & 15% for the Balance
c. 25.50% for first 200 Crores & 20.50% for the Balance
d. 20% for first 200 Crores & 17.50% for the Balance
e. 30% for first 200 Crores & 22.50% for the Balance
Insurance business) Regulations,2016 Dated: 27th April 2016, for Health Insurance Segment, the fees
paid to TPA (Third Party Administrators) shall form part of claims cost, but where-ever the TPA
services are in-house, what percentage of expense of the premium may be charged to the claims
cost?
a. Not more than 5%

b. Not more than 5.5%
c. Not more than 2.5%
d. Not more than 1%
e. Not more than 3%
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23. List out applicants from the options below,who may apply to the authority seeking singly or jointly the
permission for promoting innovation in insurance in India, under IRDAI (Regulatory Sandbox)
Regulations,2019?
1. An Insurer
2. An Intermediary or Insurance Intermediary
3. Any person other than an individual having a minimum net-worth of 10 Lakhs for previous Financial
Year.
4. Any other person recognized by the authority.
Choose the correct option from the following:

b. Only 1 and 2 are correct
c. 1, 2 and 3 are correct
e. All Insurance stakeholders could be the applicant
24. Which amongst the following statements in regard to IRDAI (Regulatory Sandbox) Regulations,2019 is
correct and aptly defined?
Objective: To strike a balance between orderly development of insurance sector on one hand and
protection of interests of policyholders on the other, while at the same time facilitating innovation;
Regulatory Sandbox: an environment used in the financial services sector, which provides testing
ground for new business models, processes and applications that may not necessarily be covered
fully by or are not fully compliant with existing Regulations;
Sandbox environment: a testing environment designed for experimentation for an un-specified period
of time without limit.
a. Only 1 and 3 are correct

b. Only 1 is correct
c. All the above are correct
d. Only 1 and 2 are correct
e. None of the above are correct
25. Amongst the enlisted categories, choose the option under which an applicant may apply to the
Authority seeking permission for promoting or implementing innovation in insurance in India in any one
or more categories?
1. Insurance Solicitation or Distribution

2. Insurance Products
3. Underwriting
4. Policy and Claims Servicing
Choose the correct option from the following:
c. Only 1, 2 and 4 are correct
e. All the above categories
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26. From the options listed,choose the conditions and objective which the Chairperson of the Authority
may consider to satisfy himself to grant permission to an applicant under IRDAI (Regulatory Sandbox)
Regulations,2019?
1. Promotes innovation beneficial to insurance in India;
2. It is in the interest of the policyholders;
3. Is conducive for the orderly growth of the industry;
4. It would promote increase in insurance penetration in the country;
a. Only 1 and 2 shall be considered

b. Only 1, 2 and 4 shall be considered
c. All the above conditions shall be considered
d. Only condition number 4 is considered
e. None of the above is considered
27. Choose the period of validity or permission granted to an applicant by the Authority under IRDAI
(Regulatory Sandbox) Regulations,2019?
a. For a period of 2 years
b. For a period of 3 years
c. For a period of 6 months
d. For a period of 12 months
e. No period mandated
28. Select out the correct definition from the options below as defined in IRDAI (Payment of Commission
or Remuneration or Reward to Insurance Agents & Insurance Intermediaries) Regulations, 2016
amended upto 29th June 2020?
1. “Commission” means the compensation paid to and received by an insurance agent from an insurer
for soliciting and procuring an insurance policy.
2. “Remuneration” means the compensation paid by an insurer and received by an insurance
intermediary and an insurance agent for soliciting and procuring an insurance policy.
3. “Remuneration” means the compensation paid by an insurer and received by an insurance
intermediary for soliciting and procuring an insurance policy.

c. Only 1 and 3 are correct
d. All the above definitions are correct
29. An “Insurance Intermediary” as defined in Section 2(1)(f) of the IRDA Act, 1999 and for the purpose of
IRDAI (Payment of Commission or Remuneration or Reward to Insurance Agents & Insurance
Intermediaries) Regulations, 2016 amended upto 29 th June 2020 includes, who amongst the
following?
1. Corporate Agents 2. Insurance Brokers
3. Insurance Agents 4. Web Aggregators
5. Insurance Marketing Firms 6. Common Public Service Centre
a. Only 1, 4, 5 and 6 are correct
b. Only 4, 5 and 6 are correct
c. All the above are Insurance Intermediary
d. Only 1, 2, 4, 5 and 6 are correct
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e. All except 6 are correct

30. According to definitions under IRDAI (Payment of Commission or Remuneration or Reward to

Insurance Agents & Insurance Intermediaries) Regulations, 2016 amended upto 29 th June 2020
“Reward” means the amounts paid, whether directly or indirectly, as an incentive by whatever name
called by an insurer to:
1. An insurance agent towards benefits such as gratuity, term insurance cover, various group
insurance covers, telephone charges, office allowance, sales promotion gift items, competition prizes
and such other items.
2. An insurance intermediary towards services such as risk analysis, gap analysis, plan design,
predictive modeling, data management, infrastructure, advertisement and such other items including
any additional incentives by whatever name called.
Choose the correct definition:

a. 1 is correct but 2 is incorrect
b. 2 is correct but 1 is incorrect
c. Only 1 is correct
e. Both 1 and 2 are correct
31. Please read the objectives detailed below in accordance to IRDAI (Payment of Commission or
Remuneration or Reward to Insurance Agents & Insurance Intermediaries) Regulations, 2016
amended upto 29th June 2020 and choose the best available option which shall include the utilization
of insurance agents and insurance intermediaries?
1. Increases insurance penetration and density in the country;

2. It is in the interests of the policyholders;
3. It is commensurate with its business strategy;
4. It brings cost efficiencies in the conduct of business and simplification of the administration of
insurance business;
5. Further gives an indication on the relative degree of importance placed on each of them.
Choose the best available option:
a. Only option no. 1, 2 and 4
b. Only option no. 1 and 5
c. Only option no. 2, 4 and 5
d. All the above
32. Noted 3 statements defines the “Applicability” under IRDAI (Payment of Commission or Remuneration
or Reward to Insurance Agents & Insurance Intermediaries) Regulations, 2016 amended upto 29 th
June 2020, choose the correct condition for applicability?
1. These regulations shall not be applicable to insurance products specified under Insurance
Regulatory and Development Authority of India (Micro Insurance) Regulations, 2015.
2. Where policies are procured directly by an insurer, no commission or remuneration shall be payable
either to insurance agents or to the insurance intermediaries.
3. An Insurer shall pay both commissions to an insurance agent and remuneration to an insurance
intermediary on the same insurance policy.
c. all the above are correct
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e. Only 1 and 2 are correct

33. What is the “Reward” specified for General Insurance including health insurance as percentage of
commission or remuneration under IRDAI (Payment of Commission or Remuneration or Reward to
Insurance Agents & Insurance Intermediaries) Regulations, 2016 amended upto 29 th June 2020?
a. Not more than 33%

b. Not more than 29%
c. Not more than 30%
d. Not more than 17.5%
e. No limit of percentage specified
34. General Insurers and Health Insurers may offer individual health products with a minimum tenure of
____ year and a maximum tenure of ____ years, provided that the premium remains unchanged for
the tenure as per clause of Registration and Scope of Health Insurance Business under IRDAI (Health
Insurance) Regulations, 2016?
Please fill in the blanks in the statement above?
a. 1 Year and 5 Year

b. 1 Year and 3 Year
c. 1 Year and 1 Year
d. 3 Year and 5 Year
e. No time stipulated
35. Group Health Policies may be offered by any insurer for a term of ___ year except credit linked
products where the term can be extended up to the loan period not exceeding ____ years, per clause
of Registration and Scope of Health Insurance Business under IRDAI (Health Insurance) Regulations,
2016?
Please fill in the blanks in the statement above?
a. 1 Year and 7 Years

b. 1 Year and 3 Years
c. 1 Year and 5 Years
d. 6 Months and 3 Years
e. No time stipulated for policy tenure
36. What is the maximum commission or remuneration payable to insurance agents/insurance

intermediaries as a percentage of premium that is allowed for Health – Group (credit linked upto 5
years) products offered by general insurers or stand-alone health insurers as per IRDAI (Payment of
Commission or Remuneration or Reward to Insurance Agents & Insurance Intermediaries)
Regulations, 2016 amended upto 29th June 2020?
a. 5.5%
b. 5%
c. 7.5%
d. 15%
e. 17.5%
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37. What is the maximum commission or remuneration payable to insurance agents/insurance
intermediaries as a percentage of premium that is allowed for Health – Individual products, for policy
tenure of more than 1 year to maximum 3 years and having 3 years single premium or 3 years regular
premium, offered by general insurers or stand-alone health insurers as per IRDAI (Payment of
Commission or Remuneration or Reward to Insurance Agents & Insurance Intermediaries)
Regulations, 2016 amended upto 29th June 2020?
a. 17.5%
b. 7.5%
c. 12.5%
d. 10%
e. 15%
38. In reference to “Modified Guidelines on Product filing in Health Insurance Business Norms on
Proportionate Deductions”, which amongst the below noted norms are correct?
1. A proportionate deduction of the ‘associated medical expenses’ shall apply, when a policyholder
chooses a higher room category than the category that is eligible as per terms and conditions of the
policy.
2. Only the Cost of Pharmacy, Implants and Medical devices are not allowed to be part of “associated
medical expenses”.
3. No proportionate deductions to be applied in respect of the hospitals which do not follow differential
billing or for those expenses in respect of which differential billing is not adopted based on the room
category.
4. No proportionate deduction for ‘ICU charges’ as different categories of ICU are not there.

d. Only 1, 3 and 4 are correct
39. Which amongst the following expenses are not allowed to be part of the definition of “associated
medical expenses” for application of proportionate deductions as per “Modified Guidelines on Product
filing in Health Insurance Business Norms on Proportionate Deductions”?
1. Cost of pharmacy and consumables.

2. Cost of room rent and doctor visiting charges.
3. Cost of implants and medical devices.
4. Cost of Diagnostics.

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40. Which amongst the two statement(s) is/are correct in regard to “Norms on Portability” as per
Guidelines on Migration and Portability of Health Insurance Policies?
1. Portability shall be allowed under all individual indemnity and benefit health insurance policies
issued by General Insurers and Health Insurers.
2. Portability shall be allowed under all individual indemnity health insurance policies issued by
General Insurers and Health Insurers including family floater policies.

c. Both are correct
d. None of the two is correct
e. 1 is correct but 2 is incorrect
41. Every individual policyholder (including members under family floater policy) covered under an
indemnity based individual health insurance policy shall be provided an option of migration at the
explicit option exercised by the policyholder?
Which amongst the below listed options are correct in regard to “Norms on Migration” as per
Guidelines on Migration and Portability of Health Insurance Policies” (Ref:
IRDAI/HLT/REG/CIR/003/01/2020 Dated: 01.01.2020)?
1. To an individual health insurance policy and not family floater,
2. To a group health insurance policy, if the member complies with the norms relating to the health
insurance coverage under the concerned group insurance policy.
3. To an individual health insurance policy or a family floater policy.

e. None is correct
42. The benefit of Migration shall be applicable to what extent as per Norms on Migration?
a. To the extent of the sum insured under the previous policy only.
b. To the extent of the sum insured choosen under the current policy and the cumulative bonus, if any,
acquired from the previous policies.
c. To the extent of sum insured choosen in the current migrated policy only.
d. To the extent of the sum insured under the previous policy and the cumulative bonus, if any,
acquired from the previous policies.
e. To the extent of the sum insured under the previous policy excluding cumulative bonus.
43. Under Migration Norms, Where underwriting is done, what is the time limit within which the insurance
company has to convey its decision to the policyholder as per Regulation 8(6) of IRDAI (Protection of
Policyholders’ interests) Regulations 2017?
a. Within 3 Days
b. Within 7 Days
c. Within 14 Days
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d. Within 15 Days
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e. No time period stipulated

44. A policyholder desirous of migrating his/her policy shall be allowed to apply to the insurance company
to migrate the policy along with all members of the family, if any, before how many days of the
premium renewal date of his/her existing policy, as per “Norms on Migration” as per Guidelines on
Migration and Portability of Health Insurance Policies” (Ref: IRDAI/HLT/REG/CIR/003/01/2020 Dated:
01.01.2020)?
a. Atleast 45 days
b. Atleast 60 days
c. At least 30 days
d. Atleast 15 days
e. No time period is stipulated
45. Please select the minimum charges (Percentage of premium) an Insurer shall levy exclusively for
Migration from a policyholder desirous of migrating his/her policy along with all members of the family,
if any, as per “Norms on Migration” as per Guidelines on Migration and Portability of Health Insurance
Policies” (Ref: IRDAI/HLT/REG/CIR/003/01/2020 Dated: 01.01.2020)?
a. 1% of the premium
b. 2% of the premium
c. At the option of the Insurer
d. No such charges shall be levied
e. 0.5% of the premium
46. AYUSH Hospital, standalone or co-located with in-patient healthcare facility of any recognized system
of medicine, registered with the local authorities, wherever applicable, and is under the supervision of
a qualified registered AYUSH Medical Practitioner must comply with which of the following criterion as
per „Modified Guidelines on Standardization in Health Insurance Business : Ref:
IRDAI/HLT/REG/209/11/2019 Dated: 26/11/2019“
1. Having atleast 15 in-patient beds;
2. Having atleast 5 in-patient beds;
3. Having qualified AYUSH Medical Practitioner in-charge round the clock;
4. Having dedicated AYUSH therapy Sections instead of equipped operation theatre. .
5. Maintaining daily records of the patients and making them accessible to the insurance company’s
authorized representative.
6. Having dedicated AYUSH therapy sections as required and/or has equipped operation theatre
where surgical procedures are to be carried out;

a. 2, 3, 4 and 6 are correct.
b. All the above are correct
c. 1, 2, 3, 5 and 6 are correct.
d. 1, 3, 4 and 6 are correct.
e. 2, 3, 5 and 6 are correct.
47. What is the number of days before which the premium shall not be received in advance to the date of
commencement of the risk covered in case of domestic travel or along with the ticket while purchasing
the travel tickets, whichever is earlier as per “Circular on Travel Insurance Products and operational
matters: Ref: IRDAI/HLT/CIR/MISC/174/09/2019 Dated: 27th September 2019.
a. 21 Days
b. 45 Days
c. 90 Days
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d. 120 Days
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e. No stipulated time for collection

48. The number of days before which the premium shall not be received in advance to the date of
commencement of the risk covered in case of Overseas Travel Insurance as per “Circular on Travel
Insurance Products and operational matters: Ref: IRDAI/HLT/CIR/MISC/174/09/2019 Dated: 27 th
September 2019?
a. 21 Days
b. 45 Days
c. 90 Days
d. 120 Days
e. No stipulations applicable.
49. ____________ is an insured (Primary/dependent) who undergoes treatment after getting admitted in a
hospital for a minimum of 24hours continuous hospitalisation or lesser in case of day care procedure.
Fill in the blank with an appropriate option?
a. In-house patient
b. Out-patient
c. In-patient
d. Referral patient
e. All the above
50. The concept of insurance involves a transfer of what? Choose the best option?
a. Liability
b. Hazard
c. Ownership
d. Risk
e. Benefit
51. The concept of indemnity under the “Insurance Domain” is based on the key principle that
policyholders should be prevented from?
a. Driving Benefit from Insurance Coverages

b. Paying in excess for an insurance cover
c. Profiting from insurance
d. Lodging claims for luxurious living
e. Boarding defined certain Risks
52. What is the nomenclature mandated to be used for the Standard Vector Borne Disease Health Policy
under Guidelines issued by IRDAI Ref: IRDAI/HLT/REG/CIR/25/02/2021 dated: 03 rd February 2021?
a. Rakshak Mashak <Name of Insurer >

b. Pathogen Plus Rakshak <Name of Insurer >
c. Mashak Rakshak <Name of Insurer >
d. Protection Plus <Name of Insurer >
e. An Insurer is free to choose the name
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53. What is the mode of coverage which shall be offered under the Standard Vector Borne Disease Health
Policy under Guidelines issued by IRDAI?
a. Only Indemnity basis

b. Both Indemnity and Benefit basis
c. Indemnity basis
d. Fixed Benefit basis
e. Daily Hospital Cash basis
54. What is the tenure of the policy which shall be offered under the Standard Vector Borne Disease
Health Policy under Guidelines issued by IRDAI?
a. 3.5 Months
b. 6.5 Months
c. 9.5 Months
d. 12 Months
e. Any of the above
55. Enlist the vector borne disease(s) which shall be covered under the Standard Vector Borne Disease
Health Policy under Guidelines issued by IRDAI Ref: IRDAI/HLT/REG/CIR/25/02/2021 dated: 03rd
February 2021?
1. Dengue Fever 2. Malaria

3. Botulism 4. Filaria (Lymphatic Filariasis)
5. Kala-Azar (Leishmaniasis) 6. Chikungunya
7. Japanese Encephalitis 8. Zika Virus
Choose the correct Option:

a. All the above except 4
b. All the above except 4, 5 and 7
c. All the above except 3 and 4
d. All the above except 3 and 5
e. All the above except 3
56. What are the heads of coverage offered under the Standard Vector Borne Disease Health Policy
through the Guidelines issued by IRDAI Ref: IRDAI/HLT/REG/CIR/25/02/2021 dated: 03rd February
2021?
a. Only In-patient Hospitalization Benefit

b. Hospitalization Benefit and Convalescent Benefit
c. Diagnosis Cover and Daily Hospital Cash Benefit
d. Hospitalization Benefit and Diagnosis Cover
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57. In reference to the Hospitalization Benefit and Diagnosis Cover offered under the Standard Vector
Borne Disease Health Policy through the Guidelines issued by IRDAI, which of the statement(s) is /are
correct?
1. Hospitalization Benefit: Lump sum benefit equal to 90% of the Sum Insured (excluding the amount
paid under diagnosis cover, if any) shall be payable on positive diagnosis of any of the vector borne
disease (s) requiring hospitalization for a minimum continuous period of 24 hours.
2. Hospitalization Benefit: Lump sum benefit equal to 100% of the Sum Insured (excluding the amount
paid under diagnosis cover, if any) shall be payable on positive diagnosis of any of the vector borne
disease (s) requiring hospitalization for a minimum continuous period of 72 hours.
3. Diagnosis Cover: 2% of the sum insured shall be payable on positive diagnosis (through laboratory
examination and confirmed by the medical practitioner) of every covered vector borne disease on the
first diagnosis during the Cover Period, subject to policy terms and conditions. The Policyholder is
entitled for payments under “diagnosis cover” payment for each disease only once in the policy year.
4. No deductibles are permitted in this product.
58. Pick the category of cover which shall be offered under the Standard Vector Borne Disease Health
Policy through the Guidelines issued by IRDAI?
a. Only Individual based
b. Only Floater based
c. Individual and Floater Sum Insured based
d. Any of the above
59. Select out the minimum and maximum sum insured which shall be offered under the Standard Vector
Borne Disease Health Policy through the Guidelines issued by IRDAI?
a. Rs. 1,00,000/- and Rs. 2,00,000/-
b. Rs. 10,000/- and Rs. 1,00,000/-
c. Rs. 10,000/- and Rs. 2,00,000/-
d. Rs. 1,00,000/- and Rs. 5,00,000/-
e. No stipulation on sum insured under the product.
60. What was the objective of IRDAI to come out with a Standard Vector Borne Disease Health Policy
through the Guidelines, Ref: IRDAI/HLT/REG/CIR/25/02/2021 dated: 03rd February 2021?
1. Objective of reducing the operating costs.
2. Pass on this benefit of reduced operational cost to the policyholders by way of affordable premiums.
3. Addressing the needs of insuring public for getting health insurance coverage to specified Vector
Borne Diseases.
4. Making general public aware on benefit insurance policies.

a. Only 1 and 2 are correct.
c. Only 1, 2 and 3 are correct.
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e. None of the above is correct.

61. What is the nomenclature mandatorily to be used for the Standard Domestic Travel Insurance Product
under Guidelines issued by IRDAI Ref: IRDAI/HLT/REG/CIR/ 119/05/2021 dated: 05th May 2021?
a. Bharat Bhraman Suraksha <Name of Insurer >

b. Bharat Yatra Raksha <Name of Insurer >
c. Swadesh Yatra Suraksha <Name of Insurer >
d. Bharat Yatra Suraksha <Name of Insurer >
e. An Insurer is free to choose Product’s name
62. How many plan variants shall be offered under the Standard Domestic Travel Insurance Product under
Guidelines issued by IRDAI Ref: IRDAI/HLT/REG/CIR/ 119/05/2021 dated: 05th May 2021?
a. 3 (Plan A to Plan C)
b. 1 (Plan A only)
c. 5 (Plan A to Plan E)
d. 6 (Plan A to Plan F)
e. 7 (Plan A to Plan G)
63. Pick the category of cover which shall be offered under the Standard Domestic Travel Insurance
Product under Guidelines issued by IRDAI?
a. Indemnity Only
b. Benefit Based Only
c. Indemnity and Benefit Based
d. Any of the above
64. What type of policies shall be offered under the Standard Domestic Travel Insurance Product under
Guidelines issued by IRDAI?
a. Only Individual basis

b. Only Group basis
c. Individual and Group Basis both
d. On Family Floater Basis
65. What shall be the waiting period under the Standard Domestic Travel Insurance Product under
Guidelines issued by IRDAI
a. First 3 days
b. First 7 Days
c. Only 1 day
d. No initial waiting period
e. Waiver of waiting period on loading of premium
66. Which of the variants under the Standard Domestic Travel Insurance Product can be extended
subject to request of policyholder for extension of duration of Trip being received by Insurer. Further
the request for extension for policy to be submitted atleast how many days before completion of term
of the existing policy.
a. Only Plan A and within 7 days
b. Only Plan A and within 3 Days
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c. Only Plan E and 3 Days

d. Only Plan E and 7 Days
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e. No extension allowed

67. Which filing procedure is applicable for Standard Domestic Travel Insurance Product and Vector Borne
Disease Health Policy, complying with the norms of “Consolidated Guidelines on Product filing in
Health Insurance Business (Ref: IRDAI/HLT/REG/CIR/194/07/2020 dated 22nd July, 2020)?
a. File and Use

b. Use and File
c. Any of the above
d. No filing is required for standard products
68. Which of the two statements in regard to Plan E on Policy Cancellations is/are correct under the
Standard Domestic Travel Insurance Product under Guidelines issued by IRDAI?
1. Under Plan-E: Domestic Trip, where the tenure of the policy is for less than or equal to 7days, the
policy can’t be cancelled once the Insured Journey is commenced.
2. Cancellation of Policy by Insured is permitted only in case where the tenure of the policy is more
than 7days under Plan-E: Domestic Trip.
Choose the correct options:
c. Both the Statements are correct
d. None is correct
69. Which amongst the following statements in regard to sublimit for room rent (in case of hospitalization
cover) is/are correct under the Standard Domestic Travel Insurance Product under Guidelines issued
by IRDAI?
1. Room Rent, Boarding, Nursing Expenses all inclusive as provided by the Hospital / Nursing Home
up to 1% of the sum insured subject to maximum of Rs.5,000/- per day.
2. Intensive Care Unit (ICU) charges/ Intensive Cardiac Care Unit (ICCU) charges all inclusive as
provided by the Hospital / Nursing Home up to 4% of the sum insured subject to maximum of
Rs.20,000/- per day.
3. Room Rent, Boarding, Nursing Expenses all inclusive as provided by the Hospital / Nursing Home
up to 2% of the sum insured subject to maximum of Rs.10000/- per day.
4. Intensive Care Unit (ICU) charges/ Intensive Cardiac Care Unit (ICCU) charges all inclusive as
provided by the Hospital / Nursing Home up to 2% of the sum insured subject to maximum of
Rs.10,000/- per day.

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70. Which amongst the following is/are mandatory benefits under the Standard Domestic Travel Insurance
1. Hospitalization expenses due to accident.
2. Accidental Death
3. Compassionate Allowance
4. Loss of checked in Baggage (Only in case of Air Travel)
5. Automatic Trip extension

d. All the above are mandatory benefits
e. All the above are optional benefits
71. Which amongst the following is/are optional benefits under the Standard Domestic Travel Insurance
1. Permanent Total Disability (PTD).
2. Missed flight connection
3. Repatriation of Mortal remains
4. Missed Flight connection
5. Trip cancellation and interruption

b. 1, 3, 4 and 5 are correct
d. 2, 4 and 5 are correct
72. What is the minimum and maximum age of entry specified under the Standard Domestic Travel
Insurance Product under Guidelines issued by IRDAI?
a. 6 months and 60 Years

b. It is similar to Overseas Travel Insurance Policy
c. No restriction on Minimum/Maximum age of entry
d. 3 months and 75 Years
e. 3 months and 65 Years
73. According to the “Additional Norms on portability under Health Insurance Policies” issued by IRDAI, to
provide seamless coverage with continuity of benefits to the account holders of various banks who are
provided health insurance coverage through Group Insurance schemes, Is the statement mentioned
hereunder True/False? (IRDAI/HLT/REG/CIR/249/10/2020 Dated:07th October 2020)
**Members of an indemnity based group health insurance policy offered to account holders of a bank
are allowed portability of their coverage to another indemnity based group health insurance policy
offered by a different insurer to the account holders of the same or any other bank of their choice.
a. True
b. False
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c. It’s an Insurer’s prerogative to decide

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d. None of the above.

74. According to IRDAI (Health Insurance) (Amendment) Regulations, 2019, state the timelines before
which the renewal premium for Health insurance policies shall not be accepted by Insurer from the
due date of the premium payment?
a. 30 Days in advance
b. 45 Days in advance
c. 60 Days in advance
d. 90 Days in advance
e. Can be decided by Insurer
75. According to IRDAI (Health Insurance) (Amendment) Regulations, 2019, Subject to terms and
conditions of the policy contract, reimbursement shall be allowed at any hospital or medical
establishment, which must be licensed or registered, as may be required, by?
1. Any Local Law as applicable

2. State Law as applicable
3. Registered with GIPSA or GI Council
4. Registered with IRDAI Networking Team
5. National Law as applicable

c. 1, 2 and 5 are correct
76. The indemnity based health insurance products solicited through PoS (Point of sales) channel may be
offered to which amongst the following listed options? (Ref: IRDA/INT/CIR/PSP/239/2017 Dated: 25th
October 2017)?
a. Only to Individual Policy holders

b. To Individual Policyholders and Group Both
c. To Individual Policyholders, Group and Government Schemes
d. Only under Government Schemes
e. All the Above
77. In accordance to IRDAI Guidelines on offering the indemnity based health insurance products solicited
through PoS (Point of sales) channel, what shall be the maximum sum insured that could be offered
per life/individual?
a. Rs. 1 Lac
b. Rs. 2.5 Lacs
c. Rs. 5 Lacs
d. Rs. 50,000/-
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78. Which amongst the following in regards to IRDAI (TPA-Health Services) (Amendment) Regulations,
2019, is inserted and in order for providing TPAs under Health policies?
1. The policyholder can choose a TPA of their choice from amongst the TPAs engaged by the insurer,
where services of TPAs are engaged by the insurer for a given insurance product.
2. Where the services of the TPA are terminated during the course of health services rendered by the
said TPA, every insurer shall allow the policyholder to choose an alternate TPA from amongst the
TPAs engaged by it.
3. The insurer shall explicitly provide the names of the TPAs amongst whom the policyholder may
choose the TPA of their choice at the point of sale.
4. The Policyholder may be allowed to change the TPA of their choice only at the point of renewal.
5. Where the Policyholder did not choose any of the TPAs, the insurer cannot allot the policy servicing
to a TPA of its choice.
6. Where the insurer engages the services of only one TPA, no option need be provided to the
policyholder.

a. 1, 2 and 3 are only correct
b. 1, 4 and 6 are only correct
c. 1 and 6 are only correct
d. 1, 2, 3, 4 and 6 are correct
79. The net worth of a TPA shall at no time during the period of registration fall below rupees _____ crore
according to IRDAI (TPA-Health Services) (Amendment) Regulations, 2019?
a. 10 Crores
b. 5 Crores
c. 4 Crores
d. 1 Crore
e. No limit as such is defined
80. What is the amount of Processing fee charged from the applicant to grant “ Certificate of Registration”
to a TPA as per IRDAI (TPA-Health Services) (Amendment) Regulations, 2019?
a. Rs. 2,00,000/- and other taxes as applicable

b. Rs. 50,000/- and other taxes as applicable
c. Rs. 1,00,000/- and other taxes as applicable
d. Rs. 15,000/- and other taxes as applicable
e. Rs. 2,50,000/- and other taxes as applicable
81. What is the amount of Registration fee charged from the applicant to grant “ Certificate of Registration”
to a TPA as per IRDAI (TPA-Health Services) (Amendment) Regulations, 2019?
a. Rs. 1,00,000/-and other taxes as applicable

c. Rs. 15,000/- and other taxes as applicable
d. Rs. 2,00,000/- and other taxes as applicable
e. Rs. 10,000/- and other taxes as applicable
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82. What are the timelines within which a TPA has to start his business operations after grant of Certificate
of Registration as a TPA as per IRDAI (TPA-Health Services) (Amendment) Regulations, 2019?
a. 6 Months
b. 15 Months
c. 12 Months
d. 2 Years
e. 3 Years
83. As per IRDAI (TPA-Health Services) (Amendment) Regulations, 2019, An applicant or any of the
promoters of the applicant against whom an order of refusal for grant of certificate of registration has
been passed by the Authority (IRDAI) shall not, for a period of ______ year from such refusal, submit
a fresh application to the Authority for grant of certificate of registration as a TPA?
a. 3 Years
b. 2 Years
c. 1 Year
d. 5 Years
84. A TPA against whom an order of revocation or cancellation or denial of the renewal has been passed
by the Authority (IRDAI) shall not, for a period of how many years from the date of such revocation or
cancellation or denial, submit a fresh application to the Authority for grant of certificate of registration
as a TPA?
a. 3 Years
b. 1 Year
c. 2 Years
d. 5 Year
e. Never in future
85. What is the amount of Renewal processing fee charged from the TPA for renewal of “ Certificate of
Registration” of TPA as per IRDAI (TPA-Health Services) (Amendment) Regulations, 2019?
a. Rs. 1,00,000/-and other taxes as applicable

c. Rs. 1,50,000/- and other taxes as applicable
d. Rs. 2,00,000/- and other taxes as applicable
e. Rs. 10,000/- and other taxes as applicable
86. In regard to IRDAI (TPA-Health Services) (Amendment) Regulations, 2019, is the noted statement true
or false?
“Where TPAs maintain files, data and other related information pertaining to the settlement of claims in
electronic form, maintenance of the same by the TPAs again in physical form is dispensed with.”
a. True
b. False
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87. With reference to “Consolidated Guidelines on Product filing in Health Insurance Business Dated:
22nd July 2022, which are the various functions a constituted PMC (Product Management Committee)
has to perform?
1. To put in place a Product Management Policy(In line with Underwriting Policy) for Health Insurance
Business.
2. It shall include reviewing products to avoid duplication or having multiple number of similar
products.
3. Annual plans at the beginning of each financial year for filing of new products and modification of
existing products;
4. Launching of products cleared under the File and Use procedure/ Use and File procedure as
stipulated in these Guidelines;
5. Designing and filing of pilot products, if any and any other matter relating to product design and
performance.

a. Only 3, 4 and 5 are correct
e. All the above are functions of Insurer’s Board
88. Nomenclature/Name of the Standard Individual Health Insurance Product mandated by IRDAI which
every General and Standalone health Insurer has to mandatorily offer on or before the stipulated date
of 01st April 2020?
a. Arogyam Sanjeevani Policy, <name of the insurer>

b. Arogyaplus Sanjeevani Policy, <name of the insurer>
c. Parivar Arogya Sanjeevani Policy, <name of the insurer>
d. Arogya Sanjeevani Policy, <name of the insurer>
89. Please go through the statement noted below in detail in regard to the “Additional Norms on portability
under Health Insurance Policies” issued by IRDAI and state whether it’s true or false for Migration?
**”Where Insurers allow lower waiting period for the Pre Existing Diseases (PEDs) (say 12 months or
24 months or 36 months), in the event of withdrawal of the said product, the existing Insurer shall give
credit to the accrued waiting period benefits of PEDs gained under the withdrawn product and allow
coverage on any of the health products available in his product portfolio with no additional
waiting period beyond the chosen PED period of the withdrawn product.”
a. True
b. False
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90. Please go through the statement noted below in detail in regard to the “Additional Norms on portability
under Health Insurance Policies” issued by IRDAI and state whether it’s true or false for Portability?
**”Where Insurers allow lower waiting period for the Pre Existing Diseases (PEDs) (say 12 months or
24 months or 36 months), in the event of withdrawal of the said product, the existing Insurer shall give
credit to the accrued waiting period benefits of PEDs gained under the withdrawn product and allow
coverage on any of the health products available in his product portfolio with no additional
waiting period beyond the chosen PED period of the withdrawn product.”
a. True, subject to the new insurer may impose only the unexpired / residual waiting period not
exceeding 48 months from the date of first issuance of porting out policy.
b. False, subject to the new insurer may not impose the unexpired / residual waiting period from the
date of first issuance of porting out policy.
91. Select the objective behind issuance of guidelines on Standard Individual Health Insurance Product by
IRDAI and to mandate all general and health insurers to offer it?
1) To take care of basic health needs of insuring public.
2) To have standard product with common policy wordings across the industry.
3) To facilitate seamless portability among insurers.
4) To facilitate covering all major critical illnesses.
5) To cover basic add-ons like personal accident
a. 1 is true
b. 1 and 2 are true
c. 1, 3 and 4 are true
d. 1, 2, 3 and 4 are true
e. 1, 2, 3, 4 and 5 are true
92. Which among the following is true in regard to the guidelines on Standard Individual Health Insurance
Product (Arogya Sanjeevani Policy)?
1) Only basic mandatory covers can be offered.
2) Basic mandatory cover along with add-ons like PA and Critical illness rider can be offered.
3) No add-ons or optional covers are allowed to be offered.
4) It can offered on indemnity basis only.
5) It can be offered on indemnity as well as benefit basis too.
6) Pricing of the product would be decided by the Regulator too
a. Only 1 and 3 are true

b. Only 1, 2 and 5 are true
c. Only 1, 3 and 4 are true
d. All the above are true
e. None of the above is untrue
93. Tick out the date mandated by the regulator from which all general and standalone health insurers
shall offer this product?
a. From 01st July 2020 onwards

b. From 01st April 2020 onwards
c. From 01st September onwards
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d. From 01st October onwards

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e. Any date to be decided by the Insurer/PMC

94. Which amongst the following is correct for AYUSH treatment covered in the Standard Individual Health
Insurance Product (Arogya Sanjeevani Policy)?
1) Expenses incurred on hospitalization under AYUSH are covered.

2) Expenses incurred on hospitalization under AYUSH are covered with a sublimit of 50% of SI are
only covered.
3) Expenses incurred on hospitalization under AYUSH are covered with a sublimit of Rs.1,00,000/-
are only covered.
4) Expenses incurred on hospitalization under AYUSH are covered without any sub-limits.
a. Only 1 and 2 are correct and covered

b. Only 4 is correct and covered
c. Only 1 and 3 are correct and covered
d. None of the above is correct and covered
e. Only 1 and 4 are correct and covered
95. Please tick out the number of days for which medical expenses are covered under the Standard
Individual Health Insurance Product (Arogya Sanjeevani Policy) pertaining to Pre and Post
Hospitalisation covered, if so?
a. No pre and post expenses are covered

b. 60/90 Days
c. 15/30 Days
d. 30/60 Days
96. Please state whether statements below are true or not in regard to coverage under the Standard
Individual Health Insurance Product (Arogya Sanjeevani Policy)?
1) The policy offers cumulative bonus benefit.

2) SI (including CB) shall be increased by 5% in respect of each claim free policy year, subject to
regular renewal without break upto a maximum of 50% of SI.
3) SI (excluding CB) shall be increased by 5% in respect of each claim free policy year, subject to
regular renewal without break upto a maximum of 50% of SI.
4) On claims occurrence in any particular year, the CB accrued may be reduced at the same rate at
which it was accrued.
5) On claims occurrence in any particular year, the CB accrued would become Zero and would accrue
as 5% of SI in subsequent claim free years.
6) If claim is made in expiring policy but notified after policy renewal, then any CB awarded shall be
withdrawn.

b. only 1,2 and 4 are correct
d. Only 1, 2, 3 and 6 are correct
e. All the above re correct
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97. State plan(s) under which the Standard Individual Health Insurance Product (Arogya Sanjeevani
Policy) can be offered?
a. Individual and Top up
b. Floater and Top up
c. Individual and Floater basis
d. Individual only
e. Floater only
98. Who among the following forms part of family definition under Standard Individual Health Insurance
1) Proposer &/or any one of the listed family members
2) Legally wedded spouse
3) Parents and Parents-in-law
4) Dependent Child(3m-25y)
5) Dependent siblings
6) Widowed daughters
a. Only 1, 2, 4 re covered
b. Only 1, 2, 3, 4 and 6 are covered
c. Only 1, 2, 3 and 4 are covered
d. Only 1 and 2 are covered
e. All the above are covered
99. What is the total number dependent family members which could be covered under the Standard
a. Maximum 4 dependent members
b. Maximum 5 dependent members
c. Maximum 7 dependent members
d. No capping on number of dependent family members
e. Maximum 9 members
100. Tick out the category of cover (s) offered under Standard Individual Health Insurance Product
(Arogya Sanjeevani Policy)?
a. Indemnity Basis with Add-on covers

b. Indemnity Basis only
c. Indemnity Basis with Critical Illness covers
d. Indemnity Basis with Critical Illness & Benefit Based covers
e. All the above
101. Which amongst the following statement is/are true in regard to the “Grace Period for Premium
Payment” under Standard Individual Health Insurance Product (Arogya Sanjeevani Policy)?
1) For all payment modes, a fixed period of 30 days is to be allowed as Grace period.
2) For Yearly payment mode, a fixed period of 30 days is to be allowed as Grace period & for all other
modes of payment a fixed period of 15 days be allowed as grace period.
3) For any premium payment mode, no Grace period is allowed.
a. Only Statement 1 is true

b. Only Statement 1 and 3 are true
c. Only 3 is true
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d. Only 2 and 3 are true

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e. Only Statement 2 is true

102. Pick out the distribution channels mandated for sale of Standard Individual Health Insurance Product
(Arogya Sanjeevani Policy) by IRDAI?
a. All distribution channels excluding Micro-Insurance Agents

b. All distribution channels including Micro-Insurance Agents, PoSP
c. All distribution channels excluding Micro-Insurance Agents, PoSP & CPSC
d. All distribution channels including Micro-Insurance Agents, PoSP & CPSC
e. All distribution channels including PoSP
103. Tick out the premium payment option allowed under Standard Individual Health Insurance Product
(Arogya Sanjeevani Policy)?
a. Only Yearly with ECS (Auto debit facility)

b. Only Yearly without ECS (Auto debit facility)
c. Yly, Hly, Qyl, Mly with ECS (Auto debit facility)
d. Yly, Hly, Qyl with ECS (Auto debit facility)
e. Yly, Hly, Qyl, Mly without ECS (Auto debit facility)
104. Which among the following statement with respect to the Standard Individual Health Insurance
Product (Arogya Sanjeevani Policy) is/are correct?
1) Minimum entry age shall be 18 years for principal insured.
2) Maximum entry age shall be 65 years.
3) There shall be lifelong renewability with no exit age.
4) Dependent child/children shall be covered from the age of 3 months to 25 years.
5) The maximum entry age can be extended to 70 years with 10% loading on premium.
6) The maximum entry age can be extended to 70 years with 10% mandatory co-pay.

b. Only 1,2 and 3 are correct
c. Only 1,2 and 6 are correct
105. Is there a fixed Co-pay applicable in the Standard Individual Health Insurance Product (Arogya
Sanjeevani Policy)? If yes, then how much?
a. No Co-pay applicable
b. Yes, its 10% is applicable across all ages
c. Yes, its 5% applicable across all ages
d. No, there is no fixed Co-pay rather its voluntary Co-pay
e. Yes a fixed Co-pay of 20% is applicable across all ages.
106. Are sublimits applicable for any procedure/disease under the Standard Individual Health Insurance
Product (Arogya Sanjeevani Policy)? If yes, name the procedure?
a. Yes, Sublimits are applicable for TKR, Hip Replacement and Cataract.
b. No sublimits are applicable, claims are paid upto sum insured.
c. Yes, Sublimits are applicable for Cataract.
d. Yes, Sublimits are applicable for TKR and Hip Replacement only.
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e. None of the above.

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107. Kindly state the sublimits applicable for Cataract under the Standard Individual Health Insurance
a. No sublimits are applicable

b. Upto 15% of Sum Insured or Rs.30,000/- whichever is lower, per eye in one policy year.
c. Upto 25% of Sum Insured or Rs.40,000/- whichever is lower, per eye in one policy year.
d. None of the above.
e. Upto 20% of Sum Insured or Rs.35,000/- whichever is lower, per eye in one policy year.
108. Which among the below noted statement is/are true in regard to the Standard Individual Health
1) The premium under this product shall be pan India basis.
2) Geographic location/zone based pricing is not allowed.
3) The pricing can be devised on the basis of metro and Non-metro cities criteria.
4) Geographic location/zone based pricing is allowed subject to appropriate loading.
a. 1 and 2 are untrue

b. Only 1 and 4 are true
c. Only 1 and 2 are true
d. Only 3 and 4 are true
e. All the above are true
109. The Standard Individual Health Insurance Product (Arogya Sanjeevani Policy) may be offered as
MICRO Insurance product subject to sum insured limits specified in IRDAI (Micro Insurance)
Regulations, 2015, and other circulars/guidelines issued in this regard by the authority from time to
time?
Please state whether the above noted statement is true or false?
a. True
b. False
110. As per the Modified Guidelines on standardization in health insurance, which among the following
statements is correct for Pre-Existing Diseases? (Ref: IRDAI/HLT/REG/CIR/225/08/2020 of 28th
August 2020).
Pre-existing disease means any condition, ailment, injury or disease:
1)That is/are diagnosed by a physician within 48 months prior to the effective date of the policy issued
by the insurer or its reinstatement or
2)That is/are diagnosed by a physician within 36 months prior to the effective date of the policy issued
by the insurer and/or
3)For which medical advice or treatment was recommended by, or received from, a physician within 48
months prior to the effective date of the policy issued by the insurer or its reinstatement.
4) A condition for which any symptoms and or signs if presented and have resulted within three months
of the issuance of the policy in a diagnostic illness or medical condition.
5)A condition for which any symptoms and or signs if presented and have resulted within 30 days of the
issuance of the policy in a diagnostic illness or medical condition.

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111. Under Standard Individual Health Insurance Product (Arogya Sanjeevani Policy), which among the
following procedures will be covered (wherever medically indicated) either as in patient or as part of
day care treatment in a hospital upto 50% of sum insured, specified in the policy schedule, during the
policy period?
1) Uterine Artery Embolization and HIFU (High intensity focused ultrasound)
2) Balloon Sinuplasty
3) Deep Brain Stimulation
4) Oral Chemotherapy
5) Immunotherapy-Monoclonal Antibody to be given as injection
6) Intra vitreal injections
7) Robotic surgeries
8) Stereotactic radio surgeries
9) Bronchial thermoplasty
10) Vaporisation of the prostate (Green Laser treatment or holmium laser treatment)
11) IONM (Intra operative Neuro Monitoring)
12) Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for hematological
conditions to be covered
a. 1 to 10 are covered
b. 5 to 10 are covered
c. 4 to 12 are covered
d. All the above are covered
112. Which among the below noted statement is/are correct in regard to Standard Individual Health
1) Expenses of Hospitalisation for a minimum period of 24 consecutive hours only shall be admissible.
However, the time limit shall not apply in respect of day care treatment.
2) In case of admission to a room/ICU/ICCU at rates exceeding the defined limits, the
reimbursement/payment of all other expenses incurred at the hospital, with the exception of cost of
medicines, shall not be effected in the same proportion as the admissible rate per day bears to the
actual rate per day of room rent/ICU/ICCU.
a. Both 1 and 2 are correct
d. None is correct
113. Which among the following is/are permanently excluded under Standard Individual Health Insurance
1) Domiciliary Hospitalisation expenses
2) OPD Treatment expenses
3) Maternity Expenses except Ectopic Pregnancy
4) Correction of eyesight (Where Refractive error is <7.5)
5) Rest Cure, rehabilitation and respite care
6) Change of gender treatments
7) Treatment taken outside the geographical limits of India.
a. Only 3, 4 and 5
b. Only 3, 4, 6 and 7
c. Only 2 and 3
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d. All the above

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114. What is the terminology used for the time period under Standard Individual Health Insurance Product
(Arogya Sanjeevani Policy) after completion of which no look back would be applied and state that
time period too?
a. Claw Back Period, 4 years

b. Denotative Period, 5 Years
c. Moratorium Period, 8 Years
d. Time Bound Exclusions, 4 Years
115. Which among the noted statement is/are true in regard to Moratorium Period defined under Standard
1)After completion of 8 years no look back would be applied.

2)It would be applicable for the sum insureds of the first policy and subsequently completion of 8
continuous years would be applicable from the date of enhancement of sum insureds only on the
enhanced limits.
3) After expiry of this period no claim under this policy shall be contestable even if proven fraud and
permanent exclusions specified in the policy contract.
4)The policy would however be subject to all limits, sublimits, co-payments as per the policy.
a. Only 1 and 2
b. Only 1, 2 and 4
c. Only 1, 2, and 3
d. All the above
116. What is the time period defined under the Standard Individual Health Insurance Product (Arogya
Sanjeevani Policy) for submission of necessary claim documents to TPA (If applicable)/Company for
reimbursement of incurred claim expenses?
a. Hospitalization, Day Care & Pre-Hospitalization: Within 45 days of date of discharge and Post-
Hospitalization: Within 15 Days of completion of post hospitalization treatment.
b. Hospitalization, Day Care & Pre-Hospitalization: Within 30 days of date of discharge and Post-
c. Hospitalization, Day Care & Pre-Hospitalization: Within 30 days of date of discharge and Post-
d. Hospitalization, Day Care & Pre-Hospitalization: Within 30 days of date of discharge and Post-
e. Hospitalization, Day Care & Pre-Hospitalization: Within 30 days of date of discharge and Post-
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117. Which among the following statement is/are correct as per Health Insurance Regulations 2016, Its
Amendment 2019 and other guidelines/circulars in regard to settlement of claim reported under
multiple policies taken by an insured during a period from the same or one or more insurers to
indemnify treatment costs?
1) The policyholder shall have the right to require a settlement of his/her claim in terms of any of
his/her policies. In all such cases the insurer if chosen by the policyholder shall be obliged to settle
the claim as long as the claim is within the limits of and according to the terms of the chosen policy.
2) Policyholder having multiple policies shall also have the right to prefer claims under other policy for
balance claim or claims disallowed under earlier chosen policy, even if the sum insured is not
exhausted in the earlier choosen policy. In such case the insurer shall independently settle the
claim subject to terms and conditions of other policy/policies so choosen.
3) If the amount to be claimed exceeds the sum insured under a single policy, the policyholder shall
have the right to choose insurers from whom he/she wants to claim the balance amount.
4) Where an insured has policies from more than one insurer to cover the same risk on indemnity
basis, the insured shall only be indemnified the hospitalization costs in accordance with the terms
and conditions of the chosen policy.
a. Only 1 and 2
b. Only 1, 2 and 3
c. Only 1, 3 and 4
d. All the above
118. Under Renewal of Policy clause of Standard Individual Health Insurance Product (Arogya Sanjeevani
Policy), if the policy is not renewed with in the grace period after due renewal date, the policy shall
terminate?
Kindly state whether above statement is true or false?
a. True
b. False
119. If the insured person has opted for payment of premium on an installment basis i.e. Half Yearly,
Quarterly or Monthly, under the Standard Individual Health Insurance Product (Arogya Sanjeevani
Policy), which among the following conditions shall apply?
1) Grace period of 15 days would be given to pay the installment premium due for the policy.
2) During such grace period, coverage will not be available from the installment premium payment
due date till the date of receipt of premium by the insurer.
3) The benefits provided under-“Waiting Periods”, “Specific Waiting Periods” sections shall continue in
the event of payment of premium within the stipulated grace period.
4) An interest will be charged if the installment premium is not paid on due date.
5) In case of installment premium due not received within the grace period, the policy will get
cancelled.

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120. Kindly state the conditions under which the policyholder may be changed during the policy period
under the Standard Individual Health Insurance Product (Arogya Sanjeevani Policy)?
a. Only in case of his/her demise

b. Only in case of change of product
c. Only in case of him/her moving out of India
d. Both a and c above
e. All the above
121. Out of the below noted statements, which is correct in regard to coverage of Pre-Existing Diseases
under the Standard Individual Health Insurance Product (Arogya Sanjeevani Policy)?
1)Only PEDs declared in the proposal form and accepted for coverage by the company shall be
covered after a waiting period of 4 years.
2)PEDs whether declared/not declared in the proposal form and accepted for coverage by the
company shall be covered after a waiting period of 4 years.
a. Only 1
b. Only 2
c. 1 and 2 both
d. None is correct
122. Ayushman Bharat-National Health Protection Mission is being managed and administered by which
among the Ministry among the following under Govt of India?
a. Ministry of Labour & Employment

b. Ministry of Child & Family Care
c. Ministry of Health & Family Welfare
d. Ministry of AYUSH
e. None of them
123. Name the agency/organization/dep’t set up the Ministry of Health and Family Welfare, GoI, with the
primary objective of coordinating the implementation, operation and management of AB-NHPM. It will
also foster co-ordination and convergence with other similar schemes being implemented by the
Government of India and State/UT Governments?
a. IRDAI
b. IIB
c. NHA (New Health Accreditation Association)
d. NHA (National Health Association)
e. NHA (National Health Authority)
124. Please pick out the mode of benefit and claim settlement available under AB-NHPM Ayushman
Bharat-National Health Protection Mission?
a. Individual SI and Both Reimbursement & Cashless Basis

b. Family Floater and Both Reimbursement & Cashless Basis
c. Family Floater and Cashless Basis.
d. Both a and c above
e. All the above
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125. Mark the type of model of implementation of AB-NHPM Ayushman Bharat-National Health Protection
Mission in various states.
a. Trust and Hybrid
b. Hybrid and Insurance
c. Trust (Govt),Insurance and Hybrid (Mix Model)
d. Insurance Only
e. Trust (Govt) Model Only
126. Tick the objective of Ayushman Bharat-National Health Protection Mission

1. Reduce out of pocket expenditure of poor
2. To reduce Catastrophic Health Expenditure
3. To provide coverage to all categories of people
4. Improve access to quality health care
5. Reduce unmet needs

b. 1, 2, 4 and 5 are correct
127. The maximum sum insured available under Ayushman Bharat-National Health Protection Mission to
the BFU (Beneficiary family unit) as a whole is?
a. 10,00,000/-
b. 5,00,000/-
c. 4,00,000/-
d. 2,50,000/-
e. Actual Amount
128. Tick out the terminology used for the family as a whole under the Ayushman Bharat-National
Health Protection Mission?
a. Identified Family Unit (IFU)
b. Beneficiary Family Union (BFU)
c. Family Defined Unit (FDU)
d. Beneficiary Family Unit (BFU)
e. All the above
129. List out the type of procedures from the options listed below covered for treatment of diseases and
medical conditions through EHCP under Ayushman Bharat-National Health Protection Mission?
a. Primary and Tertiary care

b. Secondary care only
c. Secondary, Tertiary and day care procedures
d. Primary, Secondary and Tertiary care
e. All of the above
130. Expand the abbreviation EHCP which is contemporary to PPN?

a. Expanded Health Care Provider
b. Enlisted Health Care Provider
c. Empanelled Health Care Provider
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d. Empanelled Preferred care provider

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e. All of the above

131. Who among the following are covered under the AB-NHPM Ayushman Bharat-National Health
Protection Mission Beneficiary data base for coverage?
1. 11 Defined Occupational Unorganized Workers
2. Deprived categories (D1, D2, D3, D4, D5 to D7)
3. Automatically Included category
4. Existing RSBY Families
a. 1 and 2 only
b. 2, 3 and 4 only
c. 4 only
d. All the above are covered
e. Only 2
132. What is the data base used by GoI (Government of India) for coverage under the Ayushman Bharat-
National Health Protection Mission?
a. Registry of Deprived Sections 2011

b. SECC Data 2011
c. NPR 2011
d. Census 2011
e. Unskilled Labour Registry 2011
133. Please read the statements noted below in reference to coverage under Ayushman Bharat-National
Health Protection Mission :
1. no entry or exit age restrictions will apply to the members of a Beneficiary Family Unit; and
2. no member of a Beneficiary Family Unit will be required to undergo a pre-insurance health
check-up or medical examination before their eligibility as a Beneficiary.
Which among them is/are correct?
a. 1 is correct
b. only 2 is correct
c. None is incorrect
d. Both are incorrect
e. 1 is correct 2 is incorrect
134. Please pick the capping option on the number of family members covered under Ayushman Bharat-
National Health Protection Mission as BFU (Beneficiary family unit)?
a. Only 5 Members are covered

b. Maximum 7 members covered
c. No capping on Family number
d. Only 4 Members Covered
135. Which among the following statements on coverage under Ayushman Bharat-National Health
Protection Mission is/are correct?
1. Hospitalization expense benefits Defined day care procedures
2. Follow up care benefits
3. Pre and post-hospitalisation (15 Days) treatment.
4. Pre-existing conditions/diseases are to be covered from the first day
33
5. New born child/ children benefits

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a. 1, 2 and 3 are correct and covered
b. 1, 2,3 and 4 are correct and covered
c. All the above are correct and covered
d. Only 1 and 2 are correct and covered
e. only 1 and 3 are correct and covered
136. Whether a beneficiary covered in one state under Ayushman Bharat-National Health Protection
Mission/Scheme, can take a medically necessary treatment in any other state. If so, under what
provisions?
a. No, Not eligible

b. Yes, but has to bear 50% of treatment cost
c. Yes, under Portability of Benefits
d. No, only one member can avail this benefit
137. Which among the listed condition is/are exclusions under Ayushman Bharat-National Health
Protection Mission:
1. Out-Patient Care.
2. Expenses primarily for evaluation / diagnostic purposes only
3. Any dental treatment or unless arising from disease, illness or injury and which requires
Hospitalisation for treatment.
4. Congenital external diseases
5. Fertility related procedures.
6. Drugs and Alcohol Induced illness
7. Vaccination
8. Suicide: Intentional self-injury/suicide
9. Persistent Vegetative State
Pick the correct option:

a. 1, 2, 8 and 9
b. 4, 5 and 8
c. None of the above
d. All the above
e. This is not defined in scheme
138. Can GMC policy with a conventional group of 1000 primary members be offered to a corporate entity
for a short period of 6 months as per Health Insurance Regulations 2016?
a. Yes, Can be offered for 6 months

b. Yes, Depends on the mode of payment
c. No, can only be offered for a minimum tenure of one year
d. Cannot be defined
139. After issuance of a GMC policy, the insurer can alter the Basic Rating under the policy after running
the policy for minimum of 6 months? True or false
a. True
b. False
c. Cannot be determined
34
d. Depends upon the Corporate

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140. Except travel insurance products and Pilot Products, once a proposal is accepted and a
policy is issued which is thereafter renewed periodically without any break, further renewal
shall be denied on grounds of the age and claims history of the insured. True or False?
a. True
b. Cannot be determined
c. False
d. None of the above
141. An insurer shall not deny the renewal of a health insurance policy on the ground that the
insured had made a claim or claims in the preceding policy years, except which among the
listed policies?
a. Individual Mediclaim Policies

b. Family Floater Policies
c. Critical Illness Benefit Policies
d. Indemnity Policies
e. Bancassurance Policies
142. An insured lodged a claim for an amount of Rs.5 Lacs in an indemnity policy after taking a treatment
from a Hospital fulfilling the minimum criteria for beds and hospital medical staff as per regulations.
But the hospital is not registered under the Clinical Establishments (Registration and Regulation) Act,
2010 or under the enactments specified under the Schedule of Section 56(1) of the said Act. What will
be the fate of the claim lodged based on the Hospital Registration criteria?
a. Claims Stands Denied

b. Claim will be processed after Registration of Hospital
c. Claim will be processed as per terms & conditions of the policy
d. Claim will repudiated with valid reasons on Non-registration of Hospital.
e. None of the above is correct.
143. An insured has two mediclaim policies running for the same POI (Period of insurance) with two
different insurers.
Policy A: 5 Lacs, With Copay of 20%
Policy B: 5 Lacs, No Copay
Mediclaim expenses Borne: 4 Lacs, Claim lodged under Policy A. Claim settled and paid For Rs.3.20
Lacs. Insured later claimed the Co-pay of Rs. 80 Thousand under Policy B. Insurer repudiated the
claim, stating the reason as Claims under other policy (ies) may be made only after exhaustion of Sum
Insured in the earlier chosen policy / policies. Please state whether repudiation of claim under Policy B
is correct or Not?
a. Correct
b. Incorrect
c. cannot be determined
d. None of the above is correct
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144. An insured has two mediclaim policies running for the same POI (Period of insurance) with two
different Insurers.
Policy A: 5 Lacs, With Copay of 20%
Policy B: 5 Lacs, No Copay
Mediclaim expenses Borne: 4 Lacs, Claim lodged under Policy A. Claim settled and paid For Rs.3.20
Lacs. Insured later claimed the Co-pay of Rs. 80 Thousand under Policy B. Insurer settled and paid
the claim for an amount of Rs. 80 thousand. Please state whether settlement of claim is under Policy
B is correct or Not?
a. Correct
b. Incorrect
c. Cannot be determined
d. None of the above is correct
145. An insured has a mediclaim policy with Sum Insured: 3 Lacs, Copay of 10%. The amount claimed
under the policy by the insured for hospitalization is 4.50 Lacs. What would be the final claim paid
amount :
a. 2.50 Lacs
b. 2.70 lacs
c. 3 Lacs
d. 4.50 lacs
e. 4 Lacs
146. Sum Insured: 5 Lacs, Room Rent capping: 1% of Sum insured with Copay of 10%. Proportionate
Deduction clause under the policy.
Opted Room Rent: 8000/- per day
What would be the percentage of proportionate deduction by which the expenses would be reduced?
a. 29.50%
b. 30%
c. 37.50%
d. 50%
e. 15%
147. Sum Insured: 5 Lacs, Room Rent capping: 1% of Sum insured with Copay of 10%. Proportionate
Deduction clause under the policy (Ref: IRDAI/HLT/REG/CIR/151/06/2020 Dated: 11th June 2020).
Bifurcation of Medical Expenses Borne by the Insured:
Room Rent: 2 Days: 20000/- Pharmacy: 10000/-
Diagnostics: 40000/- Consultations: 20000/-
Implant Cost: 20000/- Other Misc. Charges: 5000/-
What would be the final admissible claim paid amount?
a. Rs. 1,15,000/-
b. Rs. 72,500/-
c. Rs. 83,250/-
d. Rs. 42,500/-
e. Rs. 85,000/-
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148. Base Mediclaim Policy: 4 lacs
Super Top Up Policy: Deductible: 3 Lacs and Sum Insured: 3 Lacs
Claimed Amount: Rs. 5 Lacs
Admissible claim amount under the Base Policy is Rs. 3 Lacs and the Admissible claim amount as per
terms and conditions of Super Top up policy is: Rs. 3.50 Lacs. What would be the amount paid under
the Super Top Up Policy, if any?
a. Nil
b. 2 Lacs
c. 50,000/-
d. 3,00,000/-
e. 5,00,000/-
149. Base Mediclaim Policy: 5 lacs ,Super Top up Policy: Deductible: 7 Lacs and Sum Insured: 5 Lacs
Claim A: 3 Lacs
Claim B: 2 Lacs
Claim C: 3 Lacs
Total admissible expenses of all the three claims is Rs. 8 Lacs. What will be the claim paid amount
from the Base Policy and from the Super Top up policy, if any?
a. Base Policy: 5 Lacs and Super Top-up Policy: 3 Lacs

b. Base Policy: 3 Lacs and Super Top-up Policy: Nil
c. Base Policy: 5 Lacs and Super Top-up Policy: 1 Lacs
d. Base Policy: 5 Lacs and Super Top-up Policy: 2 Lacs
e. Base Policy: 4 Lacs and Super Top-up Policy: 1 Lacs
150. Super Top-Up Policy: with Deductible: 5 Lacs and Sum Insured: 7 Lacs. No Base Policy available
with the insured. Claim amount Lodged: 7 lacs. What would be admissible claim amount to be paid
under the Super Top up policy?
a. NIL
b. 7 Lacs
c. 2 Lacs
d. 5 lacs
e. 1 lacs
151. GMC: Insurer A: Insured Covered for 4 years: Rs. 10 lacs

Retail Policy: Insurer B: 1 Year: Rs. 10 lacs
The insured lodged a claim for total knee replacement (covered for 48 months of continuous renewal)
for an amount of Rs. 8 Lacs.
Claim was repudiated by Insurer B. Is the repudiation in line with Health Insurance Regulations-2016
and further amendments thereof, Correct or Incorrect?
a. Cannot be determined
b. Correct
c. Incorrect
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152. GMC with insurer A from 4 years for Sum Insured of Rs. 5 Lacs. Insured now reached an exit age
and thereby migrated to retail policy with same insurer with a Copay of 10%. A claim for Inguinal
Hernia in the first 30 days of the policy was lodged by the insured for an amount of Rs.50,000/-. Would
the claim be paid, if so, then for how much?
a. Cannot be determined
b. No, 30 Days waiver clause
c. Yes, Rs. 45,000/-
d. Yes, Rs. 50,000/-
153. Room Rent: 1000/-

Consultations: 2000/-
Registration Charges: 500/-
Medicine: 5000/-
Telephone Charges: 200/-
Misc. charges: 1000/-
What would be the final claim settled amount under the policy, considering it to be a policy with Sum
Insured of 5 Lacs and Copay of 10% on claim admissible amount?
a. 8700/-
b. 8500/-
c. 8100/-
d. Nil
e. 9700/-
154. Critical Illness Benefit Policy : Rs. 2 Lacs

Base Policy: 5 Lacs
Super Top up Policy: Deductible: 8 Lacs and Sum Insured: 8 Lacs
Claim lodged for Cancer Grade IV for an amount of Rs. 15 lacs. The admissible claim amount is Rs.
14 lacs. Taking all the policies into consideration, which have been in force for continuous 48 months
without break, what will be the total amount to be paid to the insured customer?
a. 12 Lacs
b. 11 lacs
c. 14 lacs
d. 13 Lacs
e. 10 Lacs
155. Insured has a critical illness benefit policy of 5 lacs. Insured suffered from one of the covered critical
illnesses under the policy and lodged a claim for Rs. 5 lacs. There after he was again hospitalised for
the same disease within 45 days from the date of discharge from the hospital and again lodged a
claim with the insurer for Rs. 5 lacs. What would be the claim payable amount under the first and
second claim?
a. Nil/Nil
b. 5 Lacs/ 5 Lacs
c. 5 Lacs/ Nil
d. Nil/ 5 lacs
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156. Insured has a Super top up policy with a room waiver clause for delinking of room rent category for
proportionate expenses of Rs. 10 lacs deductible and 15 lacs sum insured. Insured lodged a claim for
Rs. 11 lacs with the insured under the policy. The room rent charged15k per day. Total admissible
claim amount is Rs. 10 lacs. What would be the total claim amount paid under the policy to the
insured?
a. 10 Lacs
b. 11 Lacs
c. Nil
d. 15 lacs
157. Which among the following is the basis of calculation for entitlement of room rent category under the
Super top up Policy?
a. Sum Insured
b. Deductible
c. Sum Insured + Deductible
d. 1 % of the Claimed Amount
e. All of the above
158. What is the timeline set out by IRDAI for launch of an approved fresh/modified product from the date
of approval by the Insurer as per Guidelines on product filing in Health Insurance Business 2016 and
further amendments thereof?
a. 6 months
b. 3 Months
c. 12 Months
d. 30 Days
e. 45 Days
159. Kindly state the maximum time period in which the insurer will be required to comply with File and
Use Procedure afresh for an already approved or modified product, in case he is not able launch the
product?
a. 3 months from the date of approval

b. 6 months from the date of approval
c. 12 months from the date of approval
d. 9 months from the date of approval
160. Which among the following is the approval authority for a Pilot Health Product?
a. Board of the Company

b. Product Management Committee
c. IRDAI
d. Product Development Board
e. Health Insurance Dep’t
161. What is the maximum time period upto which a pilot product could be offered?
a. 3 years from the date of launch
b. 5 years from the date of launch
c. 7 years from the date of launch
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d. Upto 10 years from the date of launch

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162. Time period accorded by Regulator to PMC (Insurer) to record its decision to the authority as to
whether, withdraw or continue the Pilot Product as a regular product?
a. 45 days before expiry of such period
b. 60 days before expiry of such period
c. 30 days before expiry of such period
d. 90 days before expiry of such period
e. No such time period exist
163. State the time period before which no insurer shall ordinarily modify or revise a product from the date
of its clearance by the authority?
a. 3 years
b. 2 years
c. 5 years
d. 1 year
e. 7 years
164. For how many years the insurers shall maintain the records such as proposal form, internal notes,
details of quotation given and details of acceptance, detailed premium worksheet along with the basis
for working including previous claims details, policy schedule, list of named beneficiaries etc. for
Group Health Insurance Products?
a. 5 years from the date of expiry of the policy

b. 3 years from the date of expiry of the policy
c. 7 years from the date of expiry of the policy
d. 10 years from the date of expiry of the policy
e. No such recording is required
165. Mark the number of days in which Insurer has to submit the product performance details in respect of
every ”Pilot Product” cleared by the authority?
a. Within 30 days of close of FY

b. Within 45 days of close of FY
c. Within 60 days of close of FY
d. Within 90 days of close of FY
e. No such report is required for submission
166. As per Guidelines on product filing in Health Insurance Business, how much should be the number of
members under a Group Product to risk it a Large Group?
a. 250 members
b. 21 members
c. 100 members
d. 1000 members
e. 500 members
167. Who takes the decision to withdraw any Health Insurance product in case of General and Standalone
Health Insurers?
a. PMC
b. Board of the Company
c. IRDAI
40
d. Product Development Board

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e. TAC

168. State the number of days defined by the regulator upto which all policyholders of the withdrawn
product that are due for renewal shall be given an option of renewing the existing product or migrating
to the modified version of the product or to the new product, subject to portability norms in vogue?
a. 90 days from the date of withdrawal

b. 120 days from the date of withdrawal
c. 45 days from the date of withdrawal
d. 30 days from the date of withdrawal
e. 91 days from the date of withdrawal
169. Under the Use and File procedure who approves the product?
a. IRDAI
b. Product Development Board
c. PMC
d. Board of the Company
e. No approval required
170. Under File & Use Guidelines who has been assigned the purpose of efficient management of
insurer’s Products, product design, protection of policyholder’s interest and regulatory compliance etc.
a. Board of the company
b. IRDAI
c. PDC
d. PMC
e. Health Insurance Dep’t
171. The Health Insurance Underwriting Policy of an Insurer (General/Standalone Health) evolved is
approved by who among the following?
a. PMC
b. IRDAI
c. Product Development Dep’t
d. Board of the Company
e. No approval Required
172. IRDAI (Payment of Commission or Remuneration or Reward to Insurance agents and Insurance
Intermediaries) Regulations, 2016 came into force from which date?
a. 31st March,2017
b. 31st Dec,2017
c. 01st April, 2017
d.07 th April,2017
e. 04th April,2017
173. What is the maximum commission or remuneration as a percentage of premium allowed for Health
Insurance Products by General or Stand Alone Health Insurers?
a. Health-Individual : 15%
b. Health Group (Employer-Employee only) – Annual: 7.5%
c. Health Group (Non-Employer-Employee only) – Annual: 15%
41
d. Health Govt Schemes-- As specified in Govt Scheme/Notification

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174. What is the validity of POI of OMP Policy after the date of first issuance?
a. Valid only from the date of issuance of the policy

b. Valid only from the date and time of departure from India
c. Valid from the date of proposal of insurance
d. Valid from First day of insurance or date and time of departure from India.
175. What is the minimum number of days under an Overseas Travel Insurance Policy within which the
insured should commence his journey for the policy and POI to be valid?
a. Within 14 days of the Ist day of Insurance.

b. The Day his policy is issued
c. The date of inception of the policy mentioned in policy schedule
d. Within 07 days of Policy Issuance date
e. Wintin 21 days of the first day of Insurance
176. What could or would be the date of expiry of the OMP policy?
a. Last date of POI or on date of return to India, whichever is earlier.

b. Last date of POI as mentioned on the policy schedule
c. Date of return to India
d. On the Last date of taking a Claim in the policy
e. On date of extension of the Policy
177. A person covered under Overseas Mediclaim Policy ,while on return from abroad submitted a claim
for delay in checked in baggage as delay was for 15 hrs. Please state whether the claim will be
payabvle or not?
a. Yes, as delay is for more than 12 hours.

b. No, delay for inbound journey is not payable.
c. Yes, Payable after due scrutiny and verification.
d. Not defiuned in policy coverages
178. What is the number of day’s upto which the POI can be extended without paying extra premium due
to delay of Public transport services beyond the control of the insured person, if necessitated under an
Overseas Travel Plan?
a. 15 Days
b. 21 days
c. 07 Days
d. No Extesnion allowed
e. No such provision Exists in OMP Policy
179. Upto how many number of days can the emergency expenses be paid after the date of expiry of the
policy, if the injury/illness/accident covered has been contracted during the currency of the policy and
continues thereon, subject the insured is incapable of travel under an Overseas Travel Policy ?
a. 90 Days
b. 30 Days
c. 15 Days
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d. 21 Days
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e. 45 Days

180. Which among the following is generally not covered in an OMP B&H (Overseas Mediclaim Policy-
Business and Holiday) Policy?
a. Medical expenses and repatriation

b. PA and Personnel Liability
c. Loss of Checked Baggage
d. Maternity Benefit
e. All the above
181. What does CFT stands for in Travel Plans?

a. Continuous Frequest Traveller
b. Corporate Frequent Traveller
c. Combined Frequent Traveller
d. Current Frequent Traveller
182. Which among the following is correct under CFT policy?
a. It is an not an Annual cover

b. Valid for trips undertaken within 12 months following the date of purchase and subject to total
number of days of insured travel does not exceed 360 days
c. Valid for trips undertaken within 12 months following the date of purchase and subject to total
d. Valid for trips undertaken within 12 months following the date of purchase and subject to total
e. The duration a trip could extend for more than 60 days
183. What is the age limit for issuance of E & S policy?

a. 18 to 45 Years
b. 18 to 60 years
c. 18 to 75 Years
d. No age Limit
184. Which among the following is the Travel insurance plan which could be taken by overseas travellers
visiting India?
a. B & H OMP Policy

b. E & S OMP Policy
c. Videsh Mitra Yatra Policy
d. Destination India Policy
e. Pravasi Bhartiya Bima Policy
185. The time limit as per IRDAI Standard Guidelines for issuance of an Authorization Letter (AL) after
raising a request for Cashless facility to Insurer/TPA through Request for authorization letter (RAL)?
a. 72 Hours
b. 24 hours
c. 48 Hours
43
d. Within 12 Hours
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e. Within 60 Hours

186. What is the period of validity of an authorization letter to avail the cashless facility?
a. 30 Days from the date of approval granted
b. 07 Days from the date of approval granted
c. 21 Days from the date of approval granted
d. 05 Days from the date of approval granted
e. 15 Days from the date of approval granted
187. What does ICD Stands for?

a. Indian Classification of Diseases
b. International Classification of Diseases
c. International Statistical Classification of Diseases and related Health Problems
d. Institutional Classification of Diseases and Related Health Problems
e. Insurance Classification of Diseases and Related Health problems
188. What does CPT codes stands for:
a. Common Procedure Terminology Codes

b. Current Procedure Terminology Codes
c. Coded Procedure Terminology Codes
d. Classified Procedure Terminology Codes
e. Captured Procedure Terminology Codes
189. Tick out the correct option explaining the difference between ICD and CPT coding?
a. While CPT is used to capture the disease in a standardized format, ICD codes capture the
procedures performed to treat the illness.
b. While ICD is used to capture the disease in a standardized format, whereas CPT codes do
not capture the disease in a standardized format.
c. While ICD is used to capture the procedure of treatment of illness, whereas CPT codes do not
capture the procedures performed to treat the illness.
d. While ICD is used to capture the disease in a standardized format, CPT codes capture the
e. While ICD is used to capture the disease in a standardized format, CPT codes capture the
190. Cite the number of Critical illness diseases which have been defined under standard Nomenclature
and procedures of IRDAI Health Insurance Regulations-2016?
a. 11
b. 15
c. 21
d. 22
e. 42
191. Under the IRDAI (HI) Regulations, 2016, what is the number of Terminology whose standard definition
have been defined for implementation under all Health Insurance Products?
a. 21
b. 15
c. 46
44
d. 45
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e. 54

192. The number of days defined for Any One illness?

a. 42 Days
b. 45 Days
c. 21 Days
d. 30 days
e. 36 days
193. The Compulsary sharing of a specified percentage of cost of the admissible claim amount in Health
Insurance Products is called?
a. Voluntary Copayment
b. Excess
c. Co-Payment
d. All of the above
194. A medical treament for illness/Disease/Accident which in the normal course would require care and
treatment at a Hospital but is actually taken while confined to Home is called?
a. Domicilliary Hospitalisation
b. Day Care treatment
c. Convalescent Home
d. Deaddiction centres
195. Where there is a change in the TPA for policy servicing, insurers shall communicate to the
policyholders before how many days giving effect to the change.
a. 60 days before change

b. 90 days before change
c. 30 days before change
d. 120 Days before change
e. As deems fit to the insurer
196. Any revision or modification including a revision in the price of the policy which is approved by the
authority shall be notified to the policyholders, before how many days prior to the date when such
revision or modification comes into effect?
a. 60 days
b. 45 days
c. 90 days
d. 30 days
e. 120 days
197. What does ROHINI stands for?
a. Record of Hospitals in network of Insurance, developed by CII

b. Regularisation of Hospitals in Network of Insurance, developed by IIB
c. Registry of Hospitals in Network of Insurance,developed by IIB
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d. Roster of Hospitals in Network of Insurance, developed by WHO

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198. What does AYUSH, an acronym for Non-Allopathic/Alternate treatments stands for?
a. Ayurveda,Yashodhara,Unani,Siddha and Homeopathy systems
b. Ayurveda,Yoga and Naturopathy,Unani,Shirodhara and Homeopathy systems
c. Ayurveda,Natural Cure,Unani,Siddha and Homeopathy systems
d. Allopathic,Yoga,Unani,Siddha and Homeopathy systems
e. Ayurveda,Yoga and Naturopathy,Unani,Siddha and Homeopathy systems
199. Number of days upto which there could be No break in policy, if the premium is paid before those
number of specified days? What is the term used for that period?
a. 31 days / Grace Period
b. 30 days / free look Period
c. 30/15 days / Grace Period
d. 45 days / Free look Period
e. 36 days / Grace Period
200. For group health insurance policies, the individual members shall be given credit as per table of
waiting period provided, based on the number of years of continuous insurance cover, irrespective of,
whether the previous policy had any pre-existing disease exclusion/time bound exclusions.
True or false as per Portability Guidelines (HIR) 2016?
a. True
b. False
c. May be true
d. No such provision exist
e. Decided by the insurer
201. In order to accept a policy which is being ported in, the insurer is allowed to levy additional loading or
charges exclusively for the purpose of porting as per approved underwriting policy? True or False?
a. True
b. False
c. May be true
d. No such provision exist
e. Decided by the insurer
202. Among the listed methods, which one is followed in case of portability, if the outcome of portability is
still awaited and the insured on request renews his policy for a short period of one month?
a. Short Period Premium

b. Prorata Basis
c. Regular premium as per tariff
d. Renwal Premium
e. Short term issuance not allowed
203. Please specify the name of the close ended product with a policy term of one year that may be offered
for sale by General Insurers or Standalone Health Insurers for a period not exceeding 5 years from
the date of launch with a view and scope to innovate the risks covered that stands excluded in the
extant products?
a. Premier Product
b. Top up product
c. Pilot Product
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d. Tailor Made product

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e. Standard Product

204. Under what provision is the right accorded to an individual Health insurance policyholders (including
family cover), to transfer the credit gained for preexitsing conditions and time bound exclusions, from
one insurer to another insurer:
a. Transfer of Policy
b. Change of Plan
c. Portability
d. Interchangeability
205. Under what provision is the right accorded to an individual Health insurance policyholders (including
all members under family cover and members of group health insurance policy), to transfer the credit
gained for pre-exitsing conditions and time bound exclusions with the same insurer:
a. Transfer of Policy
b. Change of Plan
c. Portability
d. Migration
206. What is the minimum and maximum tenure upto which General insurers and Health Insurers can offer
filed Individual Health Insurance Products?
a. Minimum: 1 Year and Maximum: 5 years

b. Minimum: 1 Year and Maximum: 3 Years
c. Minimum : 1 Year and Maximum : 7 Years
d. Minimum: 6 months and Maximum: 1 Year
e. Minimum: 6 months and Maximum: 3 Years
207. What should be the minimum size of a conventional Group to be eligible for issuance for a Group
Health Insurance Policy?
a. Minimum 30: As per IRDAI-HIR 2016

b. Minimum 14: As per IRDAI-HIR 2016
c. Minimum 21: As per IRDAI-HIR 2016
d. Minimum 7: As per IRDAI-HIR 2016
e. Minimum 5: As per IRDAI-HIR 2016
208. As per IRDAI Health Insurance Regulations 2016, all health insurance policies shall ordinarily provide
for an entry age of atleats upto what age among the options below?
a. 60 Years
b. 70 Years
c. 80 Years
d. 65 Years
e. All of the above
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209. Once a proposal is accepted and a policy is issued and thereafter renewed without break
periodically,under what conditions the renewal could be denied by the insurer?
a. Age of the insured

b. Claim in the preceding policy, Enhancement of Sum Insured
c. Fraud and Misrepresentation
d. Non Cooperation by the Insured
e. Both C and D above
210. Under which among the following, coverage under a Health Insurance Policy is not provided?
a. Free Look Period
b. Grace Period
c. Short Period
d. Both a & b
211. The period from the date of receipt of policy by the insured to review the terms and conditions of the
policy and to return the same if not acceptable is called?
a. Free Look Period

b. Review Period
c. Grace Period
d. Both a & c above
212. Which among the listed type of policies do not offers the option of Free Look Period to the insured as
per Health Insurance Regulations 2016?
a. Long Term Policies
b. Policy issued for 3 years
c. Policies issued for short term
d. Policies issued for a minium of 1 year
e. All of the above
213. The insured will be allowed a period of at least 15 days from the date of receipt of the
policy to review the terms and conditions of the policy and to return the same if not
acceptable even If the insured has made a claim during the free look period. Please state
whether the statement is correct or not and whether the refund will be entertained?
a. True and Refund would be made

b. False but the refund will be entertained
c. False and No refund will be entertained
d. True but no refund will be entertained
214. What are the number days allowed under Free look period under which the insured may review the
terms and conditions of the policy and to return the same if not acceptable to him/her?
a. 07 Days from the date of receipt of policy

b. 15 Days from the date of issuance of the policy
c. 15 Days from the date of receipt of policy
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d. 07 Days from the date of issuance of policy

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215. Where a proposal deposit is refundable to a prospect under any circumstances as in case of Free look
period, is there any time limit prescribed to refund the same, and if so, then how many days?
a. Within 30days from the date of receipt of request for Free look cancellation.
b. Within 07days from the date of receipt of request for Free look cancellation.
c. Within 15 days from the date of receipt of request for Free look cancellation.
d. Within 21days from the date of receipt of request for Free look cancellation.
e. Within 10days from the date of receipt of request for Free look cancellation.
216. What is the percentage of cost of pre-insurance health check-up borne by the insurer under a Health
Insurance Product, once the proposal is accepted by the insurer?
a. Not less than 50% of Premium Amount

b. Not less than 50% of the expenses borne by the insured
c. Not less than 49% of the expenses borne by the insured
d. 100% of the cost is borne by insurer
e. 100% of the cost is borne by the insured
217. Under which of the following products Pre-Health Insurance check up is not paid/reimbursed by the
insurer?
a. Floater Mediclaim Policies

b. Retail Health Individual Policies
c. Travel Insurance Policies
d. Group Insurance Policies
e. Paid in all the above policies
218. List out the product under which the facility of Migration is not available as per HIR 2016 provsions?
a. Group Health Insurance Policies

b. Family Floater Insurance Policies
c. Pilot Products
d. Travel Insurance Products
e. Available for all the above.
219. What does NABH and NABL stands for?
a. National Approved Board for Hospitals/National Approved Board for Laboratories

b. National Accreditation Board for Homeopathy/National accreditation Board for Laboratories
c. National Accreditation Board for Hospitals/National accreditation Board for Listed Hospitals
d. National Accreditation Board for Hospitals/National accreditation Board for Laboratories
e. National Accreditation Branch for Hospitals/National accreditation Branch for Laboratories
220. State the time limit/TAT to settle or reject a claim,as the case may be,on receipt of the last necessary
document?
a. Within 21 Days
b. Within 15 Days
c. Within 07 Days
d. Within 30 days
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e. Within 45 Days
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221. State the time limit/TAT to settle or reject a claim,as the case may be,on receipt of the last necessary
document, where the circumstances of the claim warrants an investigation, in view of the Insurer?
a. Within 21 Days
b. Within 15 Days
c. Within 07 Days
d. Within 30 days
e. Within 45 Days
222. Under the norms issued by IRDAI for settlement of claim under multiple policies, which of the following
is correct?
a. They have no right to prefer claims from other policy/policies for the amount disallowed under the
earlier chosen policy, even if the sum insured is not exhausted.
b. They have the right to prefer claims from other policy/policies for the amount disallowed under the
earlier chosen policy, only if the sum insured gets exhausted.
c. They do not have the right to prefer claims from other policy/policies for the amount disallowed
under the earlier chosen policy, even if the sum insured gets exhausted.
d. They have the right to prefer claims from other policy/policies for the amount disallowed under the
earlier chosen policy, even if the sum insured is not exhausted.
e. None of the stated provisions above are correct.
223. In case of any delay in the payment of claim within 07 days from the date of acceptance of offer for
settlement by insured, the insurer shall be liable to pay interest at a rate, what is it called as and state
the percentage defined?
a. Penal Interest: 2% above the bank rate prevalent at the beginning of the FY in which the claim is
reviewed.
b. Penal Interest: 1% above the bank rate prevalent at the beginning of the FY in which the claim is
reviewed.
c. Penal Interest: 1.5 % above the bank rate prevalent at the beginning of the FY in which the claim is
reviewed
d. Penal Interest: 3 % above the bank rate prevalent at the beginning of the FY in which the claim is
reviewed
e. Penal Interest: 1.5 % above the bank rate prevalent at the beginning of the FY in which the claim is
reviewed
224. As per Health Insurance Regulations,2016, the age to be considered for calculation of premium under
Mediclaim Policies is?
a. Maximum Entry Age
b. Running Age
c. Completed Age
d. Deferred Age
e. All the Above
225. Tick out the best term which refers to a hospital/Nursing home/day care center which is under tie-up
with an Insurer, a TPA or jointly by an insurer and a TPA for providing cashless treatment to insured
patients as per Health Insurance Regulations 2016?
a. Tertiary Care Hospital
b. Preferred provider network
c. Network provider
d. Govt recognised hospital
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226. To whom does the Cashless facility be offered?
a. Govt Registered Hospitals

b. Hospitals with NABH accreditation only
c. Secondary or Tertiary care Hospitals
d. Network Providers only
e. All of the above
227. What does PPN stands for ?
a. Privileged Preferred Network

b. Provider preferred Network
c. Preferred Provider Networking
d. Preferred Provider Network
e. All of the above stands correct
228. A facility extended by the insurer or TPA on behalf of the insurer to the insured, where the payments
for the costs of treatment undergone by the insured in accordance with the policy T&C, are directly
made to the network provider by the insurer to the extent of pre-authorization approved?
a. Cashloss Facility
b. Preapproval facility
c. Pre sanction Approval Facility
d. Pre Reimbursement Facility
e. Cashless facility
229. The term used for tieup/MoU between an Insurer and Bank to sell Health Insurance Policies is called:
a. Bankinsurance
b. Bancassurance
c. Bankassurance
d. Bankinsurer
e. Bank-Health Insurance Tieup
230. Which one of the following expenses is not covered under Standard Health Mediclaim Policy-?
a. Expenses towards HIV Test of patient before operation which is covered under this policy
b. Registration Charges of Hospital
c. Dialysis Charges in case of renal failure
d. Angioplasty expenses
e. Accidental expenses
231. Kindly specify the time limit under which the Insurer or appointed TPA, has to issue an Identification
card to the insured to avail the benefit of cashless facility through a network hospital?
a. Within 07 days from the date of issuance of the policy

b. Within 15 days from the date of issuance of the policy
c. Within 14 days from the date of issuance of the policy
d. Within 21 days from the date of issuance of the policy
e. Within 10 days from the date of issuance of the policy
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232. Who all are the parties involved in a Tripartite Agreement (An agreed contractual document) for
providing Cashless services through Network providers?
a. Hospital,TPA and IRDAI

b. Hospital,Insurer and ROHINI
c. Hospital,Insurer and TPA
d. Hospital,Insurer and IIB
e. Hospital,Insurer and IRDAI
233. To utilise the services of an IRDAI licensed TPA,the insurer enters into a written agreement for defined
services known as ?
a. Service legal Agreement (SLA)

b. Service Related Agreement (SRA)
c. Health Service Agreements (HSA)
d. Service Defined Agreement (SDA)
e. Service Bipartite Agreement (SBA)
234. Under what time period the TPA should submit or handover all the files, data and other related
information pertaining to the settlement of claims to the respective insurers, as per TPA-Health
Services Regulations (Amendment) 2019?
a. On a Monthly basis within fifteen days after the close of each month and the insurer shall
accept the same under acknowledgement.
b. On a Fortnight basis within fifteen days after the close of each Fortnight and the insurer shall
c. On a quarterly basis within 90 days after the close of every quarter and the insurer shall
d. On a Half-yearly basis within fifteen days after the close of each Half-yearly and the insurer
shall accept the same under acknowledgement.
235. In case of inadmissibility of the entire health claim, which among the following is correct?
a) The TPA on its own may reject or repudiate the claim;

b) The decision and the communication with respect to rejection or repudiation of claim shall be sent
only by the concerned insurer directly to the Policy holder or the claimant as the case may be.
a. Both the statements are correct

b. Only A is correct
c. Only B is correct
d. Both the statements are incorrect
e. A is correct but B is incorrect
236. Who among the following has the authority to Reject/Repudiate a claim lodged under Health
Insurance Policies as per IRDAI-HIR 2016?
a. TPA
b. Network Provider
c. Insurer
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d. IRDAI
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e. All the above

237. A TPA cannot provide health services to more than one insurer. But an insurer can engage more than
one TPA for providing health services to its policyholders or claimants.
Kindly state whether the statements are True or False?
a. True
b. False
c. First part is correct but second is incorrect
d. First part is incorrect but second is correct
238. What is the number of days specified under provisions of Portability before the date of expiry of his
existing policy, a policyholder desirous of porting his/her policy to another insurance company shall
apply for portability?
a. 60 days
b. 30 days
c. 45 days
d. 21 days
e. 15 days
239. What is the number of days specified under provisions of Portability before the date of expiry of his
existing policy, a policyholder desirous of porting his/her policy to another insurance company can not
apply for portability?
a. 60 Days
b. 90 Days
c. 180 Days
d. 100 Days
e. No such provision exists
240. The insurer may not be liable to offer portability under which of the following conditions as per Health
Insurance Regulations?
a. If the policyholder fails to approach the new insurer atleast 45 days before the premium
renewal date
b. If the policyholder approaches the new insurer more than 60 days prior to the premium
renewal date
c. If the policyholder approaches the new insurer atleast 45 days before the premium renewal
date
d. Both a & b above
e. Both b & C above
241. On receipt of relevant portability documents from insured,the new insurer seeks details of Medical
history and claim history of the concerned policyholder,through which among the following by
uploading details as per portability generation request format mandated?
a. IIB Web Portal

b. Insurance Company Web Portal
c. TPA Web Portal
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d. IRDAI Web Portal

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e. Any of the above

242. What is the time limit defined under Portability guidelines for the existing insurer to furnish the
requisite data in the desired format to the new insurance company on IIB Web Portal?
a. Within 03 working days of receipt of request

b. Within 07 working days of receipt of request
c. Within 05 working days of receipt of request
d. Within 10 working days of receipt of request
e. Before expiry of the existing policy
243. Under what timeframe on receipt of requisite data from Insurance company,if the new insurer doesnot
communicates its decision to the proposer,then he shall not have any right to reject such proposal and
shall accept such proposal?
a. 7 days
b. 10 days
c. 15 days
d. 21 days
e. Before expiry of the existing policy
244. What is the maximum amount of commission (%) payable to any intermediary on acceptance of a
ported policy under the portability guidelines issued by IRDAI under Health Insurance Regulations
2016 and amendments thereof?
a. 15%
b. 12.5 %
c. 10%
d. 0 %
e. 7.5 %
245. The facility of portability is allowed to the following Health Insurance products?
a. Individual Health Insurance Policies

b. Family Floater Policies
c. Group Mediclaim Policies
d. Only a & b
e. All the above
246. Upto what extent would the portability shall be applicable, if along with basic Sum insured under the
previous policy the insured has accrued cumulative Bonus?
a. Sum Insured Only

b. Sum Insured + Cumulative Bonus
c. Fresh Sum Insured
d. A & B above
e. All of the above
247. The look back period for pre-existing disease from first commencement date of mediclaim policy as
per Guidelines on Standardization of Health Insurance 2016 is?
a. 36 months
b. 48 months
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c. 36 months
d. No limits
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e. 12 months

248. Which among the following shall form part of TPA services as per TPA-Health Services Regulations
2016?
a. Directly make payments in respect of claims

b. Reject or repudiate any of the claims directly
c. Handle or service claims other than hospitalisation cover under a PA policy
d. A & B above
249. Which words are to be included in their name by every TPA and applicant seeking registration as TPA
from the authority to reflect that it is engaged or proposes to engage in the business of TPA for
rendering Health services as per IRDAI-TPA Regulations 2016?
a. TPA Insurance
b. Health Insurance
c. Health Service Provider
d. Insurance TPA
e. All of the above
250. The License issued by IRDAI to TPA for servicing of Health Policies is valid for how many years?
a. 1 year
b. 2 year
c. 3 year
d. 4 year
e. 5 year
251. The term specifically used for charges paid for services or supplies,which are the standard charges for
the specific provider and consistent with the prevailing charges in the Geographical area for identical
or similar services,taking into account the nature of the illness/injury involved is?
a. Standard and Customary Charges

b. Resonable and Standard Charges
c. Resonable and Tariffed Charges
d. Standard Medical Necessary Charges
e. Reasonable and Customary Charges
252. Tick out the best from listed items in regard to Group Mediclaim Policies from Risk assessment
aspect?
a. High Volume and High Margin
b. Low Volume and High Margin
c. High Volume and Low margin
d. Low Volume and Low Margin
e. All the bove are correct
253. Under which of the following conditions a fresh proposal form is not required from the insured at the
time of renewal of a health insurance policy?
a. Enhancement of Sum insured

b. Inclusion of Family Members
c. Renewal without enhancement of Sum Insured
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d. Change of Risk profile

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e. All of the above

254. The Insurance Information Bureau (IIB) collects Health Insurance Data from Insurers and TPA’s in
respect of which among the following?
a. Policy and Claims only

b. Policy,Member and Claims
c. Policy and Members only
d. Member and Policy data only
255. As per IRDAI Health Insurance Standardization guidelines,What is the terminology used for the
medical expenses incurred immediately before the insured person is hospitalised along with the
condition when they become admissible? Pick the right option from the following:
1. Pre-Hospitalisation Expenses: Such Medical Expenses are incurred for the same condition for which
the Insured Person’s Hospitalization was required.
2. OPD Expenses: The In-patient Hospitalization claim for such Hospitalization is admissible by the
Insurance Company.
3. Pre-Hospitalisation Expenses: The In-patient Hospitalization claim for such Hospitalization is
admissible by the Insurance Company.
4. OPD Expenses: Such Medical Expenses are incurred for the same condition for which the Insured
Person’s Hospitalization was required.
c. 1 and 2 is correct
d. 1 and 3 is correct
256. As per IRDAI Health Insurance Standardization Guidelines,What is the terminology used for the
medical expenses incurred immediately after the insured person is discharged from the hospital along
with the conditions when they become admissible? Pick the right option from the following:
1. Post-Hospitalisation Expenses: Such Medical Expenses are incurred not for the same condition
for which the Insured Person’s Hospitalization was required.
2. Post Hospitalisation Expenses: The In-patient Hospitalization claim for such Hospitalization is
3. Post-Hospitalisation Expenses: The In-patient Hospitalization claim for such Hospitalization is not
4. Post Expenses: Such Medical Expenses are incurred for the same condition for which the Insured
Person’s Hospitalization was required.
c. 1 and 2 is correct
d. 2 and 4 is correct
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257. Please pick the medical condition under which the 30 days waiting period exclusion will not be applied,
when the policy is taken for the first time?
a. Hospitalization due to Pre Existing Disease

b. Hospitalisation due to Defined Critical Illnesses
c. Hospitalisation due to maternity
d. Hospitalisation for AYUSH treatments
e. Hospitalisation due to an accident
258. What does reinstatement of sum insured offered under Health Insurance products means and
elabaorate the condition of offer and acceptance?
a. After payment of claim, the sum insured (which gets reduced on payment of a claim) can be
restored to the original limit by paying extra premium. It could be offered at any time during
the currency of the policy.
b. After payment of claim, the sum insured (which gets reduced on payment of a claim) can be
restored to the original limit by paying an extra premium. It can only be offered at the time of
inception of the policy.
c. After payment of claim, the sum insured (which gets reduced on payment of a claim) can be
restored to the original limit by paying extra premium. It can only be offered after policy has
been renewed regularly for 48 months.
d. After payment of claim, the sum insured (which gets reduced on payment of a claim) can be
restored to the original limit by paying extra premium. It can only be offered if the policy covers
more than 5 members.
e. All the above are correct.
259. List out the best possible definition for Super Top Up Cover or a high deductible plan?
a. Top-Up policies offers cover for high sum insured over and above a specified percentage of
claimed amount (called threshold Value).
b. Top-Up policies offers cover for high sum insured over and above a specified number of
accidental claims (called threshold number).
c. Top-Up policies offers cover for high sum insured over and above a specified amount which is
150% of the Sum Insured (called threshold Sum Insured.
d. Top-Up policies offers cover for high sum insured over and above a specified amount (called
threshold).
e. Top-Up policies offers cover for high sum insured over and above a specified number of
ailments (called threshold number).
260. Tick out the eligible condition out of the listed items for admissibility of claim under a Top up/Super
top-Up cover in health insurance?
a. the medical costs incurred must not be greater than the deductible (or threshold) level chosen
under the plan
b. the medical costs incurred may be greater than the deductible (or threshold) level chosen
under the plan
c. the medical costs incurred must be greater than the sum insured (or threshold) level chosen
under the plan
d. the medical costs incurred must be greater than the deductible (or threshold) level chosen
under the plan
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261. In case the top-up plan requires the deductible amount to be crossed at every single event of
hospitalization, the plan is known as:
a. High Threshold based high deductible plan.
b. Calamity based high deductible plan.
c. Catastrophe based low deductible plan.
d. Catastrophe based high deductible plan.
262. The top-up plans that allow the deductible to be crossed post a series of Hospitalizations during the
policy period are known as:
a. Aggregate based high frequency plans.
b. Aggregate based high impact plans.
c. Aggregate based high sum insured plans.
d. Aggregate based high deductible plans.
263. The Universal Health Insurance Schemes is available to which of the following:
a. Group of 15 or more families
b. Group of 50 or more families
c. Group of 100 or more families
d. Group of 75 or more families
e. All of the above.
264. The maximum Sum Insured which is available under UHIS policy is:
a. 50000/-
b. 100000/-
c. 10000/-
d. 30000/-
e. 25000/-
265. RSBY (Rashtriya Swasthya Bima Yojana) is launched by whom among the following and who are
eligible for coverage under it?
a. Ministry of Health & Family Welfare/BPL Families
b. Ministry of Health and AYUSH/BPL Families
c. Ministry of Finance/BPL Families
d. Ministry of Labour & Employment/BPL Families
e. Ministry of Labour & Employment/APL Families
266. Which of the following is correct in regard to RSBY:

1. SI of 30000/- on floater basis.
2. PED covered.
3. Cashless coverage for all eligible health services.
4. Pre and Post Hospitalisation expenses are paid.
5. Transport allowance of 100/- per visit.
6. Central Govt:State Govt: 3:1 Ratio (Share of premium)
7. Any one illness will be deemed to mean continuous period of illness and it includes relapse within 60
days from the date of last consultation with the hospital.
a. None of the above is incorrect
b. 2,4,6 are correct
c. 1,2,3 are correct
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d. 1,2,3,4,5 and 6 are correct

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e. All the above are incorrect.

267. In relation to Bhavishya Arogya Policy, which of the statement is/are correct:
1. Deferred Mediclaim Policy.

2. Proposer may join at any time between 25 to 55 years.
3. Can choose retirement age between 55 to60 years subject to a clear gap of 4 years (DoJ & DoR).
4. It provides an option of assignment.
5. Does not have PED,30 days waiting period and Ist Year Exclusion clause..
6. Can be availed on Group basis.
a. 1 and 4 are correct.

b. 1,2,3 are correct.
c. None of the above is correct.
d. All the above are correct.
e. 1,2,4,6 are correct.
268. Which among the following in regard to Pradhanmantri Suraksha Bima Yojana is/are incorrect?
1. Scope: All SB A/c Holders from 18-70 Years
2. Aadhaar would be the primay KYC
3. POI: 01st June to 31st May every year
4. Benefit: 2 Lacs for Death
5. PTD (Permanent Total Disability): 2 lacs
6. Premium of Rs.12/- per person per annum
7. Termination: Attaining 70 yrs age,Closure of SB (Savings Bank) account and Coverage under
multiple accounts.
a) 1,2 and 4 are incorect

b) 2,5,6,7 are incorrect
c) Only 7 in incorrect
d) 5 and 7 is incorrect
e) None of the above
269. On which of the following listed options, premium calculation is done under a group policy?
a. Age profile of the Group

b. Size of the group
c. Claims experience of the group
d. Additional covers
e. All the above
270. Tick the correct terminology used for the listed situation under GMC polices:
There arise situations where the sum insured of the family is exhausted, especially in the case of
major illness of a family member. In such situations, which cover brings relief, whereby the excess
expenses over and above the family sum insured are met from,subject to the discretionary authority of
the HR of Insured Corporate.
a. Top-up Cover
b. Super Top up cover
c. Life Hardship Survival Benefit
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d. Corporate Buffer
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e. Restored Sum Insured

271. Health Insurance deals with which of the following?
a. Mortality
b. Morbidity
c. Morbidity & Mortality Both
e. All the Above
272. Which among the following is/are morbid factors (Risk of falling ill) which needs to be considered
carefully while assessing a risk?
a. Age & Gender

b. Habits,Occupation, Envionment & residence
c. Family History & Past illness or surgery
d. Build & Curent Health Status
e. All the above
273. State whether the below statement is true/false?

Group insurance is underwritten mainly on the law of averages, implying that when all members of a
standard group are covered under a group health insurance policy, the individuals constituting the
group can anti-select against the insurer.
a. False
b. True
c. May be true
d. May be false
e. Couldnot be ascertained
274. Who among the following is/are not the stakeholders in claim process under Health Insurance policy?
a. Customer
b. Underwriters & Insurance intermediaries
c. Providers/Hospitals/TPA
d. Govt of India
e. Insurance Company Shareholders
275. As per PPHI (Protection of Policyholders Interest) Regulations,2017, the premium pertaining to health
related or critical illness riders shall not exceed how much percentage of the premium under the basic
product?
a. 50%
b. 25%
c. 100%
d. 125%
e. 10%
60
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276. Which of the following statement is/are correct as per Health Insurance Regulations- 2016?
1. The Company’s board approved underwriting policy shall cover the approach and aspects relating to
offering health insurance coverage only to standard lives and not to sub-standard lives.
2. Any proposal for health insurance may be accepted as proposed or on modified terms or denied
wholly based on the Board approved underwriting policy.
a) Only 1 is correct.
b) Only 2 is correct
c) Both of the stratements are correct
d) 1 is correct but 2 is incorrect
e) 1 is incorrect but 2 is correct
277. According to Health Insurance Regulations-2016, an Insurer (General/Health) shall devise a proposal
form to be submitted by a proposer seeking a health insurance policy, to capture all the information
necessary to underwrite a proposal in accordance with which of the below listed documents?
a. PMC approved Underwriting Policy of the Company.

b. IRDAI approved Underwriting Policy of the Company.
c. Board approved Underwriting Policy of the Company.
d. On the discretion of the underwriter
e. All the above
278. State whether the statement is true/false or otherwise as per HIR (Health Insurance Regulations)-
2016:
“If a claim is made in any particular year, the cumulative bonus accrued may be reduced at the same
rate at which it has accrued”
a. True
b. False
c. Could not be ascertained.
d. Cumulative Bonus stands deleted from regulations.
e. Cumulative bonus is not related to claim history
279. Pick out the correct option from the listed statements:
The discounts and loadings offered by the Insurer at the time of underwriting a proposal whether fresh
or renewal shall:
1. Be at the discretion of the insurer;
2. Be based on an objective criteria;
3. Be disclosed upfront in the prospectus and policy document along with the objective criteria, and
shall be as approved under the Product Filing Guidelines.
4. Further a specific consent of the policyholder for such loadings shall be obtained before issuance
of policy.

d. Only 2, 3 and 4 are correct
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280. The insurance company shall endeavor to enter into Agreements with adequate number of both public
and private sector network providers across the geographical spread. The copy of the agreement shall
be maintained by the Insurer for a period of how many years?
a. Not less than seven years from the date of the expiry or termination of the agreement.
b. Not less than ten years from the date of the expiry or termination of the agreement.
c. Not less than fifteen years from the date of the expiry or termination of the agreement.
d. Not less than five years from the date of the expiry or termination of the agreement.
e. Not less than twelve years from the date of the expiry or termination of the agreement.
281. The clause of Any One Illness is not applicable to which of the listed health products?
a. Family Floater Products

b. Benefit Based Products
c. Critical Illness Products
e. Applicable to all the above products
282. Pick out the correct option to explain the term congenital anomaly?
a. Present since 3 years of age & is abnormal in form,structure or position.

b. Present since 18 years of age & is abnormal in form,structure or position.
c. Present since birth & is abnormal in form,structure or position.
d. Present since puberty & is abnormal in form,structure or position.
283. A disease, illness or injury that is likely to respond quickly to treatment which aims to return the person
to his or her state of health immediately before suffering the disease/ illness/ injury which leads to full
recovery is called?
a. Chronic Condition
b. Acute Condition
c. Post-Op Condition
d. Adverse Condition
e. All the above
284. Inpatient care means treatment for which the insured person has to stay in a hospital for more than 24
hours for a covered event.
For which of the below listed health insurance products, it is not applicable?
a. Family Floater Products

b. Benefit Based Products
c. Critical Illness Products
e. Applicable to all the above products
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Page

285. Maternity expenses means;
1.) Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean
sections incurred during hospitalization);
2.) Expenses not related towards lawful medical termination of pregnancy during the policy period.
Which of the above statement is/are correct?
c. 1 is incorrect but 2 is correct
d. 1 is correct but 2 is incorrect
e. Both the statemenst are correct
286. Where discounts are obtained from any of the Network Providers or from any other Hospitals outside
the network, either by TPAs or by the Insurers, it shall be ensured that the discounts, if any, so
obtained from the network providers / hospitals, are passed on to whom among the following as per
Health Insurance Regulations 2016?
a. Insurer
b. Govt of India
c. Regulator
d. Insured
e. TPA
287. Ayushman Bharat - National Health Protection Mission will subsume which of the following on-going
centrally sponsored schemes?
a. ESIC (Employee state insurance Corporation)

b. Rashtriya Swasthya Bima Yojana (RSBY)
c. CGHS (Central Government Health Scheme)
d. Senior Citizen Health Insurance Scheme (SCHIS)
Choose the correct option?
a. b only
b. c and d only
c. b and d only
d. All the above
288. Under AB-PMJAY-NHPM, ABHA (earlier known as Health ID) is the first step towards creating safer
and efficient digital health records for you and your family. You can opt-in to create a digitally secure
ABHA, which allows you to access and share your health data with your consent, with participating
healthcare providers and payers?
What is the full form of ABHA?
a. Asha Bharatiya Health Accreditation

b. Ayushman Bharat Health Account
c. Account of Beneficiaries in Health Accreditation
63
d. Ayushman Bharat Host Account

Page

289. Overseas or Domestic Travel Insurance policies can also be offered by General Insurers and Health
Insurers ,as an add-on cover to a health or personal accident policy?
Please state whether the statement is regard to IRDAI (Health Regulations) is correct or not?
a. True
b. False
290. Which amongst the following is correct in regard to Health Underwriting Policy of an Insurer as
enumerated under IRDAI (Health Regulations)?
1. Shall also cover the approach and aspects relating to offering health insurance coverage not
only to standard lives but also to sub-standard lives.
2. Objective underwriting parameters to differentiate the various classes of risks being accepted in
accordance with the respective risk categorisation.
3. Acceptance or denial of proposal. Denial to be informed in writing and with reasons recorded.
4. Devise mechanisms or incentives to reward policyholders for early entry, continued renewals
(wherever applicable), favourable claims experience, preventive and wellness habits

291. A proposal form should capture all the necessary information to underwrite a proposal in accordance
with which amongst the following guided document?
a. Underwriting Policy of GI Council

b. Broad Underwriting Guidelines of IRDAI
c. Underwriting Policy of the Company (Insurer)
d. Underwriting Guidelines of GIPSA Board
292. According to IRDAI (Health Regulations) “The premiums filed shall ordinarily be not changed for a
period of how many years after a product has been cleared in accordance to the product filing
guidelines specified by the Authority.“.
a. 5 Years
b. 1 Years
c. 2 Years
d. 3 Years
e. No time stipulated by IRDAI
293. Which amongst the following individual health products shall not have the facility of Free Look period
according to IRDAI (Health Regulations)?
a. Policies renewed under Grace period
b. Renewals
c. Short-term Policies
d. Fresh Annual Policies

a. Only b is Correct
b. Only a and b is correct
64
c. Only a, b and c is correct

Page
d. All the above

294. Where the outcome of acceptance of portability is still awaited from the new insurer on the date of
renewal and the policy has been extended for a short on Prorata basis and under which there is a
claim reported, in that case. Is the statement True/False?
**The existing insurer may charge the balance premium for remaining part of the policy year provided
the claims are accepted by the existing insurer. In such cases, policyholder shall be liable to pay the
premium for the balance period and continue with the existing insurer for that policy year.
a. True
b. False
295. The procedure of filing Individual Products, Riders or Add-ons of Health Insurance Business offered
to Individuals under Health Insurance adopted as per Consolidated Guidelines on Product filing in
Health Insurance Business Dated: 22nd July 2022 is?
a. Use and File

b. File and Use
c. Any of the above two
d. Only approval through PMC is required
296. The procedure of filing Group products (other than pilot products) offered by General Insurers and
Health Insurers, including products offered for schemes sponsored by the State and
Central Governments adopted as per Consolidated Guidelines on Product filing in Health Insurance
Business Dated: 22nd July 2022 is?
a. File and Use

b. Only PMC approval
c. Only Insurer’s Board approval
d. Use and File
e. Any of the above
297. The procedure of Pilot Health Insurance Products (both Individual and Group), Health plus Life
Combi-Products (both Individual and Group), Non-Life Insurance Package and Health Package
Products, as per Consolidated Guidelines on Product filing in Health Insurance Business Dated: 22nd
July 2022 is?
a. Use and File

b. File and Use
c. Any of the above two
d. Only approval through PMC is required.
298. List out the nature of complaints (receive and consider) that are entertained by the Insurance
Ombudsman as per Insurance Ombudsman Rules, 2017?
1. Delay in settlement of claims, beyond time specified in extant regulations.
2. Any partial or total repudiation of claims.
3. Disputes over premium paid or payable in terms of insurance policy.
4. Misrepresentation of policy terms and conditions at any time in the policy document or policy
contract.
5. Policy servicing related grievances against insurers and their agents and intermediaries.
65
6. Issuance of insurance policy which is not in conformity to the submitted proposal form.
Page
7. Non-issuance of insurance policy after receipt of premium.

a. Only 1, 3, and 4 are correct.

b. Only 2, 4 and 5 are correct.
299. As per Insurance Ombudsman Rules, 2017, is there any time limit to approach the Insurance
Ombudsman, if yes, then the time limit?
a. Yes, within 6 months

b. No time limit
c. Yes, within 1 year
d. Yes, within 3 years
e. Any of the above
300. What is the financial jurisdiction of an Insurance Ombudsman?
a. Not exceeding Rs. 10 Lacs (including relevant expenses, if any)

b. Not exceeding Rs. 50 Lacs (including relevant expenses, if any)
c. Not exceeding Rs. 30 Lacs (including relevant expenses, if any)
d. Not exceeding Rs. 100 Lacs (including relevant expenses, if any)
e. No specified limit to award compensation.
301. As per Insurance Ombudsman Rules, 2017, can a complaint, who has already approached
Consumer Forum/Court/Arbitration on the same subject, approach the Insurance Ombudsman?
a. Yes, if he/she wish to.

b. Yes, but only after approval from Insurer
c. No
d. No such provision available.
302. As per Insurance Ombudsman Rules, 2017, within what time shall the ombudsman dispose of the
complaint in case both the parties agree for mediation and also in case they do not agree for
mediation?
a. 45 Days and 3 Months
b. 3 Month and 6 Months
c. 21 Days and 3 Months
d. 1 Month and 3 Months
303. As per Insurance Ombudsman Rules, 2017, is there any time limit for compliance of Award by
Insurers?
a. 60 days from the receipt of award

b. 45 days from the receipt of award
c. 30 days from the receipt of award
d. 21 days from the receipt of award
e. Within 1 year from the receipt of award
66
Page

Answers to Health Questions (1 to 303)
Question Question Question Question
No. Answer No. Answer No. Answer No. Answer
1 D 51 C 101 E 151 B
2 C 52 C 102 D 152 C
3 C 53 D 103 C 153 C
4 C 54 D 104 D 154 D
5 B 55 E 105 C 155 C
6 D 56 D 106 C 156 C
7 A 57 C 107 C 157 B
8 C 58 C 108 C 158 A
9 D 59 C 109 A 159 C
10 C 60 C 110 C 160 B
11 D 61 D 111 D 161 B
12 B 62 C 112 C 162 C
13 C 63 C 113 D 163 D
14 B 64 C 114 C 164 A
15 A 65 D 115 B 165 C
16 D 66 C 116 D 166 E
17 C 67 B 117 D 167 A
18 D 68 C 118 A 168 A
19 B 69 D 119 D 169 C
20 C 70 C 120 D 170 D
21 E 71 D 121 A 171 D
22 E 72 C 122 C 172 C
23 D 73 B 123 E 173 E
24 D 74 D 124 C 174 D
25 E 75 C 125 C 175 A
26 C 76 A 126 B 176 A
27 C 77 C 127 B 177 B
28 C 78 D 128 D 178 C
29 D 79 D 129 C 179 E
30 E 80 C 130 C 180 D
31 D 81 D 131 D 181 B
32 E 82 C 132 B 182 D
33 C 83 C 133 C 183 B
34 B 84 C 134 C 184 D
35 C 85 C 135 C 185 C
36 D 86 A 136 C 186 E
37 E 87 D 137 D 187 C
38 D 88 D 138 C 188 B
39 C 89 A 139 B 189 D
67
40 B 90 A 140 C 190 D
41 C 91 C 141 C 191 C
Page

42 D 92 C 142 C 192 B
43 D 93 B 143 B 193 C
44 C 94 E 144 A 194 A
45 D 95 D 145 B 195 C
46 E 96 C 146 C 196 C
47 C 97 C 147 C 197 C
48 E 98 C 148 C 198 E
49 C 99 D 149 C 199 C
50 D 100 B 150 C 200 A
Question Question Question

No. Answer No. Answer No. Answer
201 B 251 E 301 C
202 B 252 C 302 D
203 C 253 C 303 C
204 C 254 B
205 D 255 D
206 B 256 D
207 D 257 E
208 D 258 B
209 E 259 D
210 B 260 D
211 A 261 D
212 C 262 D
213 C 263 C
214 C 264 D
215 C 265 D
216 B 266 A
217 C 267 D
218 D 268 E
219 D 269 E
220 D 270 D
221 E 271 B
222 D 272 E
223 A 273 A
224 C 274 D
225 C 275 C
226 D 276 E
227 D 277 C
228 E 278 A
229 B 279 D
230 B 280 D
231 B 281 D
68
232 C 282 C
Page
233 C 283 B
234 C 284 D
235 C 285 D
236 C 286 D
237 D 287 C
238 C 288 B
239 A 289 A
240 D 290 D
241 A 291 C
242 B 292 D
243 C 293 C
244 D 294 A
245 D 295 B
246 B 296 D
247 B 297 B
248 E 298 D
249 D 299 C
250 C 300 C
69
Page

Health - Questionnaire-2022 For Promotional Exam by RR

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Health Questionnaire: Version 5 (1-303):- 08th March 2022

HEALTH INSURANCE QUESTIONNAIRE-2022

Choose the correct option:

a. Rs. 2,50,000 Per Asset/Cover

a. Minimum 1 Year/ Maximum 3 Year

Rajnish Ranga, Dy. Manager, Health Dept, HO-OICL

a. 18 Years and 79 Years

a. Minimum 9.5 Months/ Maximum 1 Year

a. Upto Rs. 5,000 premium p.a. per MSM Enterprise

e. All the above are correct

Rajnish Ranga, Dy. Manager, Health Dept, HO-OICL

1. A Non-Government Organization (NGO)

Choose the correct option from above:

a. Only 1, 2, 3 are correct

a. Only 1, 2, 3 and 5 are correct

e. None of the above is correct

Rajnish Ranga, Dy. Manager, Health Dept, HO-OICL

a. 10% of the premium

e. None of the two statements is correct

Rajnish Ranga, Dy. Manager, Health Dept, HO-OICL

20. In accordance to IRDAI (Expenses of Management of Insurers transacting General or Health

a. Not more than 5%

Rajnish Ranga, Dy. Manager, Health Dept, HO-OICL

Choose the correct option from the following:

a. Only 1 and 3 are correct

1. Insurance Solicitation or Distribution

Choose the correct option from the following:

Rajnish Ranga, Dy. Manager, Health Dept, HO-OICL

a. Only 1 and 2 shall be considered

Choose the correct option:

e. All except 6 are correct

Rajnish Ranga, Dy. Manager, Health Dept, HO-OICL

30. According to definitions under IRDAI (Payment of Commission or Remuneration or Reward to

Choose the correct definition:

1. Increases insurance penetration and density in the country;

e. Only 1 and 2 are correct

Rajnish Ranga, Dy. Manager, Health Dept, HO-OICL

a. Not more than 33%

a. 1 Year and 5 Year

a. 1 Year and 7 Years

36. What is the maximum commission or remuneration payable to insurance agents/insurance

Rajnish Ranga, Dy. Manager, Health Dept, HO-OICL

Choose the correct option:

a. Only 1 and 2 are correct

1. Cost of pharmacy and consumables.

Choose the correct option:

Rajnish Ranga, Dy. Manager, Health Dept, HO-OICL

Choose the correct option:

Choose the correct option:

e. No time period stipulated

Rajnish Ranga, Dy. Manager, Health Dept, HO-OICL

Choose the correct option:

e. No stipulated time for collection

Rajnish Ranga, Dy. Manager, Health Dept, HO-OICL

a. Driving Benefit from Insurance Coverages

a. Rakshak Mashak <Name of Insurer >

Rajnish Ranga, Dy. Manager, Health Dept, HO-OICL

a. Only Indemnity basis

1. Dengue Fever 2. Malaria

Choose the correct Option:

a. Only In-patient Hospitalization Benefit

Rajnish Ranga, Dy. Manager, Health Dept, HO-OICL

Choose the correct option:

d. All the above are correct