axondendriteplus/IC38-Corporate-Agent-Questions huggingface dataset:
Category: Life
Question: What is claim intimation in the insurance claim process?
1. The final stage of the claim process
2. The process of investigating a claim
3. The act of informing the insurance company of a planned or emergency hospitalization
4. The process of determining the amount to be paid for a claim
Answer: option 3
Category: Life
Question: Which of the following statements is true regarding claim intimation in health insurance?
1. Claim intimation is not mandatory
2. Claim intimation is required before 48 hours of hospitalization in case of an emergency
3. Claim intimation is required within 48 hours of hospitalization in case of an emergency
4. claim intimation is required before hospitalization in case of planned admission, and within 24 hours of hospitalization in case of an emergency. 
Answer: option 4
Category: Life
Question: How is claim intimation to Insurer / TPA possible according to the statement?
1. Only Through telegrams
2. Only Through fax
3. Through Mobile Apps/ call centres/ internet/ e-mail
4. Only Through postal mail
Answer: option 3
Category: Life
Question: What happens after a company or TPA receives an intimation about Mr. X's claim?
1. The claim is immediately approved
2. The documents are ignored
3. The details are matched for accuracy and a reference number is generated
4. The claimant is asked to provide more documents
Answer: option 3
Category: Life
Question: Which of the following is true regarding the scrutiny of claims for final settlement on a reimbursement basis?
1. Claims are accepted without any scrutiny or verification of documents. 
2. Claims are scrutinized for admissibility, sum assured, deductibles, and sub-limits. 
3. Claims are only scrutinized for admissibility, but not for sum assured, deductibles, and sub-limits. 
4. Claims are scrutinized for sum assured, but not for admissibility, deductibles, and sub-limits. 
Answer: option 2
Category: Life
Question: What action is taken by the company in case the intimation is for a planned surgery under the Cash- less scheme?
1. Pre-authorization of likely expenditure is given to the hospital
2. The claim is directly processed
3. The hospital is contacted for more information
4. The claim is rejected
Answer: option 1
Category: Life
Question: Which of the following alternative modes of treatment may be covered by health insurance policies, but may have sub-limits?
1. Unani
2. Siddha
3. Homeopathy
4. All of the above
Answer: option 4
Category: Life
Question: What is the recent directive of IRDAI regarding telemedicine in medical insurance policies?
1. Insurers are not allowed to cover telemedicine in their policies. 
2. Telemedicine is allowed only for non- coronavirus-related medical consultations. 
3. Telemedicine is allowed wherever regular medical consultation is allowed. 
4. Policyholders are required to visit the hospital for all medical consultations. 
Answer: option 3
Category: Life
Question: Which of the following is NOT a factor that decides the claim amount payable?
1. Sum insured available for the member under the policy
2. Deductible amount
3. Balance sum insured available under the policy for the member after taking into account any claim made already
4. Sub-limits
Answer: option 2
Category: Life
Question: What are Reasonable and Customary Charges?
1. Charges that are higher than the prevailing charges in the geographical area
2. Charges for services or supplies that are unique to a particular provider
3. Charges that are decided solely by the insurer
4. Charges for services or supplies that are consistent with the prevailing charges in the geographical area for identical or similar services
Answer: option 4
Category: Life
Question: What has been standardized under IRDAI Health Insurance Standardization Guidelines?
1. Sum insured available for the member under the policy
2. Balance sum insured available under the policy for the member after taking into account any claim made already
3. Non-payable items in health insurance
4. Deductible amount
Answer: option 3
Category: Life
Question: How are payments made for a payable claim amount?
1. By cheque or bank transfer
2. By cash only
3. Only by cheque
4. By transferring the claim money to the insurance company's account
Answer: option 1
Category: Life
Question: Which of the following is not a possible reason for denial of health insurance claims?
1. No active treatment; admission is only for investigation purpose
2. Illness treated is excluded under the policy
3. Hospitalization is more than 24 hours
4. The cause of illness is abuse of alcohol or drugs
Answer: option 3
Category: Life
Question: What percentage of submitted health claims are usually denied?
1. 5% to 10%
2. 10% to 15%
3. 15% to 20%
4. 20% to 25%
Answer: option 2
Category: Life
Question: What is the time frame within which investigations for suspect claims should be completed?
1. 30 days from the date of receipt of claim intimation
2. 60 days from the date of receipt of claim intimation
3. 90 days from the date of receipt of claim intimation
4. 120 days from the date of receipt of claim intimation
Answer: option 3
Category: Life
Question: Within how many days of completing the investigation should a claim be settled?
1. 30 days
2. 15 days
3. 60 days
4. 90 days
Answer: option 1
Category: Life
Question: What are some examples of frauds committed in health insurance?
1. Impersonation
2. Fabrication of documents
3. Inflation of expenses
4. All of the above
Answer: option 4
Category: Life
Question: What options are available for customers if their claim is denied?
1. IRDAI
2. The Consumer Commissions
3. Insurance Ombudsman
4. All of the above
Answer: option 4
Category: Life
Question: What is the first step for a customer covered under health insurance to avail the cashless facility?
1. The customer approaches the treating doctor for admission
2. The customer approaches the hospital’s insurance desk with insurance details
3. The customer pays the hospital charges in advance
4. The customer contacts the TPA directly
Answer: option 2
Category: Life
Question: Who takes the decision on whether the cashless authorization could be provided or not?
1. The hospital
2. The patient
3. The TPA
4. The insurer
Answer: option 3
Category: Life
Question: What does the hospital do when the patient is ready for discharge?
1. Check the amount of credit in the account of the patient approved by the TPA against the actual treatmnet charges covered by Insurance
2. Request the patient to pay the entire treatment charges in cash
3. Ask the patient to undergo further treatment
4. Transfer the patient to another hospital
Answer: option 1
Category: Life
Question: What is the purpose of reserving in the context of insurance companies?
1. To make provisions for all claims in the books of the insurer based on the status of the claims
2. To hold claim amounts until payments are due
3. To ensure that policyholders pay their premiums on time
4. To estimate the profits that the insurer will earn from investments
Answer: option 1
Category: Life
Question: What does the TPA do after studying the information provided in the cashless authorization form?
1. Approves the cashless authorization without delay
2. Takes a decision on whether cashless authorization could be provided and, if so, for how much amount
3. Rejects the cashless authorization immediately
4. None of the above
Answer: option 2
Category: Life
Question: What should mr. X do if he doesn't have his insurance details with him?
1. He should contact the hospital
2. He should contact the TPA through a 24 hour helpline
3. He should wait until they have their insurance details
4. He should pay for the treatment out of pocket
Answer: option 2
Category: Life
Question: What should Mr. X do if the hospital suggested by his doctor is not in the TPA network?
1. He should choose another hospital in the network of the TPA
2. He should contact the TPA to check for options where cashless facility is available
3. He should pay for the treatment out of pocket
4. He should contact the consulting doctor for further advice
Answer: option 2
Category: Life
Question: When should a customer inform the TPA about the discharge?
1. After the patient is discharged
2. Before the patient is admitted to the hospital
3. At the time of filling the pre- authorization form
4. In advance of the discharge and request the hospital to send to the TPA any additional approval that may be required
Answer: option 4
Category: Life
Question: What is the most important document required to process a health insurance claim?
1. Investigation report
2. Consolidated and detailed bills
3. Receipt for payment
4. Discharge summary
Answer: option 4
Category: Life
Question: What is the purpose of investigation reports in health insurance claims?
1. To provide a summary of the patient's condition
2. To provide a break-up of the bills
3. To assist in comparing the diagnosis and treatment
4. To verify the identity of the patient
Answer: option 3
Category: Life
Question: What is the purpose of the claim form in health insurance claims?
1. To provide a summary of the patient's condition
2. To request processing of the claim
3. To provide a break-up of the bills
4. To assist in comparing the diagnosis and treatment
Answer: option 2
Category: Life
Question: Which document may be required for accident claims?
1. Consolidated and detailed bills
2. Identity proof
3. Dialysis/Chemotherapy/Physiotherapy charts
4. FIR or Medico-legal certificate
Answer: option 4
Category: Life
Question: What is the purpose of having a membership with the TPA?
1. To obtain discounts on medical treatment at hospitals. 
2. To receive reimbursement for medical expenses not covered by the policy. 
3. To avail cashless facility for hospitalization or treatment covered by the policy, and to process claims when required. 
4. To receive medical advice and consultation from a team of healthcare professionals. 
Answer: option 3
Category: Life
Question: What document does the TPA issue to the hospital for cashless treatment?
1. Medical report
2. Discharge summary
3. Pre-authorization or Letter of Guarantee
4. Prescription for medication
Answer: option 3
Category: Life
Question: What is claims investigation about?
1. Determining the validity of the claim and finding out the real cause and extent of the loss
2. Assessing the credibility of the claimant's occupation
3. Verifying the authenticity of the claimant's identity documents
4. Calculating the premium to be charged for the policy
Answer: option 1
Category: Life
Question: What documents are required for name and address verification for AML (Anti-money laundering) purposes?
1. Birth certificate and rental agreement
2. Passport and bank statement
3. Aadhar card and credit card statement
4. PAN card and telephone bill
Answer: option 4
Category: Life
Question: What is the role of assistance companies in overseas claims?
1. They process claims on behalf of insurance companies
2. They provide assistance to customers in case of contingencies covered under the policy
3. They offer tie-up arrangements with hospitals for cashless treatment
4. They provide legal assistance to customers during claims process
Answer: option 2
Category: Life
Question: Which of the following is NOT a service provided by assistance companies during overseas travel insurance claims?
1. Medical service provider referrals
2. Interpreter Referral
3. Delivery of Essential Medicines
4. Rental car booking
Answer: option 4
Category: Life
Question: What is the fee charged by assistance companies for their services?
1. It varies depending on agreement with the particular insurance company, benefits covered etc. 
2. It is a fixed amount for all customers of the insurance company
3. It is determined by the insurance company and is the same for all assistance companies
4. There is no fee charged for the services provided by assistance companies
Answer: option 1
Category: Life
Question: Which of the following steps is necessary for hospitalization in case of a travel insurance claim?
1. Submit a written request to the insurance company
2. Visit any hospital of choice
3. Intimate the call centre and proceed to a specified hospital with a valid travel insurance policy
4. None of the above
Answer: option 3
Category: Life
Question: How do hospitals verify the validity of an overseas travel insurance policy?
1. The hospitals do not verify the validity of the policy before treatment
2. The hospitals contacts the assistance companies/ insurers on the call centre numbers to check the validity of the policy and verify coverages. 
3. The hospitals call the insured's family or friends to confirm the policy details
4. The hospitals relies on the insured's word that they have a valid policy. 
Answer: option 2
Category: Life
Question: Which type of claim payment is made in foreign currency?
1. Cashless claims
2. Reimbursement claims
3. Both cashless and reimbursement claims
4. None of the above
Answer: option 1
Category: Life
Question: What is the currency conversion rate used while processing reimbursement claims?
1. The rate as on date of loss
2. The rate as on date of filing the claim
3. The rate as on the date of discharge from the hospital
4. The rate as on the date of admission to the hospital
Answer: option 1
Category: Life
Question: What currency is used for payments for admissible claims in reimbursement claims for overseas travel insurance?
1. British Pound (GBP)
2. Indian Rupee (INR)
3. United States Dollar (USD)
4. Euro (EUR)
Answer: option 2
Category: Life
Question: Which document is required to certify the disability of an insured individual?
1. Birth certificate
2. Passport
3. Permanent disability certificate from a civil surgeon or equivalent competent doctors
4. Driving license
Answer: option 3
Category: Life
Question: The IRDA was established in the year __________ under the IRDA Act, 1999. 
1. 1999
2. 2000
3. 2002
4. 2003
Answer: option 2
Category: Life
Question: Mr. Vimal is a 32-Years' Old, Healthy, Non-Smoker, Teetotaller Individual; Who applies for Life Assurance from ABC Limited Insurance Company. Which One of the Following Statements, will Hold True, with Regard to Risk- Acceptance by the Insurance Company?
1. Risk will be Accepted at Ordinary Rates. 
2. Risk will be Accepted With an Extra, Over the Tabular Rate of Premium. 
3. Risk will be Accepted, With a Lien on Sum- Assured. 
4. Risk will be Accepted, With a Restrictive Clause. 
Answer: option 1
Category: Life
Question: Who bears the cost of a pre-policy medical check- up in a health insurance policy
1. Prospective client
2. Insurer
3. Government
4. Healthcare provider
Answer: option 2
Category: Life
Question: Which document may be required for accident claims?
1. Consolidated and detailed bills
2. Identity proof
3. Dialysis/Chemotherapy/Physiotherap y charts
4. FIR or Medico-legal certificate
Answer: option 4
Category: Life
Question: What principle begins with the Proposal form for insurance?
1. Principle of utmost bad faith
2. Principle of utmost honesty
3. Principle of utmost good faith
4. Principle of utmost negligence
Answer: option 3
Category: Life
Question: Why does the proposer need to inform details about their previous insurances to the insurer in property insurance?
1. To ensure that the principle of contribution is applied
2. To restrict the amount of coverage depending on other PA policies
3. To give the insurer information about the subject matter of insurance
4. To decide on conducting risk inspections or collecting further details
Answer: option 1
Category: Life
Question: What physical features of the subject matter are included in the proposal form?
1. Type and quality of construction
2. Age of the subject matter
3. Presence of fire-fighting equipment
4. All of the above
Answer: option 4
Category: Life
Question: What is the time frame within which the insurer must process a proposal according to the Protection of Policyholders’ Interests Regulations, 2017?
1. 10 days
2. 15 days
3. 20 days
4. 30 days
Answer: option 2
Category: Life
Question: When should the premium be paid in an insurance contract?
1. After the policy period has ended
2. Before the claim is filed by the insured
3. Before the expiry of the policy. 
4. In advance, before the inception date of the insurance contract
Answer: option 4
Category: Life
Question: What does Section 64 VB of the Insurance Act-1938 state regarding the payment of insurance premiums?
1. Insurers may assume risks without receiving any premium
2. Insurers may assume risks without guarantee of premium payment
3. Insurers must receive the premium in advance or guarantee of payment before assuming the risk
4. Insurers must receive the premium after the risk is assumed
Answer: option 3
Category: Life
Question: What is the purpose of the proposal form in insurance?
1. To assess the policyholder's financial stability
2. To gather information about the risk to be insured
3. To determine the premium amount quoted by other insurance companies. 
4. To provide coverage for potential losses
Answer: option 2
Category: Life
Question: What is the time limit for an insurance agent to deposit the premium collected on behalf of an insurer?
1. 48 hours
2. 24 hours excluding bank and postal holidays
3. 7 days
4. 1 month
Answer: option 2
Category: Life
Question: How should any refund of premium due to an insured be paid by the insurer?
1. By crediting it to the account of the agent
2. By direct payment to the insured through crossed or order cheque or electronic mode
3. By sending it to the insurer's bank account
4. By deducting it from the premium of a new policy
Answer: option 2
Category: Life
Question: What is the validity of a cover note?
1. Up to 1 year
2. Up to 6 months
3. Up to 60 days
4. Up to 30 days
Answer: option 3
Category: Life
Question: In which classes of business are cover notes predominantly used?
1. Health and life insurance
2. Property and liability insurance
3. Marine and motor insurance
4. Homeowners insurance
Answer: option 3
Category: Life
Question: When are marine cover notes typically issued?
1. When all details required for the policy are known
2. When there is difficulty securing adequate shipping space
3. When the cargo has already been shipped
4. When the cargo is being transported inland
Answer: option 2
Category: Life
Question: What is the basis of valuation for loss or damage prior to declaration and/or shipment on board the steamer under a marine cover note?
1. Market value of the goods at the time of loss or damage
2. Cost of the goods at the time of loss or damage
3. Prime cost of the goods plus charges actually incurred and for which the assured is liable
4. Value of the goods declared at the time of issuance of the cover note
Answer: option 3
Category: Life
Question: What is the purpose of the certificate included in the Motor insurance policy?
1. To certify that the insured has paid the premium
2. A certificate of compliance, certifying that the cover note complies with the Insurance Act, 1938
3. A certificate of inspection, certifying that the insured vehicle is in good condition
4. A certificate to the effect that the cover note is issued in accordance with the provisions of Chapters X and XI of the Motor Vehicles Act, 1988
Answer: option 4
Category: Life
Question: What types of risks are typically covered by fire insurance proposal forms?
1. Complex industrial risks
2. Agricultural risks
3. Standard risks like houses and shops
4. Risks located in remote areas
Answer: option 3
Category: Life
Question: Which of the following statements is false regarding the Motor Cover Note?
1. It includes the registration mark and number, or description of the vehicles insured
2. It does not mention the effective date and time of commencement of insurance for the purpose of the Act
3. It includes the name and address of the insured
4. It includes limitations as to use and additional risks, if any
Answer: option 2
Category: Life
Question: How long can a Cover Note's validity be extended?
1. 15 days
2. 10 days
3. 30 days
4. 20 days
Answer: option 1
Category: Life
Question: Are companies encouraging or discouraging the use of Cover Notes?
1. It varies from company to company
2. Neutral
3. Encouraging
4. Discouraging
Answer: option 4
Category: Life
Question: Who is entitled to drive the insured vehicle according to the certificate of insurance?
1. Only the insured
2. Only the person holding an effective learner's license
3. Any person who is driving on the insured's order or with his permission and holds and effective driving license. 
4. Only the person holding a commercial driver's license
Answer: option 3
Category: Life
Question: What is the purpose of a policy document in insurance?
1. To provide evidence of the contract of insurance
2. To describe the insured property in detail
3. To specify the period of insurance
4. To mention the exclusions from coverage
Answer: option 1
Category: Life
Question: Which act governs the stamping of a policy document in India?
1. Indian Evidence Act, 1872
2. Indian Contract Act, 1872
3. Indian Stamp Act, 1899
4. Indian Insurance Act, 1938
Answer: option 3
Category: Life
Question: What is a warranty in insurance?
1. A separate document from the policy
2. A condition that is not important for the validity of the contract
3. A part of both cover notes and policy document
4. A condition that can be disregarded if it is not material to the risk
Answer: option 3
Category: Life
Question: What happens if a warranty is breached in insurance?
1. The policy becomes voidable at the option of the insured. 
2. The insurer is obliged to cover the loss. 
3. The insurer may process the claims according to norms and guidelines. 
4. The policy becomes voidable at the option of the insurer. 
Answer: option 4
Category: Life
Question: What is warranted in Fire Insurance for cigarette filter manufacturing?
1. No hazardous goods shall be stored in the insured premises during the currency of policy
2. No manufacturing activity is carried out in the insured premises for consecutive period of 30 days or more
3. No solvents having flash point below 30 degrees Celsius are used/ stored in the premises
4. The property is guarded by a watchman for twenty four hours
Answer: option 3
Category: Life
Question: What is warranted in burglary insurance?
1. No hazardous goods shall be stored in the insured premises during the currency of policy
2. The insured vessel will not navigate in a certain area
3. The property is guarded by a watchman for twenty four hours
4. Goods must be packed in tin-lined cases
Answer: option 3
Category: Life
Question: Which of the following is NOT a reason for issuing an endorsement?
1. Variations/ changes in sum insured
2. Change of insurable interest by way of sale, mortgage, etc. 
3. Extension of insurance to cover additional perils/ extension of policy period
4. Request for a refund of premium by the insured
Answer: option 4
Category: Life
Question: What is the purpose of the "Increase in Stock Value Cover" endorsement?
1. To increase the sum insured of the policy
2. To cover additional perils
3. To change the name or address of the insured
4. To cancel the policy
Answer: option 1
Category: Life
Question: If a policy is issued in an ambiguous manner, how will it be interpreted by the courts?
1. In favor of the insurer
2. In favor of the broker
3. In favor of the insured
4. In favor of agent
Answer: option 3
Category: Life
Question: If an endorsement contradicts other parts of the contract, which document's meaning will prevail?
1. The endorsement
2. The policy
3. The clauses in italics
4. The clauses printed or typed in the margin of the policy
Answer: option 1
Category: Life
Question: Which part of a policy is given more importance than the wording within the body of the policy?
1. The standard printed policy form
2. The clauses in italics
3. The clauses printed or typed in the margin of the policy
4. The endorsements
Answer: option 3
Category: Life
Question: Which document overrides both marginal clauses and the clauses in the body of the policy?
1. Clauses in italics
2. Clauses printed or typed in the margin
3. Clauses attached or pasted to the policy
4. Endorsements
Answer: option 3