IF7 Flashcards
1
Q
. An organisation which provides insurance to healthcare insurers against large losses is known as A. an employee healthcare trust. B. a healthcare reinsurer. C. a health cash fund. D. a third party administrator
A
b
2
Q
2. The proportion of non-emergency surgery carried out in the UK by private hospitals compared to National Health Service hospitals is A. 5% B. 15% C. 20% D. 25%
A
b
3
Q
- Emergency surgery is mainly carried out by what type of establishment
A. private hospital.
B. National Health Service hospital.
C. National Health Service walk-in centre.
D. General Practitioner surgery.
A
b
4
Q
4. What type of dividends, if any, are payable by provident insurers? A. None. B. Debenture-based payments. C. Equity-based distributions. D. UK-share dividends
A
a
5
Q
- When a healthcare trust is set up to provide healthcare for a group of employees, what is
the main purpose of arranging stop loss insurance?
A. To avoid the need for a policy excess.
B. To minimise the duration of the waiting period.
C. To protect the trustees if the trust fails.
D. To protect the trust fund from higher than expected claims costs.
A
d
6
Q
- What restriction does an employee healthcare trust usually place on claim payments?
A. Benefits are not absolutely guaranteed.
B. A ceiling is placed on the number of claims that may be made per annum.
C. Claims must not exceed £10,000 per annum.
D. Each claim must not exceed £10,000
A
a
7
Q
- Two small healthcare insurance broking firms belong to the same network. What common
relationship do they have?
A. They are deemed to act on behalf of the same clients.
B. They are owned by the same parent company.
C. They are regulated through the same umbrella organisation.
D. They are tied to the same product provider.
A
c
8
Q
- Worksite marketing of healthcare cover is primarily aimed at promoting
A. company paid health cash plans.
B. Employee Assistance Programmes.
C. dental capitation plans.
D. voluntary group private medical insurance.
A
d
9
Q
- A firm employing 2,000 employees wishes to set up a company-paid private medical insurance
scheme and requires advice on how to obtain the best possible deal. Which distribution channel is
likely to be best for such an arrangement?
A. A direct insurer.
B. The internet.
C. A specialist independent intermediary.
D. A specialist tied intermediary.
A
c
10
Q
10. A potential disadvantage for an insurer using a direct sales force to distribute private medical insurance is A. greater control over sales processes. B. greater cross-selling opportunities. C. increased infrastructure costs. D. paying commissions.
A
c
11
Q
- General Practitioners are involved in the provision of services through which organisation?
A. The British Medical Association.
B. The local Clinical Commissioning Group.
C. The National Institute for Health and Care Excellence.
D. The General Medical Council.
A
b
12
Q
12. What specific condition automatically entitles patients to free National Health Service (NHS) dental treatment? A. Alzheimer’s. B. Diabetes. C. Haemophilia. D. Pregnancy.
A
d
13
Q
- Which body is responsible for recommending the treatments the National Health Service (NHS)
should provide?
A. The British Medical Association.
B. The Department of Health.
C. NHS Improvement.
D. National Institute for Health and Care Excellence.
A
d
14
Q
- What development in the American healthcare market has significantly increased competition for
market share?
A. The emergence of managed care.
B. The fall in the cost of critical illness insurance.
C. The new underwriting approach to long-term care.
D. The rise in the coverage of dental insurance.
A
a
15
Q
15. In Germany, what type of healthcare insurance, in addition to private medical insurance, is provided under the State health insurance scheme? A. Critical illness insurance. B. Income protection insurance. C. Long-term care insurance. D. Personal accident insurance.
A
c
16
Q
- The benefit provided under an income protection insurance policy as a percentage of the insured’s
income is usually limited to a maximum of around
A. 25%.
B. 60%.
C. 100%.
D. 150%
A
b
17
Q
- A policy that assists with the day-to-day cost of dental and optical bills as well as therapy such as
physiotherapy is known as a
A. flexible benefit scheme.
B. health cash plan.
C. personal accident and sickness plan.
D. small and medium enterprise private medical insurance
A
b
18
Q
- What service is usually excluded under a comprehensive private medical insurance policy?
A. Hospital accommodation.
B. Inpatient diagnostic tests.
C. Private consultations with a general practitioner (GP).
D. Surgery as a day patient.
A
c
19
Q
- Alice runs a company employing 50 people. She wants to ensure that all staff have access to
prompt medical treatment. The most appropriate product for this is
A. a capitation plan.
B. a health cash plan.
C. occupational health services.
D. a private medical insurance policy.
A
d
20
Q
- Medical history disregarded is a term most likely to be found in a
A. a corporate private medical insurance policy.
B. an individual critical illness policy.
C. an individual private medical insurance policy.
D. voluntary private medical insurance policy.
A
a
21
Q
- A health cash plan offers a cash payment when a patient stays at which type(s) of hospital?
A. A National Health Service (NHS) hospital only.
B. A private ward of a National Health Service (NHS) hospital only.
C. A private hospital only.
D. A private hospital or a National Health Service (NHS) hospital.
A
d
22
Q
- When a personal accident insurance policy includes a hospitalisation benefit, the benefit is usually
expressed as a
A. fixed daily amount.
B. percentage of salary.
C. sliding scale according to disability.
D. fixed lump sum according to hospital band
A
a
23
Q
- Which type of insurance product provides for regular eye tests and any glasses or contact lenses
required to protect vision?
A. A health cash plan.
B. An income protection insurance policy.
C. A personal accident insurance policy.
D. A private medical insurance policy.
A
a
24
Q
- Kevin is concerned by the high one-off charges for his dental treatment, so he is looking for a way
to spread the payments and budget for the overall cost. What type of healthcare product
is likely to best suit his needs?
A. A dental capitation plan.
B. A health cash plan.
C. A major medical expenses insurance policy.
D. A standard private medical insurance policy.
A
a
25
Q
- William has worked all of his life in England and chooses to retire in Spain. He needs to purchase
insurance to cover potential hospital bills. The most appropriate insurance policy for him is
A. an annual travel insurance policy.
B. a health cash plan.
C. an international medical insurance policy.
D. a UK private medical insurance policy.
A
c
26
Q
26. A fitness for work assessment is a feature of A. a health cash plan. B. an immediate needs care annuity. C. an occupational health service. D. a private medical insurance policy.
A
c
27
Q
- Daniel goes on holiday to America where he becomes unwell. What medical benefit is unlikely to
be recoverable under his travel insurance policy?
A. Diagnostic tests.
B. Inpatient costs.
C. Outpatient costs.
D. Over-the-counter medication
A
d
28
Q
- Graham and Paula are both 60 years old and do NOT want to use any of their substantial
investments to pay for nursing home care should they need it. What type of insurance product
would be most suitable in these circumstances?
A. A critical illness insurance policy.
B. A health cash plan.
C. A long-term care insurance policy.
D. A private medical insurance policy
A
c
29
Q
- Sheila is a self-employed interior designer. What would be the main benefit to her of taking out
private medical insurance?
A. She could elect to get treatment at a time when it was convenient for her business.
B. She would get earlier emergency treatment than under the National Health Service (NHS).
C. She would receive a lump sum if she were to be hospitalised.
D. She would receive an income for the time she was unable to work
A
a
30
Q
- The benefit under a critical illness insurance policy is normally paid in the form of
A. a deferred annuity.
B. an immediate annuity.
C. a one-off lump-sum payment.
D. a series of regular payments until retirement age.
A
c
31
Q
- Ben wishes to take out a low-cost insurance policy which will cover the more expensive types of
private inpatient treatment. What type of medical insurance policy is he most likely to buy?
A. A comprehensive private medical insurance policy.
B. A health cash plan.
C. An income protection insurance policy.
D. A major medical expenses policy.
A
d
32
Q
- Jane has an in-patient only private medical insurance policy with no excess. She recently started
suffering from abdominal pain, so her GP referred her to a private specialist. After an initial
consultation, her specialist referred her for a day case procedure the following week. Two days
later she received a follow-up consultation with her specialist. Which of the treatments, if any, are
covered by her policy?
A. None of the treatments.
B. The day case procedure only.
C. The day case procedure and the follow up consultation only.
D. The day case procedure and both consultations.
A
b
33
Q
- When is primary care covered under a travel insurance policy, if at all?
A. Never.
B. In an emergency.
C. Always, subject to a maximum financial limit.
D. Only when required as routine treatment for an ongoing medical condition.
A
b
34
Q
34. What cover will a health cash plan usually provide that is NOT normally covered under a private medical insurance policy? A. Nursing care. B. Outpatient treatment. C. Routine dental treatment. D. Surgical procedures.
A
c
35
Q
35. The main function of an income protection insurance policy is to provide an income on A. death. B. illness. C. redundancy. D. retirement.
A
b
36
Q
- Under a ‘member get member’ loyalty scheme, when is a cash bonus normally paid to the existing
member?
A. On submission of a quotation request by the new member.
B. On payment of the new member’s first premium.
C. On completion of the new member’s first year.
D. On completion of a specified claim-free period by the new member
A
b
37
Q
37. Who is responsible for assessing the risk when transacting healthcare insurance? A. The claims manager B. The intermediary. C. The policyholder. D. The underwriter.
A
d
38
Q
- When obtaining a medically underwritten budget private medical insurance policy for a client, an
intermediary should typically ask
A. details of hospital admissions only over the last five years.
B. details of all previous and existing medical conditions over the last five years.
C. whether the client is on a waiting list of more than six weeks for surgery.
D. no medical questions.
A
b
39
Q
- Who, if anyone, is primarily responsible for providing customers who have taken out a healthcare
policy via an intermediary with information on mid-term changes to the policy?
A. The insurer only.
B. The insurance intermediary only.
C. Both the insurer and the intermediary.
D. Neither the insurer nor the intermediary
A
a
40
Q
- When is a fact-find usually undertaken?
A. Prior to an application form being completed.
B. Once an application form has been completed but before the policy is accepted by the insurer.
C. Once the policy is accepted by the insurer.
D. On receipt of a completed claim form.
A
a