Other

Question 1

List general exclusions in healthcare contracts

Answer 1

war, terrorism
cosmetic surgery
drugs/ alcohol
self-inflicted injury
hazardous activities/ sports
criminal activities
pre-existing conditions
failure to follow medical advice

Question 2

List reasons for general exclusions in healthcare contracts

Answer 2

manage anti-selection risk
reduce moral (intentional) hazard
reduce underwriting - eg reduce number of questions on application form
reduce cost to insurer - more affordable premiums
difficulty to price risks - lack of sufficient data, too much uncertainty
in line with regulation - benefits cannot be triggered by criminal acts

Question 3

What type of response is expected from an “Implications” question?

Answer 3

Positive and negative comments

Question 4

Why is it important to consider the state of the economy

Answer 4

a worsening economy may lead to an increase in fraudulent claims