IC-38 Insurance Agent Exam - Health case studies
IC-38 Insurance Agent Exam - Health · Put your knowledge to work in context.
IC-38 is the Insurance Institute of India's pre-licence examination for insurance agents, and the health variant of the IC-38 course material is the study route for candidates who intend to sell health insurance products. The Institute publishes a dedicated IC 38 Study Material of Insurance Agent and a Model Question Bank, and the same Grace Passing Marks – IC-38 Examination page is listed for every distribution channel (agents, corporate agents, insurance marketing firms, web aggregators, brokers and authorised verifiers), which tells you the exam is a common gateway rather than a channel-specific test. The IC-38 Insurance Agent Exam - Health case studies are 5 cases and about 4,321 words.
1Porting a Five-Year-Old Floater After a Mid-Term Diabetes Diagnosis
Ramesh Nair, 47, has held a ₹10,00,000 family floater (self, wife, two children) with Insurer A since 1 April 2019 - five continuous renewals, never late, and two small claims (₹38,000 for dengue in 2021, ₹22,000 for a wrist fracture in 2022). At his 2023 check-up his HbA1c came back at 7.8% and his physician started metformin.
945 words, about 5 min2Room-Rent Cap, Co-Payment and an Inflated Bill on an Appendectomy Claim
Leela Krishnan, 64, has held a ₹5,00,000 individual indemnity policy since June 2019, renewed every year without a break and with no claims so far. The wording caps room rent at 1% of sum insured per day, applies a 10% co-payment to every claim because she was over 60 at inception, excludes consumables such as gloves, syringes and attendant meals, and carries the usual 30-day initial and 90-day specific-disease waiting periods.
798 words, about 4 min3Repudiation for Concealed Hypertension Two Years into a Health Policy
Vikram Shah, 52, bought a ₹15,00,000 individual health policy on 10 January 2022 through an agent. The proposal form asked: 'Have you ever been treated for, or advised treatment for, high blood pressure, heart disease, diabetes or any other ailment?' He answered 'No'.
862 words, about 4 min4Pregnancy, a Planned Resignation and a Maternity Waiting Period
Kavya Rao, 29, a software engineer, is covered by her employer's group health policy: ₹5,00,000 per employee, maternity sub-limit ₹50,000, a nine-month maternity waiting period, and cover that ends on the day she leaves the company. She is 20 weeks pregnant; the baby is due in early October.
829 words, about 4 min5₹17 Lakh of Claims Against ₹7 Lakh of Hospital Bills
Anand Verma, 45, was admitted on 12 February 2024 with severe chest pain and was diagnosed with an acute ST-elevation myocardial infarction. He had primary angioplasty with two drug-eluting stents and was discharged after five days.
887 words, about 4 min