IC-38 Insurance Agent Exam - Health study plan

Map the IC-38 Health Insurance syllabus into a one-page outline covering risk pooling, health insurance products, underwriting, claims, regulation, and ethics, and mark the weighting of each area

Define at least 30 core health insurance terms (insurer, insured, premium, deductible, co-payment, waiting period, pre-existing condition, indemnity, benefit period, subrogation) in your own words

Explain in writing how adverse selection and moral hazard shape health insurance pricing and policy design, using two concrete examples

List the main categories of health products (individual, group, critical illness, hospital cash, personal accident, long-term care) and the distinguishing features of each

Break down the structure of a health insurance policy into its parts: declarations, insuring clause, exclusions, conditions, definitions, and endorsements

Interpret at least 10 sample policy clauses and state in one sentence what each clause obliges the insurer or insured to do

Compare indemnity and defined-benefit health products on benefit calculation, payout triggers, and typical claim scenarios

Draft a table of common exclusions and the rationale behind each (pre-existing conditions, cosmetic treatment, self-inflicted injury, experimental treatment)

Trace the individual health underwriting process from application through medical evidence, risk classification, and policy issue

Apply the concepts of waiting periods, pre-existing condition clauses, and moratorium underwriting to three hypothetical applicants and justify the decision for each

Identify the information an agent must collect accurately on a health application and explain why non-disclosure affects claim outcomes

Distinguish standard, substandard, and declined risk decisions and the alternatives (exclusion riders, premium loading) available for each

Sequence the health claim lifecycle from notification through document collection, assessment, adjudication, and settlement or repudiation

Calculate claim payouts for five scenarios involving deductibles, co-payment percentages, sub-limits, and per-day hospital cash benefits

Explain the role of third-party administrators, network hospitals, and cashless authorization in health claims

Describe the agent's duties during a claim, including what the agent may and may not do on the insured's behalf

Summarize the regulatory framework governing health insurance sales, including licensing, conduct rules, product filing, and grievance redressal

Explain the purpose and mechanics of health insurance portability, renewability guarantees, and the free-look period

Identify at least eight unfair sales or claims practices and the compliance consequence of each

Outline anti-money-laundering and know-your-customer obligations as they apply to health insurance applications

Analyze the ethical duties of an agent toward the applicant, the insurer, and the regulator, and resolve three conflict-of-interest scenarios in writing

Build a needs-analysis framework that matches a client's age, dependents, income, and existing cover to an appropriate health product mix

Prepare and rehearse a compliant sales presentation that discloses exclusions, waiting periods, and claim procedure without misrepresentation

Distinguish suitability, disclosure, and replacement obligations and explain how each is documented in the sales file

Consolidate all domain 1 material into a personal one-page formula and definitions sheet covering premium, benefits, deductibles, co-payment, and claim settlement

Complete two full-length timed practice exams under exam conditions and log every error by topic

Re-study the three weakest topics identified from practice exams and restate each in your own words

Answer 40 rapid-fire recall questions on definitions, exclusions, and regulatory limits without reference material

Review the error log and formula sheet daily, converting each remaining weak point into a flashcard

Simulate the exam three times at full length, targeting a stable score above your week 4 baseline by at least 10 percentage points

Practice explaining five complex provisions aloud in under two minutes each to test recall under pressure

Finalize exam-day logistics: identification, timing plan, question-reading strategy, and a rule for when to skip and return