III IC-24 case studies
III IC-24 · Put your knowledge to work in context.
IC-24 is a subject code in the professional examination programme of the Insurance Institute of India (III), the institute behind the Licentiate, Associateship and Fellowship designations and a family of specialised diplomas. Candidates typically encounter IC-24 as one paper among several needed for a professional qualification, and it is most relevant to people already working in insurance - underwriters, claims handlers, operations and compliance staff - who want a formal, examination-based credential rather than a training certificate. The III IC-24 case studies are 5 cases and about 4,053 words.
1Portability, PED Waiting-Period Credit and Room-Category Deduction
Mr Anil Kulkarni, 47, bought a ₹10,00,000 family floater from Insurer A on 1 April 2021. He declared Type 2 diabetes, diagnosed in 2018, at proposal; Insurer A applied a three-year pre-existing disease (PED) waiting period, which expired on 31 March 2024.
809 words, about 4 min2Personal Accident: Occupational Change, Disability Table and Multiple Covers
Mr Rajesh Nair, 41, production supervisor at a Kochi steel fabricator, held a personal accident policy for a capital sum insured of ₹40,00,000, declaring his occupation as "supervisory/administrative - Class I". The annual premium was ₹6,000.
823 words, about 4 min3Cashless Refusal, TPA Conduct and Reimbursement Arithmetic
M/s Deccan Precision Pvt Ltd holds a group mediclaim policy from Insurer Q, administered by TPA R, covering 1,240 employees and dependants for ₹5,00,000 per family, policy year 1 April 2025 to 31 March 2026. The wording carries a 10% co-payment, a list of 180 non-payable consumables, and a clause that charges must be "reasonable, customary and necessary".
793 words, about 4 min4Critical Illness: Definition Failure, Survival Clause and the Moratorium
Mr Sunil Deshmukh, 55, has held a critical illness policy since 1 March 2019 with a sum insured of ₹25,00,000 covering 18 conditions, including "heart attack" and "coronary artery disease requiring surgery". The wording defines heart attack as death of heart muscle evidenced by typical chest pain plus fresh ECG changes plus a rise in cardiac markers - specifically troponin-I above 1.0 ng/mL - and states that "angioplasty, stent insertion or any other intra-arterial procedure is not covered under this condition".
836 words, about 4 min5Senior Citizen Claim: Deductible, Co-payment, Cataract and AYUSH Sub-limits
Mrs Kamala Iyer, 68, has held a senior citizen indemnity policy since 1 February 2022, renewed without break, sum insured ₹5,00,000. Terms: deductible ₹25,000 "each and every claim"; co-payment 20% for insureds above 60; cataract sub-limit ₹40,000 per eye, with day-care procedures covered; AYUSH treatment sub-limit 25% of sum insured per policy year, payable only at a government-recognised AYUSH hospital; 24-hour hospitalisation not required for listed day-care procedures.
792 words, about 4 min