III IC-28 study guide
III IC-28 · Work through your exam, one topic at a time.
IC-28 is one of the paper codes in the professional examination series administered by the Insurance Institute of India (III), the body behind the Licentiate, Associateship and Fellowship designations and a wide catalogue of subject-specific papers such as IC-01, IC-02 and many others. Candidates typically encounter IC-28 as a single subject within a staged programme, so the paper is usually taken alongside or after foundation-level subjects rather than in isolation. The III IC-28 study guide has 5 sections and about 1,789 words.
01Foundations of Health Insurance and the Nature of the Cover
IC-28 opens with the foundations of health insurance as a class of business: how medical costs are pooled, why the product rests on indemnity, and where it sits in Indian insurance law. The vocabulary set here is used in every later chapter, so examiners test definitions precisely.
409 words, about 2 min02Health Insurance Products and Product Design
Product knowledge: how indemnity covers are structured and costed, which fixed-benefit and standardised products exist, and how sub-limits, floaters and co-payments change the payout. Hospitalisation indemnity: sum insured per person per year, covering room, ICU, surgeon and anaesthetist fees, medicines, diagnostics, day-care procedures, and pre- and post-hospitalisation expenses (commonly 30 days before and 60 days after admission; the standard Arogya Sanjeevani wording uses these windows).
284 words, about 1 min03Health Insurance Underwriting and Risk Selection
How risk is classified, priced and controlled for individual, family and group health business, and which tools keep the risk pool solvent. Rating factors: age, gender, sum insured, city zone, plan type, family size and the individual's health history - body mass index, blood pressure, diabetes, cardiac and renal history, tobacco and alcohol use, family history and occupation.
380 words, about 2 min04Claims Management, Deductions and Third Party Administrators
The claims journey, the arithmetic of deduction, and the division of duties between insurer, TPA and hospital. Numeric deduction questions are common here.
344 words, about 2 min05Regulation, Portability, Fraud Control and the Indian Health Market
The regulatory frame - licensing, product design standards, policyholder protection, portability - alongside fraud typologies and the structure of India's health insurance market. The IRDAI (Health Insurance) Regulations, 2016 govern product design, underwriting, claims and portability; the TPA Regulations, 2016 license and control third-party administrators; the Protection of Policyholders' Interests Regulations, 2017 cover disclosure, grievance redressal and timelines.
372 words, about 2 min