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IAI Subject SA1 Health and Care Specialist Advanced practice questions are available now; exam metadata is being verified.
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A health insurer's solvency falls because a large reinsurer downgrades and the recoverable is doubtful. This is an example of which risk category in the insurer's risk register?
A
B
C
D
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2026 Statistics
Key Facts: IAI SA1 Exam
3h 15m
Exam Duration
IAI SA1 format
50%
Pass Mark
IAI SP/SA marking rule
36 months
Max PED Waiting
IRDAI Master Circular 2024
5 years
Moratorium Period
IRDAI Master Circular 2024
150%
Min Solvency Ratio
IRDAI solvency norms
7
Syllabus Domains
SA1 prep coverage
IAI Subject SA1 Health and Care Specialist Advanced is a written application paper of 3 hours 15 minutes that builds on Subject SP1 and tests senior-level health and care actuarial practice in the Indian jurisdiction. The syllabus spans the IRDAI-regulated market, product design and pricing, underwriting and claims, reserving and capital, reinsurance, healthcare financing and risk management, applying the 2024 IRDAI Insurance Products Regulations and Master Circular on Health Insurance Business (which cut the PED waiting period to 36 months and the moratorium to 5 years). IAI passes SP and SA candidates at a minimum of 50%. This free prep offers 100 MCQ knowledge-practice questions; the real exam is a written paper, not multiple choice.
Sample IAI SA1 Practice Questions
Try these sample questions to test your IAI SA1 exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1Under the IRDAI Master Circular on Health Insurance Business (29 May 2024), what is the maximum waiting period an Indian insurer may impose for a Pre-Existing Disease (PED)?
A.36 months
B.24 months
C.12 months
D.48 months
Explanation: IRDAI reduced the maximum PED waiting period from 48 months to 36 months (3 years). A senior health and care actuary must price and reserve products consistent with this cap, since shorter exclusion windows accelerate the emergence of PED claims.
2Following the 2024 IRDAI reforms, after how many continuous policy years does the moratorium provision prevent an insurer from contesting a health claim on grounds of non-disclosure or misrepresentation (except established fraud)?
A.7 years
B.5 years
C.3 years
D.8 years
Explanation: The moratorium period was cut from 8 years to 5 years (60 months). After 5 continuous years, claims cannot be repudiated for non-disclosure or misrepresentation except in cases of proven fraud, which materially affects late-duration claims experience assumptions.
3The IRDAI (Insurance Products) Regulations, 2024 require that, before product approval, due diligence on capital, profitability, underwriting and reinsurance risks be recorded by which body within the insurer?
A.The General Insurance Council
B.The Appointed Actuary alone
C.The Product Management Committee
D.The Reserve Bank of India
Explanation: Under the 2024 Products Regulations, the Product Management Committee (PMC) must carry out due diligence and record concurrence on product-related risks including capital, profitability, underwriting and reinsurance before approval. The Appointed Actuary contributes but approval is a committee responsibility.
4A health insurer offers an indemnity hospitalisation product reimbursing actual costs subject to a sum insured. Which principal risk is MOST directly transferred to the insurer under this design compared with a fixed-benefit (Hospital Cash) product?
A.Currency risk
B.Operational settlement risk
C.Persistency risk
D.Medical inflation and cost-escalation risk
Explanation: Indemnity products reimburse actual treatment costs, so the insurer bears medical inflation and cost-escalation risk directly. Fixed-benefit products pay a defined amount per event, capping the insurer's exposure to rising treatment costs and shifting that risk to the policyholder.
5When pricing a long-term care (LTC) product, which actuarial assumption is generally the MOST material driver of cost and the most difficult to estimate reliably?
A.Disability/morbidity transition intensities and recovery rates
B.Marketing acquisition cost
C.Stamp duty
D.Lapse rate in the first policy year
Explanation: LTC cost is dominated by the intensity of becoming care-dependent and the duration of dependency, captured through morbidity transition and recovery intensities in a multi-state model. These are sparse-data, long-horizon assumptions and are the chief source of pricing uncertainty.
6An actuary prices a one-year hospitalisation cover. Expected claim frequency is 0.15 per policy and the expected claim severity is Rs 60,000. If expenses and profit loading total 25% of the risk premium and there is no investment offset, what office (gross) premium per policy is required?
A.Rs 9,000
B.Rs 11,250
C.Rs 12,000
D.Rs 13,500
Explanation: Risk premium = frequency x severity = 0.15 x 60,000 = Rs 9,000. Loading of 25% gives office premium = 9,000 x 1.25 = Rs 11,250. This frequency-severity build-up is the standard short-term health pricing approach.
7In Critical Illness (CI) product design, an 'accelerated' benefit structure means the CI sum assured is:
A.Indexed to medical inflation annually
B.Paid in addition to the death benefit on a life cover
C.Paid as an advance of, and reduces, the death benefit on the same life cover
D.Paid only if the insured survives 30 days after a death claim
Explanation: An accelerated CI rider advances part or all of the death benefit on diagnosis of a covered condition, reducing the remaining death benefit. A 'standalone' or 'additional' CI benefit instead pays on top of the death cover, which is more expensive to price.
8Which underwriting approach is MOST appropriate for a large group medical insurance scheme covering all employees of a corporate, where individual medical evidence would be impractical?
A.Declining all members with any disclosed condition
B.Pricing each member by individual mortality table only
C.Full medical examination for every member
D.Experience rating combined with a free-cover limit and minimal individual underwriting
Explanation: Group schemes use a free-cover limit below which no individual evidence is required, relying on the group's size and natural selection of an employed population. Pricing is typically experience-rated using the scheme's own claims history, with individual underwriting reserved for amounts above the free-cover limit.
9Under the 2024 IRDAI Master Circular, when an insured requests cashless authorisation, the insurer must grant FINAL authorisation upon receipt of the hospital's discharge request within:
A.3 hours
B.24 hours
C.7 days
D.1 hour
Explanation: IRDAI mandates that final cashless authorisation be granted within 3 hours of receiving the discharge request, with initial authorisation within 1 hour of request. These service standards affect claims-handling operations and the insurer's liquidity and reserving for claims in transit.
10A reserving actuary estimates outstanding claims for a health portfolio. Which reserve specifically covers claims that have occurred but not yet been reported to the insurer at the valuation date?
A.Unearned Premium Reserve (UPR)
B.Incurred But Not Reported (IBNR) reserve
C.Premium Deficiency Reserve (PDR)
D.Solvency margin
Explanation: The IBNR reserve provides for claim events that have occurred before the valuation date but have not yet been reported. It is distinct from the UPR (unexpired risk on earned premium) and the PDR (deficiency where future premiums are inadequate), and is typically estimated using chain-ladder or Bornhuetter-Ferguson methods.
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Verified exam format metadata for IAI Subject SA1 Health and Care Specialist Advanced is pending. The practice questions above remain available while official exam length, timing, passing score, fee, and administrator details are reviewed.