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LLQP · Accident and Sickness Insurance

600 Accident & Sickness Practice Questions

Published independent questions grouped by competency component. Counts are bank inventory, not an official exam distribution. Public answer access and account features depend on the current page and plan.

1.Assess the client's needs and situation

35% of the exam · 210 questions
  1. The single most important fact for sizing a client's disability income need is:1.1
  2. A client is a self-employed electrician. Why does the agent need to know his daily job duties, not just his job title?1.1
  3. A client has been in her current role for three months after ten years in a different field. For disability underwriting and needs analysis, this matters because:1.1
  4. Which of the following health facts is most relevant to a client's disability insurance situation?1.1
  5. A client's income consists of a modest salary plus large annual bonuses. For disability insurance purposes the agent should:1.1
  6. Why does the disability needs analysis ask about the client's participation in employer-sponsored savings plans?1.1
  7. A client has three months of expenses in savings. In a disability needs analysis this affects:1.1
  8. A client's monthly cash-flow statement is used in a disability needs analysis to:1.1
  9. A client's debts include a mortgage, a car loan and credit cards. In the disability needs analysis, the agent records for each:1.1
  10. Which document does the curriculum specifically list for verifying a client's income in an A&S needs analysis?1.1
  11. For a group A&S client, the 'employee data sheet' provides:1.1
  12. Why does the curriculum list 'two years of claims experience' for a group client?1.1
  13. A client is a stay-at-home parent with no earned income. For disability insurance purposes:1.1
  14. A client with a family history of early-onset cancer asks which A&S product is most affected by that history. The agent should say:1.1
  15. A client is 58 and plans to retire at 65. This affects the disability recommendation mainly by:1.1
  16. A client's business partner asks whether the partner's own disability matters to the client's A&S planning. The agent should explain:1.1
  17. A client's occupation involves frequent international travel to remote regions. For disability and critical illness underwriting this is:1.1
  18. A client's spouse earns the same income as the client. How does this affect the client's disability need?1.1
  19. Which of the following is a source of 'unearned income' in the client's financial situation?1.1
  20. A client owns her own consulting business with no employees. Which business expense would continue if she were disabled?1.1
  21. A client's beneficiaries for assets are listed in the fact-finding. Why does this matter for A&S planning?1.1
  22. A client asks why the agent wants to know how assets are owned (jointly or individually). In the A&S context the answer is:1.1
  23. A client mentions a back injury five years ago that fully resolved. The agent should:1.1
  24. Which element of a client's situation most affects the definition of disability that should be recommended?1.1
  25. A client's employer is a small business with five employees. In assessing a group A&S plan for it, the agent should recognize that:1.1
  26. A client's income has fallen sharply this year due to a slow business. For DI purposes:1.1
  27. A client asks whether her smoking affects A&S insurance as much as it affects life insurance. The agent should say:1.1
  28. A group client asks what 'nature of business' has to do with its A&S quote. The agent should explain that:1.1
  29. Which of the following would be recorded under a client's 'lifestyle' for A&S purposes?1.1
  30. A client's household relies on her income and her husband's; they have two children and a mortgage. If either spouse were disabled long-term, the most likely financial consequence is:1.1
  31. A client asks whether his age affects the cost of disability insurance. The agent should explain that:1.1
  32. Which of the following is an example of a client's 'financial responsibilities and commitments between family members' relevant to A&S?1.1
  33. A client has a large investment portfolio generating income but a modest salary. For disability insurance:1.1
  34. A client's job involves rotating shifts and heavy lifting. For A&S purposes this suggests:1.1
  35. A client asks why the agent needs the details of her group benefits booklet. The best answer is:1.1
  36. A client's business is highly seasonal. Which A&S design consideration follows?1.1
  37. A client tells the agent she has 'no health issues' but is on medication for high blood pressure. The agent should:1.1
  38. For a group client, why does the curriculum list the 'employee data sheet' alongside the 'nature of business'?1.1
  39. A client has a spouse and children and expects to inherit a large sum in a few years. In the A&S needs analysis the inheritance should be:1.1
  40. A client who works from home as a software developer asks whether her occupation is 'low risk' for disability. The agent should explain that:1.1
  41. A client has group long-term disability coverage of 60% of salary to a monthly maximum. The first thing the agent should check is:1.2
  42. A client's group LTD plan has a two-year 'own occupation' period followed by an 'any occupation' definition. This means:1.2
  43. A client pays 100% of the premium for her group LTD coverage through payroll deduction. Her benefits, if she becomes disabled, will be:1.2
  44. A client's group LTD is employer-paid. In assessing its adequacy, the agent must remember that:1.2
  45. A client's individual disability policy has an 'any occupation' definition of total disability. The agent should note that:1.2
  46. A client asks what Employment Insurance provides if she cannot work because of illness. The accurate answer is:1.2
  47. CPP disability benefits are payable when the contributor:1.2
  48. A client injured at work receives workers' compensation benefits. In assessing existing coverage, the agent should note that workers' compensation:1.2
  49. A client's mortgage lender sold her 'mortgage disability insurance'. The review should note that it:1.2
  50. A client's existing critical illness policy covers three conditions: cancer, heart attack and stroke. In reviewing it, the agent should:1.2
  51. A client has group short-term disability (STD) that pays for 17 weeks and group LTD starting at week 18. His individual DI policy has a 90-day waiting period. The review should note:1.2
  52. A group LTD plan has an 'all-sources maximum' of 85% of pre-disability earnings. This means:1.2
  53. A client's group benefits include an extended health care plan with a lifetime maximum for out-of-country emergency care. The review should note:1.2
  54. A client says she does not need private health coverage because her province "covers everything". The agent should explain that provincial plans cover:1.2
  55. A client's existing individual DI policy is 'guaranteed renewable'. In the review this means the insurer:1.2
  56. A client's existing DI benefit period is two years. The review should flag that:1.2
  57. A client's group plan provides dependent coverage for her spouse and children. On her death or termination:1.2
  58. A client's group LTD plan integrates with CPP disability on a 'direct offset' basis. If she qualifies for CPP disability:1.2
  59. A client has individual DI purchased ten years ago based on her income at that time. Her income has doubled since. The review should note:1.2
  60. A client's existing LTC policy pays a daily benefit for facility care only. The review should consider:1.2
  61. A client asks whether her group AD&D coverage counts as disability insurance. The agent should explain:1.2
  62. A client's group plan includes an Employee Assistance Program. In the review this is:1.2
  63. A client's individual DI policy has a 'presumptive disability' clause. In the review the agent should explain that it:1.2
  64. A client has a personal critical illness policy and group life but no disability coverage. The most significant gap is:1.2
  65. A client's group STD plan is registered under the EI premium reduction program. In the review, this tells the agent that:1.2
  66. A client's existing coverage includes a hospital indemnity policy paying a fixed daily amount while hospitalized. The review should treat it as:1.2
  67. A client's individual DI policy excludes disabilities arising from a pre-existing back condition. The review should:1.2
  68. A client's disability coverage through a professional association is 'step-rated' by five-year age bands. The review should note that:1.2
  69. A client with a modest income relies on a provincial disability assistance program as her only coverage. The agent should understand that such programs:1.2
  70. Which existing-coverage detail most affects the recommended waiting period for new individual DI?1.2
  71. A client asks whether his group LTD benefit will keep pace with inflation during a long claim. The agent should check for:1.2
  72. A client's existing DI policy has a 'recurrent disability' provision. This means:1.2
  73. A client's existing critical illness policy has a 30-day survival period. This means:1.2
  74. Which of the following is a legitimate reason a group member's LTD claim might be denied even though he cannot do his job?1.2
  75. A client asks whether he should keep an old DI policy with a small benefit now that he has group LTD. The agent should consider:1.2
  76. A client's group plan has a non-evidence maximum for LTD below her salary-based entitlement, and she was declined for the excess. Her coverage is therefore:1.2
  77. In assessing a client's existing coverage, 'advantages and disadvantages of existing coverage' means:1.2
  78. A client's group EHC plan has a coordination of benefits provision and her spouse has a plan too. For her own claims:1.2
  79. A client's existing individual DI policy is owned and paid for by his corporation, with the corporation as beneficiary. The review should note that:1.2
  80. A client's existing coverage includes a critical illness policy with a 'return of premium on expiry' rider. The review should note that:1.2
  81. The primary financial risk that disability insurance addresses is:1.3
  82. A 35-year-old client asks whether she is more likely to die or become disabled before 65. The accurate statement is:1.3
  83. The income replacement need in a disability analysis is best calculated as:1.3
  84. Why do insurers limit disability benefits to a percentage of income rather than 100%?1.3
  85. A client is diagnosed with a serious illness but recovers within a year and returns to work. During that year she had extra medical, travel and child-care costs and a spouse who took unpaid leave. This scenario illustrates the need for:1.3
  86. In articulating a client's critical illness need, the agent typically considers:1.3
  87. A client's greatest fear is needing nursing-home or in-home care in old age and consuming the estate she wants to leave. The need this identifies is:1.3
  88. Activities of daily living (ADLs) used to trigger LTC benefits typically include:1.3
  89. A self-employed dentist's practice has fixed monthly costs (rent, staff, equipment leases) that continue if she is disabled. The need is:1.3
  90. Two partners have a buy-sell agreement that requires a buyout if one is permanently disabled. The need created is:1.3
  91. A small company depends on a sales manager who generates most of its revenue. If he is disabled for a year, the company's need is for:1.3
  92. An employer wants to attract and retain staff and asks how group A&S benefits help. The agent should explain that group benefits:1.3
  93. A client's individual DI benefits will be tax-free because she pays the premiums personally. In articulating her need this means:1.3
  94. A client asks why inflation matters in a disability needs analysis. The best answer is:1.3
  95. A client's group LTD covers 66% of salary, taxable, to a maximum that is below her formula amount. Her articulated disability need is:1.3
  96. A client's spouse has left the workforce to raise children. The couple asks what happens if the spouse suffers a serious illness. The need identified is:1.3
  97. A client's family has a young child with a chronic condition requiring drugs not covered provincially. The need identified is:1.3
  98. A client who snowbirds in the southern United States for four months each winter has a need for:1.3
  99. Which of the following would raise a client's disability income need rather than lower it?1.3
  100. A client with a mortgage asks whether he should insure the mortgage against disability. The agent should explain:1.3
  101. A client asks how long the disability benefit should last. The agent should explain that the benefit period should reflect:1.3
  102. A client with limited budget can afford either a 30-day or a 90-day waiting period on the same benefit to age 65, or a 30-day waiting period with a 2-year benefit. The best articulation of need is:1.3
  103. A client asks whether her CI need is reduced by her group LTD. The agent should explain:1.3
  104. A client's need for long-term care is affected most by:1.3
  105. A single client with no dependants and substantial savings asks whether he needs disability insurance. The best response is:1.3
  106. Which of the following is an example of a group need the agent should articulate for an employer client?1.3
  107. A client asks whether a disability would affect her retirement. The agent should explain that:1.3
  108. A client asks what 'standard of living' means in her disability analysis. The agent should say:1.3
  109. A client is a physician earning a high income. Her practice is incorporated and pays her a salary and dividends. The insurable income for DI purposes is generally:1.3
  110. An employer asks whether it should pay the LTD premium for employees as a goodwill gesture. The agent should explain the trade-off:1.3
  111. A client asks how much CI to buy. The agent's approach should be:1.3
  112. A client who owns rental properties says his income would continue if disabled, so he does not need DI. The agent should:1.3
  113. A client's employer offers a health spending account. In articulating her extended health need this means:1.3
  114. A client asks whether she can be over-insured for disability. The agent should explain:1.3
  115. A client whose parents both needed years of care asks whether LTC insurance is relevant at age 50. The agent should say:1.3
  116. A client's needs analysis shows a disability income gap, a CI need and an LTC need, but a limited budget. The agent should prioritize:1.3
  117. A client who is a commissioned salesperson asks why his DI need might be larger than a salaried employee's. The agent should explain:1.3
  118. An employer with mostly young, healthy employees asks whether group benefits are worth it. The agent should explain that the need includes:1.3
  119. A client's greatest single expense is his children's private school tuition. In a disability analysis:1.3
  120. Which statement about the relationship between disability insurance and life insurance needs is correct?1.3
  121. A client who is 30 asks whether a two-year benefit period is 'good enough' since most disabilities are short. The agent should explain:1.3
  122. A client's need for dental coverage is best characterized as:1.3
  123. A client's spouse works for the same small business as the client. If the business fails because of the client's disability:1.3
  124. A client asks whether workers' compensation reduces her DI need. The agent should explain:1.3
  125. A client asks whether she needs individual DI when her employer's group plan is 'generous'. The most important portability point is:1.3
  126. For a client whose main concern is the cost of care for a parent with dementia, which product need is illustrated?1.3
  127. A client asks whether the financial impact of a serious illness on her family is really different from disability. The agent should give an example such as:1.3
  128. A group client asks what determines the need for a short-term disability plan versus relying on EI sickness benefits. The agent should explain:1.3
  129. A client asks whether his need for disability coverage ends at retirement. The agent should explain:1.3
  130. In documenting a client's articulated A&S needs, the agent should record:1.3
  131. A client's household expenses include a large monthly contribution to an RESP. During disability, this contribution:1.3
  132. A client with a serious chronic condition is likely uninsurable for DI and CI. The agent should:1.3
  133. A client asks what percentage of pre-disability income she should aim to replace. The agent's guidance is:1.3
  134. An employer with a high-turnover workforce asks about group benefit needs. The agent should note that:1.3
  135. A client asks whether her emergency fund makes disability insurance unnecessary. The agent should explain that an emergency fund:1.3
  136. A client's spouse asks whether she would qualify for CPP survivor benefits if the client became disabled. The agent should clarify:1.3
  137. A client asks how a CI benefit differs from a disability benefit in terms of use. The agent should explain:1.3
  138. An articulated need for an incorporated business owner might include 'protecting the ability to deduct fixed costs while disabled'. Which product and tax point apply?1.3
  139. A client asks whether the need for A&S coverage changes when she has children. The agent should explain:1.3
  140. In articulating a group client's needs, the agent should also address the employees' perspective, which includes:1.3
  141. A client works as a courier through a delivery app and is paid per job with no employer. In the A&S fact-find this matters because:1.1
  142. A client holds two part-time jobs, each with its own small group plan. For the disability needs analysis the agent should:1.1
  143. A commission-only realtor asks how her income will be treated for disability underwriting. The agent should explain that insurers:1.1
  144. A client is on maternity leave and receiving employment insurance benefits. For an individual disability application the agent should recognize that:1.1
  145. A client incorporated her consulting practice last year and pays herself by dividend rather than salary. For disability underwriting this matters because:1.1
  146. A unionized factory worker tells the agent his benefits are 'in the collective agreement'. The agent should:1.1
  147. A client is an apprentice electrician whose income will rise substantially as he completes his hours. The needs analysis should:1.1
  148. A client mentions that she is currently receiving physiotherapy for a shoulder injury that is improving. The agent should:1.1
  149. A client who has recently moved from another province asks whether his coverage needs change. The agent should note that:1.1
  150. A client works remotely from Canada for an employer based in another country. The disability fact-find must establish:1.1
  151. A client volunteers as a firefighter on evenings and weekends. In the fact-find this should be recorded because:1.1
  152. A client is a farmer whose income varies with the harvest and who lives on the operation. The A&S analysis should treat:1.1
  153. A client's take-home pay depends heavily on overtime that his employer cannot guarantee. The agent should:1.1
  154. A client supports an adult child with a developmental disability who lives at home. For the A&S analysis this means:1.1
  155. A client is caring for an aging parent and has cut back to four days a week. The agent should record that:1.1
  156. A newly arrived permanent resident asks about disability coverage. The agent should establish first:1.1
  157. A client plans a twelve-month unpaid sabbatical next year. The agent should explain that:1.1
  158. A client tells the agent she is pregnant and plans to apply for disability coverage. The agent should explain that insurers:1.1
  159. A client has elective knee surgery scheduled in six weeks. For a disability application the agent should:1.1
  160. A client changed employers three weeks ago and is within a probationary period. For group and individual A&S coverage this means:1.1
  161. A client's household budget depends on both spouses working, and both are self-employed. In the A&S analysis:1.1
  162. A client mentions a period of treatment for depression that ended two years ago. In the fact-find the agent should:1.1
  163. For a group A&S client, why does the agent ask about the employer's turnover rate?1.1
  164. A client asks why the agent wants to know how long she has held her professional licence. The best answer is that:1.1
  165. A client has creditor disability insurance on a car loan. In the coverage review this should be counted as:1.2
  166. A client's provincial drug plan has an income-based deductible. In the extended health review this means:1.2
  167. A client's employer self-insures its short-term disability plan through an administrative services only arrangement. The review should note that:1.2
  168. A client belongs to a health spending account through work. In the coverage review this is best described as:1.2
  169. A client asks whether his provincial health plan covers an ambulance ride. The accurate answer is that:1.2
  170. A client's group extended health plan coordinates with her spouse's plan. For their child's dental claim, the first payer is determined by:1.2
  171. A client has travel medical coverage through a credit card. In the review the agent should confirm:1.2
  172. A client on a provincial disability assistance program asks whether a private disability benefit would affect it. The accurate answer is:1.2
  173. An employee's group LTD plan is fully employee-paid but the employer collects the premium through payroll. The benefit will be:1.2
  174. A client's group plan includes a health care spending account and a wellness account. The review should note that:1.2
  175. A member is off sick on the day a new group disability plan takes effect. The 'actively at work' rule means that:1.2
  176. A client's critical illness policy was issued with a moratorium on cancer claims in the first ninety days. At review, four years later, this means:1.2
  177. A client's employer terminated the group health plan last month. For the family's drug coverage the review should identify:1.2
  178. An employee asks whether she can claim both her own group plan and her spouse's for the same dental bill. The correct explanation is:1.2
  179. A client has an old disability policy with an 'any occupation' definition from the outset. In the review the agent should:1.2
  180. A self-employed client has been paying into an association plan for years. At review the agent finds the plan is not guaranteed renewable. This means:1.2
  181. A client receives a disability benefit from a motor vehicle accident scheme after a collision. For the coverage review this benefit is:1.2
  182. A client's extended health plan pays paramedical services to a per-practitioner annual maximum. The review should note that:1.2
  183. A client's employer pays the premium for group critical illness coverage. The tax treatment is that:1.2
  184. A client bought a hospital cash plan advertised on television. In the review the agent should explain that it:1.2
  185. A client's group LTD plan defines pre-disability earnings as base salary only. For a client who earns large bonuses this means:1.2
  186. A retired client asks whether her former employer's retiree health plan is secure. The agent should explain that:1.2
  187. In reviewing a couple's coverage, the agent finds both are insured under one spouse's family health plan. The relevant risk is:1.2
  188. A client asks why he should consider critical illness coverage when he already has disability insurance. The best explanation is:1.3
  189. A client's need analysis shows he could manage three months without income but not six. This points to:1.3
  190. A client argues that she does not need long-term care coverage because her children will look after her. The agent should explain that:1.3
  191. A dentist asks why his disability need is different from an office manager's earning the same income. The key difference is:1.3
  192. A couple in their early sixties ask which A&S risk is most likely to affect their retirement plan. The analysis should highlight:1.3
  193. A client asks whether critical illness coverage on her children is worth considering. The balanced answer is that:1.3
  194. A business owner asks what would happen to her fixed costs if she were disabled for eight months. The need identified is:1.3
  195. Two partners want the business to be bought out if either becomes permanently disabled. The product that meets this need is:1.3
  196. A client's household could absorb a short disability but not the loss of the family home. The need this identifies is:1.3
  197. A client's health coverage comes through her husband's employer, and he retires next year. The need this identifies is:1.3
  198. A client's greatest fear is the cost of drugs not covered by her employer's plan after she retires. The need points to:1.3
  199. A client tells the agent he already has enough coverage because his group plan pays two-thirds of salary. The needs analysis should test whether:1.3
  200. A client asks why travel medical insurance matters when she is only visiting the United States for a week. The agent should explain that:1.3
  201. A client's need analysis identifies both an income replacement gap and a long-term care exposure, with a limited budget. The agent should:1.3
  202. A client asks whether he should insure against the cost of a private room in a long-term care facility. The analysis should note that:1.3
  203. A client who is the sole owner of a small business with four employees asks what A&S needs her business has. The analysis should identify:1.3
  204. A client's analysis shows an income replacement need that will fall sharply once the mortgage is paid in twelve years. This suggests:1.3
  205. A client asks what a critical illness benefit is typically used for. The most accurate answer is:1.3
  206. A client in a physically demanding trade cannot afford full disability coverage. The needs analysis should consider:1.3
  207. A client's employer offers optional critical illness coverage at group rates. Compared with an individual policy, the group version usually:1.3
  208. A client's analysis shows she would return to part-time work after a serious illness rather than stop entirely. The design feature that matters most is:1.3
  209. A client asks whether he should insure against the cost of dental work for his family. The analysis should treat dental as:1.3
  210. Summarizing the needs analysis for a client, the agent should present:1.3

2.Analyze the available products that meet the client's needs

30% of the exam · 180 questions
  1. Under an 'own occupation' definition, a surgeon who can no longer operate but takes a full-time teaching position is:2.1
  2. Under a 'regular occupation' definition of total disability, the insured is totally disabled if he:2.1
  3. A disability policy's 'any occupation' definition usually qualifies the test with:2.1
  4. Partial disability benefits under an individual DI policy are typically paid when the insured:2.1
  5. Residual disability benefits are calculated on:2.1
  6. The waiting (elimination) period in a disability policy is:2.1
  7. A 'non-cancellable' disability policy guarantees that:2.1
  8. A 'cancellable' or 'commercial' disability policy allows the insurer to:2.1
  9. A disability policy's benefit period 'to age 65' means:2.1
  10. An 'accident-only' disability policy is characterized by:2.1
  11. The 'pre-existing condition' provision in an individual DI policy generally:2.1
  12. A disability policy's 'incontestability' provision means that after a stated period (commonly two years):2.1
  13. The 'grace period' in a disability policy:2.1
  14. A DI policy's 'reinstatement' provision allows a lapsed policy to be restored:2.1
  15. The 'relation of earnings to insurance' provision in a disability policy:2.1
  16. Standard exclusions in individual disability policies commonly include disability resulting from:2.1
  17. The tax treatment of benefits from an individually owned DI policy with premiums paid by the insured from after-tax income is:2.1
  18. Key person disability insurance is owned and paid for by the business. Its benefits are:2.1
  19. A disability buyout policy typically differs from income replacement DI in that it:2.1
  20. Business overhead expense insurance typically covers:2.1
  21. A 'presumptive total disability' provision typically deems the insured totally disabled on:2.1
  22. A DI policy's 'waiver of premium' provision means:2.1
  23. A 'rehabilitation' provision in a DI policy typically:2.1
  24. A 'recurrent disability' provision generally treats a relapse of the same cause within a stated period (often six months) after return to work as:2.1
  25. The 'transplant' and 'cosmetic surgery' provisions in some DI policies:2.1
  26. Occupational classes in DI underwriting reflect:2.1
  27. Under an individual DI policy, benefits for total disability are usually paid:2.1
  28. A 'conditionally renewable' disability policy:2.1
  29. A DI policy's 'issue and participation limits' refer to:2.1
  30. A disability policy with a 'lifetime accident benefit' pays:2.1
  31. The 'legal actions' provision in an A&S policy:2.1
  32. A DI policy issued with a 'rating' (extra premium) reflects:2.1
  33. A DI policy's 'change of occupation' provision typically allows the insurer to:2.1
  34. A DI policy's 'integration' or 'offset' with government benefits means:2.1
  35. Under provincial uniform accident and sickness legislation, the insurer must be notified of a claim:2.1
  36. A DI policy's 'return to work' benefit or 'transition' benefit is designed to:2.1
  37. A 'graded' or 'step-rate' premium structure on a DI policy means:2.1
  38. A 'guaranteed insurability' feature on a group LTD plan (non-evidence maximum) means:2.1
  39. A 'first day hospital' or 'zero-day accident' feature in a DI policy means:2.1
  40. The 'misstatement of age' provision in an A&S policy provides that:2.1
  41. Critical illness insurance pays:2.1
  42. Most comprehensive CI policies include 'partial payment' or 'early-stage' benefits, which:2.1
  43. A CI policy's 'moratorium' or 'exclusion period' for cancer means:2.1
  44. The 'survival period' in a CI policy:2.1
  45. A CI policy's definitions of covered conditions are important because:2.1
  46. CI policies are commonly available as:2.1
  47. Children's critical illness coverage typically:2.1
  48. Long-term care insurance benefits are triggered when the insured:2.1
  49. LTC policies pay benefits on either a 'reimbursement' or an 'indemnity (income)' basis. The difference is:2.1
  50. A typical LTC policy's benefit is defined by:2.1
  51. Group short-term disability (STD) plans typically:2.1
  52. Group LTD plans typically differ from individual DI in that group LTD:2.1
  53. A group extended health care plan typically covers:2.1
  54. 'Co-insurance' in a group health or dental plan means:2.1
  55. A group dental plan typically classifies services as:2.1
  56. Travel medical insurance generally:2.1
  57. A group benefits booklet lists AD&D coverage alongside life and LTD. The AD&D benefit pays:2.1
  58. A hospital indemnity (hospital cash) policy pays:2.1
  59. Employment Insurance sickness benefits are available to:2.1
  60. Which government program coordinates with an individual DI policy through a possible offset AND also affects the definition of insurable income?2.1
  61. A group plan's 'eligibility waiting period' (probationary period) is:2.1
  62. Under a group plan, 'evidence of insurability' is generally required when:2.1
  63. The 'birthday rule' in coordination of benefits provides that for dependent children:2.1
  64. A 'flexible benefits' (flex) group plan:2.1
  65. Under Canadian tax rules, employer-paid premiums for group extended health and dental coverage are:2.1
  66. A group LTD plan may be either 'insured' or 'administrative services only (ASO)'. Under ASO:2.1
  67. The 'conversion privilege' for group health coverage allows a terminating employee to:2.1
  68. CPP disability benefits stop when the beneficiary:2.1
  69. A 'return of premium' feature on a CI policy that refunds premiums at death:2.1
  70. A CI policy is generally owned personally and paid with after-tax dollars. Its benefit is:2.1
  71. A 'simplified issue' or 'guaranteed issue' DI or CI product is characterized by:2.1
  72. A new employer offers an extended health care plan. That private coverage exists mainly because provincial plans typically do NOT cover:2.1
  73. A DI policy that covers 'own occupation' for the full benefit period compared with one that covers own occupation for two years then 'any occupation':2.1
  74. Which statement about the taxation of group STD and LTD benefits is correct?2.1
  75. A group plan's 'pre-existing condition' limitation for LTD typically:2.1
  76. Which product pays a benefit to an insured who has a cognitive impairment such as dementia but no physical limitations?2.1
  77. A 'catastrophic' or 'high-deductible' drug plan is designed to:2.1
  78. An Employee Assistance Program typically provides:2.1
  79. A CI policy that is 'convertible' allows the insured to:2.1
  80. Which feature distinguishes disability insurance from critical illness insurance in the event a client is disabled by a condition NOT on the CI list, such as a severe back injury?2.1
  81. A future purchase option (FPO) rider on a disability policy lets the insured:2.2
  82. A cost-of-living adjustment (COLA) rider on a DI policy:2.2
  83. A return-of-premium rider on a DI policy typically:2.2
  84. An 'own occupation' rider added to a regular-occupation DI policy:2.2
  85. A residual disability rider:2.2
  86. A 'retirement protection' rider on a DI policy:2.2
  87. A 'hospital confinement' or 'first day hospital' rider on a DI policy:2.2
  88. A 'partial disability' rider (where not built in) typically pays:2.2
  89. A 'waiver of premium' rider on a CI policy:2.2
  90. A 'return of premium on surrender/expiry' rider on a CI policy:2.2
  91. A 'second event' or 'multiple payout' feature on a CI policy allows:2.2
  92. A 'long-term care conversion' option on a CI or DI policy allows:2.2
  93. An 'inflation protection' option on an LTC policy:2.2
  94. A 'return of premium on death' rider on an LTC policy:2.2
  95. A 'guaranteed insurability' or 'FPO' rider is most valuable to:2.2
  96. A 'lifetime benefit' rider on a DI policy typically:2.2
  97. A 'business overhead expense' benefit can sometimes be added to personal DI as a rider. Its purpose is:2.2
  98. A 'catastrophic disability' rider pays:2.2
  99. A 'regular occupation to 65' or 'extended regular occupation' rider addresses:2.2
  100. A client asks whether to add an accidental death and dismemberment rider to her DI policy. She should understand that the rider:2.2
  101. A 'CI rider' attached to a life or DI policy compared with a stand-alone CI policy:2.2
  102. A 'cost-of-living' feature that indexes the DI benefit BEFORE a claim (automatic increase benefit) differs from COLA in that it:2.2
  103. A 'survivor benefit' on a DI policy:2.2
  104. A 'child care' or 'dependent care' benefit rider on a CI policy:2.2
  105. When recommending riders, the agent should prioritize:2.2
  106. A 'medical/hospital expense' rider on a travel or health policy typically:2.2
  107. A 'waiver of premium' rider on an LTC policy typically waives premiums:2.2
  108. A 'shared care' or 'joint' LTC option for a couple:2.2
  109. A 'loss of licence' or 'professional licence' benefit in a DI policy for pilots or physicians:2.2
  110. A 'terminal illness' or 'accelerated' benefit within a CI or life policy:2.2
  111. A DI rider that pays an additional benefit for 'Social Insurance substitute' or 'integrated benefit' works by:2.2
  112. For a self-employed contractor with variable income, which two riders are most likely to be recommended together?2.2
  113. An 'exclusion rider' (impairment rider) on a DI policy:2.2
  114. Which rider is generally NOT available or NOT useful on a group LTD plan but is common on individual DI?2.2
  115. A 'premium refund at age 65' on an LTC or DI policy is a form of:2.2
  116. Which rider directly addresses the risk that a young insured's 30-year claim would lose half its purchasing power?2.2
  117. A 'spousal' or 'family' CI rider:2.2
  118. A 'non-cancellable' upgrade offered as a rider on a guaranteed renewable policy:2.2
  119. For a 62-year-old client with three years to retirement, which DI riders are generally poor value?2.2
  120. A 'home care' benefit option on an LTC policy:2.2
  121. A disability policy defines total disability as the inability to perform the important duties of the insured's own occupation. Under this definition the insured:2.1
  122. A 'regular occupation' definition of disability differs from a pure own-occupation definition because it:2.1
  123. A policy is described as non-cancellable and guaranteed renewable. This means the insurer:2.1
  124. A disability contract described as 'commencement of disability' for benefit period purposes means the benefit period is measured from:2.1
  125. A disability policy contains a 'presumptive disability' provision. Its effect is to:2.1
  126. A residual disability benefit is payable when the insured:2.2
  127. A disability contract requires the insured to be under the regular care of a physician. The purpose of this requirement is to:2.1
  128. A critical illness policy's survival period requires the insured to:2.1
  129. A long-term care policy that pays on a reimbursement basis will:2.1
  130. A long-term care policy's benefit trigger is most commonly expressed as:2.1
  131. An extended health care plan's co-insurance provision means the plan:2.1
  132. A dental plan's 'basic services' category normally includes:2.1
  133. A travel medical policy's 'stability period' clause requires that:2.1
  134. An accidental death and dismemberment policy pays a dismemberment benefit according to:2.1
  135. Employment insurance sickness benefits differ from a group short-term disability plan because they are:2.1
  136. A group long-term disability plan's 'own occupation period' is typically:2.1
  137. A group plan member takes a parental leave. Her group life and health coverage will usually:2.1
  138. A critical illness contract's 'covered conditions' list matters because:2.1
  139. A disability policy's 'misstatement of age' provision provides that, if the insured's age was wrong at issue:2.1
  140. A travel medical policy's emergency evacuation benefit covers:2.1
  141. A key person disability policy is owned by and payable to:2.1
  142. Workers' compensation differs from a private disability policy in that it:2.1
  143. A disability policy with an 'integrated' or 'social insurance' benefit is designed to:2.1
  144. A long-term care policy's elimination period is best described as:2.1
  145. An extended health plan's vision benefit is usually structured as:2.1
  146. A guaranteed insurability rider on a long-term care contract allows the owner to:2.2
  147. A guaranteed standard issue group disability arrangement differs from ordinary group coverage because it:2.1
  148. A critical illness policy's 'pre-existing condition' clause typically:2.1
  149. A disability policy sold on a 'cancellable' basis gives the insurer the right to:2.1
  150. A hospital indemnity contract differs from an extended health plan because it:2.1
  151. A long-term care contract written on an 'income' or indemnity-free basis pays:2.1
  152. A group plan's 'non-evidence maximum' for long-term disability means:2.1
  153. Travel medical coverage for a client with a chronic but stable heart condition will typically:2.1
  154. A disability policy's 'cost of living adjustment' provision applies:2.2
  155. An extended health plan's 'reasonable and customary' limit means the plan pays:2.1
  156. A group life and disability plan is renewed annually. For the member this means:2.1
  157. A critical illness policy's 'loss of independent existence' benefit is triggered by:2.1
  158. A disability contract's 'exclusions' most commonly include:2.1
  159. A group travel benefit that covers members 'for trips of up to sixty days' means that:2.1
  160. A disability policy's 'rehabilitation' provision typically allows the insurer to:2.1
  161. A critical illness contract's coverage of early-stage cancers is usually provided as:2.1
  162. A group accidental death and dismemberment plan written on a '24-hour' basis covers:2.1
  163. A short-term disability plan registered under the employment insurance premium reduction program must:2.1
  164. A disability contract's 'own occupation to age 65' feature is most valuable to:2.2
  165. An extended health plan's drug benefit administered through a 'managed formulary' means:2.1
  166. A group critical illness plan differs from an individual contract principally because it:2.1
  167. A disability policy's 'proof of loss' requirement obliges the claimant to:2.1
  168. A long-term care policy that pays for 'home care' typically requires:2.1
  169. A travel policy's 'trip interruption' benefit responds when:2.1
  170. A group short-term disability plan's benefit is usually expressed as:2.1
  171. A shared care rider on a couple's long-term care policies allows one spouse to:2.2
  172. A multiple-occurrence provision on a critical illness contract allows the insured to:2.2
  173. A student loan protection rider on a disability policy is designed to:2.2
  174. A non-forfeiture option on a long-term care policy provides that, if the client stops paying premiums:2.2
  175. A hospital confinement rider on a disability policy provides that:2.2
  176. A critical illness policy's 'return of premium on death' rider provides that:2.2
  177. A long-term care contract's inflation protection option typically:2.2
  178. A disability policy's automatic increase feature differs from a future purchase option because it:2.2
  179. A waiver of premium rider added to a critical illness policy usually waives premiums:2.2
  180. When recommending riders on a disability policy, the professional standard is to:2.2

3.Implement a recommendation adapted to the client's needs and situation

25% of the exam · 150 questions
  1. The four main areas of individual disability underwriting are:3.1
  2. Financial underwriting in DI is designed to:3.1
  3. A business owner applying for DI is usually asked for:3.1
  4. Occupational underwriting assigns a class based on:3.1
  5. Which medical history is most likely to result in an exclusion rider rather than a decline on a DI application?3.1
  6. Mental health history in DI underwriting:3.1
  7. Lifestyle underwriting for DI considers:3.1
  8. In CI underwriting, the most heavily weighted factor is typically:3.1
  9. A family history of two first-degree relatives with cancer before age 60 on a CI application is likely to result in:3.1
  10. LTC underwriting focuses on:3.1
  11. Possible outcomes of individual A&S underwriting include:3.1
  12. A 'postponement' decision means:3.1
  13. An applicant's disclosure of other disability coverage in force or applied for matters because:3.1
  14. The role of the attending physician's statement (APS) in A&S underwriting is to:3.1
  15. A paramedical examination for DI or CI typically includes:3.1
  16. The 'MIB' (Medical Information Bureau) in underwriting is:3.1
  17. Group underwriting differs from individual underwriting in that it evaluates:3.1
  18. Why do group insurers require a minimum participation percentage (often 75% for contributory plans, 100% for non-contributory)?3.1
  19. A group with a high proportion of employees in a hazardous industry will typically face:3.1
  20. In group underwriting, 'geographic location' matters because:3.1
  21. A group's 'prior claims experience' is used to:3.1
  22. Which group plan design feature most directly reduces the insurer's anti-selection risk?3.1
  23. The insurer's underwriting of a DI application is also influenced by the 'purpose' of the coverage because:3.1
  24. Smoker status in DI and CI underwriting is generally defined as:3.1
  25. Build (height and weight) affects A&S underwriting because:3.1
  26. Foreign residence or extended travel in DI underwriting may result in:3.1
  27. For a DI applicant whose income has been volatile for three years, the underwriter will most likely:3.1
  28. A newly self-employed applicant (six months in business) applying for DI is likely to face:3.1
  29. A group LTD member whose salary increases above the non-evidence maximum:3.1
  30. An applicant's failure to disclose a material fact on an A&S application, discovered within the contestability period, allows the insurer to:3.1
  31. Occupational classes are also used to set:3.1
  32. A DI applicant discloses a DUI conviction two years ago. The underwriter will likely:3.1
  33. For group health and dental, the insurer's underwriting of a small employer typically results in:3.1
  34. A CI applicant with a benign, resolved condition (for example, a removed skin lesion confirmed non-cancerous) is likely to be:3.1
  35. The underwriter's treatment of an applicant's 'existing group LTD' when reviewing an individual DI application is to:3.1
  36. Temporary or 'conditional' coverage during A&S underwriting:3.1
  37. An applicant for LTC insurance at age 72 will likely face:3.1
  38. When an insurer offers a DI policy with a rating and an exclusion, the agent's responsibility is to:3.1
  39. In DI underwriting, a 'duties questionnaire' or 'occupational supplement' is used when:3.1
  40. The genetic testing position in Canadian insurance underwriting is that insurers:3.1
  41. A recommendation for A&S coverage should be based on:3.2
  42. A 40-year-old self-employed architect with no group coverage, moderate savings and rising income. The most suitable core recommendation is:3.2
  43. A 30-year-old employee with employer-paid group LTD at 66% taxable to a cap below her salary. The most suitable individual recommendation is:3.2
  44. A client with a modest budget must choose between DI and CI. The agent's recommendation should generally:3.2
  45. For a business with two equal owners and a buy-sell agreement covering disability, the recommendation should include:3.2
  46. When recommending ownership of a personal DI policy for an incorporated professional, the agent should generally advise:3.2
  47. A recommendation for a 55-year-old with a family history of dementia and a desire to stay at home if care is needed should emphasize:3.2
  48. A group client with 12 employees, tight cash flow and high turnover. The recommended plan design would likely include:3.2
  49. A recommendation for a client who travels to the United States for three months each winter should include:3.2
  50. When a client's needs exceed the benefit an insurer will issue, the recommendation should:3.2
  51. A client asks whether to buy a CI rider on her life policy or a stand-alone CI policy. The recommendation should weigh:3.2
  52. A client's existing DI policy from ten years ago has an own-occupation definition, non-cancellable premium and no offsets, but a benefit now well below her income. The recommendation should be:3.2
  53. The recommended waiting period for a client with group STD lasting 26 weeks and six months of savings is most likely:3.2
  54. For a client who is uninsurable for individual DI, the recommendation should explore:3.2
  55. When presenting a DI recommendation, the agent should explain the definition of disability because:3.2
  56. A recommendation of a level-premium versus step-rate DI policy should be based on:3.2
  57. A recommendation for a physician's CI amount is commonly framed as:3.2
  58. When recommending group benefits, the agent should advise the employer that changing insurers frequently for lower premiums:3.2
  59. A client asks for a written recommendation. It should include:3.2
  60. For a dual-income couple with children where only one spouse has group LTD, the recommendation should:3.2
  61. Before proposing a recommendation, the agent should confirm which regulatory and professional obligations?3.2
  62. A client wants the cheapest DI available. The agent should:3.2
  63. For a business owner, the recommendation of BOE should specify:3.2
  64. A recommendation involving replacement of an existing A&S policy must:3.2
  65. A recommendation for a client in a hazardous occupation (roofer) who can only obtain a limited DI product should:3.2
  66. For a corporately owned CI policy on a shareholder, the agent should explain that:3.2
  67. When recommending a group LTD benefit formula, the agent should consider:3.2
  68. A recommendation for a client who wants both DI and CI but can afford only DI now should:3.2
  69. A client with a large emergency fund and high income asks whether a shorter waiting period is 'worth it'. The recommendation is usually:3.2
  70. A recommendation should address inflation for a 28-year-old client with a to-65 DI benefit by:3.2
  71. For an employer who wants to provide LTC-like protection to employees, the agent should advise that:3.2
  72. A recommendation must be presented in a way that:3.2
  73. For a client whose group EHC plan has a lifetime maximum on drug coverage, the recommendation could include:3.2
  74. When recommending CI for a client with a strong family history of heart disease, the agent should set expectations that:3.2
  75. The final element of a recommendation is to confirm that the client:3.2
  76. The A&S application is important because:3.3
  77. The agent's duty when completing an A&S application is to:3.3
  78. The 'duty of disclosure' in an A&S application requires the applicant to:3.3
  79. For an A&S contract to be formed, the following must generally occur:3.3
  80. If the client's health changes between application and delivery (for example, a new diagnosis), the agent must:3.3
  81. At policy delivery, the agent should:3.3
  82. The 'free-look' or rescission period gives the policyowner the right to:3.3
  83. Which implementation requirement is unique to disability buyout or key person coverage compared with personal DI?3.3
  84. For group implementation, the employer must typically:3.3
  85. A 'pre-authorized debit' (PAD) premium arrangement requires:3.3
  86. When an insurer issues a DI policy 'other than as applied for' (for example, a longer waiting period), the policy is:3.3
  87. Privacy obligations during implementation require the agent to:3.3
  88. The 'effective date' of an individual A&S policy is generally:3.3
  89. Fraud in the application (deliberate misstatement) has the consequence that:3.3
  90. For a CI application, the implementation step should specifically confirm that the client understands:3.3
  91. For LTC implementation, the insurer may require:3.3
  92. If a client refuses to answer an application question, the agent should:3.3
  93. The agent's record-keeping obligation at implementation includes:3.3
  94. For a group plan, the 'plan document' or 'booklet' given to employees:3.3
  95. The first premium for an individual A&S policy is usually collected:3.3
  96. Which statement about the agent's authority in implementing an A&S policy is correct?3.3
  97. For a DI application involving replacement of an existing policy, the implementation should ensure:3.3
  98. If the client is not the person paying the premium (for example, a parent paying for an adult child's DI), the implementation should:3.3
  99. The agent should tell the client that underwriting for DI or CI typically takes:3.3
  100. The final step in implementing an A&S recommendation is:3.3
  101. An underwriter assigns a disability applicant to occupational class 2 rather than class 4. The practical effect is that:3.1
  102. A disability applicant discloses a back condition that resolved four years ago with no recurrence. The likely underwriting outcome is:3.1
  103. Financial underwriting for an individual disability application exists to:3.1
  104. A critical illness applicant's mother and sister both had breast cancer before fifty. The underwriter is likely to:3.1
  105. An applicant for long-term care coverage is seventy-two. The insurer is most likely to require:3.1
  106. Group long-term disability coverage within the non-evidence maximum is issued without individual medical questions because:3.1
  107. An applicant is a professional with a high income but heavy business debt. In financial underwriting the debt:3.1
  108. An applicant for disability coverage holds a private pilot's licence and flies about fifty hours a year. The usual outcome is:3.1
  109. An applicant's build falls outside the insurer's height and weight table. For disability coverage this is likely to mean:3.1
  110. For a small group applying for its first disability plan, the insurer's main underwriting concern is:3.1
  111. An applicant reports taking medication for anxiety, prescribed by a family physician. The agent should expect the underwriter to:3.1
  112. Whether an A&S applicant must complete a paramedical examination is normally decided by:3.1
  113. An applicant is postponed rather than declined for critical illness coverage. This means:3.1
  114. An applicant answers the tobacco question as a non-smoker but a urine sample detects nicotine. The insurer will:3.1
  115. A group client asks why the insurer wants two years of claims experience before quoting. The reason is that:3.1
  116. An applicant for disability coverage works two jobs totalling seventy hours a week. The underwriter is likely to:3.1
  117. An applicant's disability policy is issued with an exclusion rider for a knee injury. Some years later the client asks whether it can be removed. The agent should:3.1
  118. Simplified issue A&S products ask fewer medical questions than fully underwritten contracts. The trade-off is that they:3.1
  119. A client can afford either a shorter waiting period or a longer benefit period, but not both. The agent should generally recommend:3.2
  120. A corporately employed client asks whether the corporation should own her personal disability policy. The agent should explain that:3.2
  121. A client's group plan already provides sixty per cent of salary to a monthly maximum. The individual recommendation should:3.2
  122. A client in his late fifties asks how long his disability benefit period should run. The recommendation should usually be:3.2
  123. A client wants the lowest possible disability premium and asks the agent to remove the residual benefit. The agent should:3.2
  124. An employer asks how to design a group long-term disability plan that best serves its employees. The agent should raise:3.2
  125. A client's needs analysis supports both disability and critical illness coverage, but the budget covers only one. The agent should ordinarily:3.2
  126. A self-employed client with no group coverage is recommended a disability policy. The agent should also consider:3.2
  127. A client asks whether to buy critical illness coverage with or without a return of premium rider. The agent should explain that:3.2
  128. A client's occupational class makes an own-occupation definition unavailable. The agent should:3.2
  129. A group client wants to reduce the cost of its benefits plan. The design change most likely to preserve catastrophic protection is:3.2
  130. A client asks why the agent recommends a shorter waiting period than the one that would be cheapest. The best answer is:3.2
  131. A client with a modest budget and dependent children asks what to cover first. The recommendation should address:3.2
  132. A client asks whether her disability benefit should be indexed. The agent should explain that indexing:3.2
  133. An employer asks whether to pay the long-term disability premium or have employees pay it. The agent should explain that:3.2
  134. A client asks the agent to compare two disability quotes that differ in price by a significant margin. The agent should compare:3.2
  135. A client's recommendation includes long-term care coverage at age fifty-eight. The agent should explain that buying now:3.2
  136. Before submitting an A&S application, the agent must ensure that:3.3
  137. A client pays the first premium with the disability application. The agent should explain that this:3.3
  138. An A&S policy is issued with a rating and an exclusion. At delivery the agent must:3.3
  139. The agent must verify the client's identity for a large annuity-style A&S transaction because:3.3
  140. A client asks whether a disability policy can be backdated so that premiums start next month. The agent should explain that:3.3
  141. A client tells the agent at delivery that she has seen a specialist since applying. The agent must:3.3
  142. An A&S application asks whether the applicant has other coverage in force or pending. The purpose is to:3.3
  143. The agent's file for an implemented A&S recommendation should contain:3.3
  144. A client wants to pay the premium for his adult daughter's disability policy. At implementation the agent must:3.3
  145. A group A&S plan is being implemented. The sponsor must provide:3.3
  146. At delivery the agent should explain the A&S policy's claim procedure because:3.3
  147. An agent implementing a replacement of an existing A&S policy must:3.3
  148. A client asks whether her A&S policy can be cancelled after delivery if she changes her mind. The agent should explain:3.3
  149. A client's A&S application is declined. The agent's responsibility is to:3.3
  150. The implementation of an A&S recommendation is complete when:3.3

4.Provide customer service during the validity period of the coverage

10% of the exam · 60 questions
  1. A client asks to increase her DI benefit two years after issue without an FPO rider. The agent should explain that the increase:4.1
  2. A client asks to reduce his DI benefit to save premium. The agent should:4.1
  3. A DI policyholder changes from an office job to a construction job. The correct service action is:4.1
  4. An exclusion rider for a knee condition was added three years ago; the client has been symptom-free since. The agent should:4.1
  5. A client's DI policy is guaranteed renewable and the insurer announces a class premium increase. The agent should explain:4.1
  6. A client wants to cancel his DI policy because he has 'never used it'. The agent should:4.1
  7. A group member leaves employment. The agent should inform them that their group coverage:4.1
  8. A DI policy lapses because a PAD payment failed while the client was travelling. The client returns within 45 days. The agent should:4.1
  9. A client exercises an FPO option. The insurer will require:4.1
  10. A CI policyholder's term-10 policy is approaching renewal with a large premium increase. The service conversation should cover:4.1
  11. A client asks to add a COLA rider to an existing DI policy. The agent should explain that:4.1
  12. A group plan sponsor asks to change the LTD formula from employer-paid to employee-paid mid-year. The agent should explain:4.1
  13. A client's DI policy reaches its expiry age (65). The agent should explain that:4.1
  14. The purpose of a periodic A&S policy review is to:4.1
  15. A group member's spouse gains coverage under their own employer's plan. The member should:4.1
  16. A client with a non-cancellable DI policy stops paying premiums after a dispute with the insurer about a claim. The agent should warn that:4.1
  17. When a client moves to another province, the agent should:4.1
  18. A group sponsor asks to terminate the plan. The agent should advise:4.1
  19. A client's address, name and banking details change after marriage. For A&S policies, the agent should:4.1
  20. An insurer proposes to cancel a 'cancellable' A&S policy at renewal. The agent should:4.1
  21. The first thing an agent should tell a client who becomes disabled is to:4.2
  22. A disability claim typically requires:4.2
  23. The agent's role in the claims process is to:4.2
  24. A client diagnosed with cancer asks what her critical illness insurer will require before paying. The claim requires:4.2
  25. A client whose father can no longer bathe or dress himself asks how to claim on his long-term care policy. The claim requires:4.2
  26. A claimant asks how long the insurer may take to pay a disability benefit once proof is received. The agent should explain:4.2
  27. The insurer requests an 'independent medical examination' (IME) during a DI claim. The claimant should be told:4.2
  28. A claimant on DI benefits wants to try returning to work part-time. The agent should explain:4.2
  29. A group LTD claimant is told to apply for CPP disability. This is because:4.2
  30. A claim is denied. The agent should:4.2
  31. Benefits from a personally owned, personally paid DI policy received during a claim are:4.2
  32. A claimant receiving DI benefits asks whether she must keep paying premiums. The agent should explain:4.2
  33. For an extended health claim (for example, a prescription), the claimant typically:4.2
  34. A travel medical claim while abroad should be handled by:4.2
  35. A DI claimant dies during a claim. The agent should:4.2
  36. A claimant's DI benefit is being reduced under the relation-of-earnings provision because his income fell before disability. The agent should explain:4.2
  37. A group LTD claimant is approaching the two-year definition change. The agent should tell her:4.2
  38. A CI claim is filed for a heart attack; the insurer requests cardiac enzyme and ECG evidence. The claimant asks why a doctor's letter is not enough. The agent should explain:4.2
  39. The claimant asks whether the agent will be told about her medical details during the claim. The agent should explain:4.2
  40. A claimant on a residual disability benefit must provide, in addition to medical proof:4.2
  41. A client asks to reduce the waiting period on his in-force disability policy. The agent should explain that the change:4.1
  42. A client's disability policy lapsed six weeks ago for non-payment. The agent should:4.1
  43. A client on claim asks whether she must keep paying premiums. The accurate answer depends on:4.1
  44. A client's non-cancellable disability policy reaches the expiry age stated in the contract. At that point:4.1
  45. A client changes from an office role to a construction site role. The agent should:4.1
  46. A client wants to exercise the future purchase option on her disability policy. The agent should confirm:4.1
  47. A group member leaves her employer. For her extended health coverage the agent should explain:4.1
  48. A client asks the agent to cancel her critical illness policy because money is tight. The agent should first:4.1
  49. A client's long-term care policy includes an inflation protection option she declined at issue. At review the agent should:4.1
  50. A client's disability policy has been in force for three years and he asks to increase the benefit. The agent should explain that:4.1
  51. A client begins a disability claim. The notice obligation under the statutory conditions requires that:4.2
  52. A group long-term disability claim normally requires three statements, from the claimant, the physician and:4.2
  53. A claimant's disability benefits are reduced because she has been approved for a government disability benefit. This reflects:4.2
  54. A critical illness claimant is asked for a specialist's report and diagnostic test results. This is because:4.2
  55. A disability claimant tells the agent she is moving abroad while her claim continues. The agent should explain that:4.2
  56. A long-term care claim requires the claimant to establish that:4.2
  57. An extended health claim is denied because the service was provided by an unregistered practitioner. The agent should:4.2
  58. A travel medical claim is denied because the client's blood pressure medication was adjusted shortly before departure. The reason is:4.2
  59. A disability claim is denied and the claimant disagrees. The agent should explain that the next steps are:4.2
  60. After a client's A&S claim has been paid, the agent's continuing service should include:4.2

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