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LLQP · Accident and Sickness Insurance

600 Accident & Sickness Practice Questions

Grouped by the competency components CISRO uses to build the exam, in the same proportions. Each question opens to its answer and a worked explanation.

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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