LLQP Accident & Sickness · Component 4.2 · 10% of the exam
A claimant asks how long the insurer may take to pay a disability benefit once proof is received. The agent should explain:
- AImmediately on receipt of the claim form, since the insurer has already underwritten the risk
- Within the period set by statute and the policy after satisfactory proof, with benefits paid monthly in arrears
- COnly after litigation, since insurers routinely deny first claims and pay only when compelled by a court
- DWithin one year of the claim, which is the period the statutory conditions allow for investigation
Correct answer: B) Within the period set by statute and the policy after satisfactory proof, with benefits paid monthly in arrears
Statutory conditions set payment timelines after proof. Delays usually stem from incomplete proof.
Why the other options are wrong
- AAssessment takes time.
- CLitigation is exceptional.
- DA year is far outside the statutory and contractual payment timelines.
Exam tip
Payment follows satisfactory proof within the contractual/statutory period; monthly in arrears.
Common mistake
Failing to explain 'in arrears' to a cash-strapped claimant.
What this tests
CISRO competency component 4.2 — Provide customer service during the validity period of the coverage — which is weighted at 10% of the Accident & Sickness module. Written against the published curriculum.
More from component 4
- The agent's role in the claims process is to:
- 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:
- When a client moves to another province, the agent should:
- A client asks to reduce the waiting period on his in-force disability policy. The agent should explain that the change:
- A client's disability policy lapsed six weeks ago for non-payment. The agent should:
- A client on claim asks whether she must keep paying premiums. The accurate answer depends on:
Practice the whole Accident & Sickness module
Timed sets weighted like the exam, and review of every question you miss. Free to start.