LLQP Accident & Sickness · Component 4.2 · 10% of the exam
A claimant on DI benefits wants to try returning to work part-time. The agent should explain:
- AAny work must be kept from the insurer, since the policy pays only while the claimant is not working
- BAny return to work ends the claim entirely, and a relapse would require a new waiting period
- CBenefits double during the first months back at work to reward the claimant's effort
- Residual, partial and recurrent provisions may support a gradual return; the insurer should be told first
Correct answer: D) Residual, partial and recurrent provisions may support a gradual return; the insurer should be told first
Return-to-work provisions are designed for this. Concealing work is fraud.
Why the other options are wrong
- AConcealment is fraud.
- BResidual provisions allow work with reduced benefits.
- CBenefits reduce with earnings.
Exam tip
Return to work: use residual/partial, recurrent protection; inform insurer.
Common mistake
Not informing the insurer of a return to work.
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.