LLQP Accident & Sickness · Component 4.2 · 10% of the exam
A claimant's disability benefits are reduced because she has been approved for a government disability benefit. This reflects:
- The contract's offset provision, which counts listed benefits against the amount the insurer pays
- BA penalty for applying to the government programme without the insurer's prior written consent
- CAn error by the insurer, since government benefits are paid in addition to private coverage
- DThe end of the claim, since approval elsewhere means the private insurer's obligation is discharged
Correct answer: A) The contract's offset provision, which counts listed benefits against the amount the insurer pays
Offsets are designed to keep combined income below the contract's ceiling, and plans commonly require claimants to apply for the government benefit in the first place.
Why the other options are wrong
- BClaimants are usually required to apply, not penalized for doing so.
- COffsetting is the ordinary operation of the contract.
- DThe private claim continues; only the amount changes.
Exam tip
Offsets reduce the payment, not the entitlement.
Common mistake
Projecting a claimant's income by adding every benefit at its full amount.
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.