LLQP Accident & Sickness · Component 4.2 · 10% of the exam
A client diagnosed with cancer asks what her critical illness insurer will require before paying. The claim requires:
- AProof of income loss, since the lump sum is calculated on the earnings the claimant has given up
- BAn employer's statement confirming the claimant has stopped working because of the illness
- CA diagnosis letter from the family physician, which the insurer accepts without further evidence
- A claim form, specialist confirmation that the definition is met with supporting tests, and the survival period
Correct answer: D) A claim form, specialist confirmation that the definition is met with supporting tests, and the survival period
CI claims turn on definitions and evidence. Specialist confirmation is usually required.
Why the other options are wrong
- ACI does not require income loss.
- BEmployment is irrelevant to CI.
- CThe definition must be met with evidence.
Exam tip
CI claim: definition met + specialist evidence + survival period.
Common mistake
Filing a CI claim before the survival period has elapsed and calling it denied.
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.