LLQP Accident & Sickness · Component 1.2 · 35% of the exam
A client's extended health plan pays paramedical services to a per-practitioner annual maximum. The review should note that:
- AThe maximum applies to the family as a whole, so one member's claims exhaust it for everyone
- Extended chiropractic or physiotherapy after an injury can exhaust the maximum quickly
- CThe maximum resets every time the member changes practitioners within the same category
- DParamedical maximums are set by provincial regulation and are identical in every plan
Correct answer: B) Extended chiropractic or physiotherapy after an injury can exhaust the maximum quickly
A per-practitioner cap is easily reached during rehabilitation after a significant injury, which is exactly when the member most needs the service, so the shortfall belongs in the analysis.
Why the other options are wrong
- AParamedical maximums normally apply per covered person, not per family.
- CChanging practitioners within a category does not create a fresh maximum.
- DParamedical limits are plan design choices and vary widely.
Exam tip
Paramedical caps bite hardest during rehabilitation.
Common mistake
Describing paramedical coverage as unlimited because it is listed in the booklet.
What this tests
CISRO competency component 1.2 — Assess the client's needs and situation — which is weighted at 35% of the Accident & Sickness module. Written against the published curriculum.
More from component 1
- The single most important fact for sizing a client's disability income need is:
- A client's beneficiaries for assets are listed in the fact-finding. Why does this matter for A&S planning?
- A client asks why the agent wants to know how assets are owned (jointly or individually). In the A&S context the answer is:
- A client mentions a back injury five years ago that fully resolved. The agent should:
- Which element of a client's situation most affects the definition of disability that should be recommended?
- Which of the following health facts is most relevant to a client's disability insurance situation?
Practice the whole Accident & Sickness module
Timed sets weighted like the exam, and review of every question you miss. Free to start.