LLQP Accident & Sickness · Component 2.1 · 30% of the exam
A critical illness contract's 'covered conditions' list matters because:
- AThe insurer must pay for any serious condition a physician certifies, listed or not
- BA longer list always means a better contract, whatever the definitions behind it
- CEvery insurer uses the same list of conditions, so the number covered is a marketing point only
- Conditions not on the list, or not meeting the contract's definition, produce no benefit
Correct answer: D) Conditions not on the list, or not meeting the contract's definition, produce no benefit
Critical illness is a defined-event product, so both the presence of the condition on the list and the precise wording of its definition decide whether a claim succeeds.
Why the other options are wrong
- AA physician's opinion cannot add a condition the contract does not cover.
- BA long list of narrowly defined conditions can be worse than a short list of broad ones.
- CLists and definitions differ materially between insurers.
Exam tip
Read the definitions, not just the count of conditions.
Common mistake
Comparing critical illness contracts by the number of conditions alone.
What this tests
CISRO competency component 2.1 — Analyze the available products that meet the client's needs — which is weighted at 30% of the Accident & Sickness module. Written against the published curriculum.
More from component 2
- A group benefits booklet lists AD&D coverage alongside life and LTD. The AD&D benefit pays:
- A hospital indemnity (hospital cash) policy pays:
- Employment Insurance sickness benefits are available to:
- Which government program coordinates with an individual DI policy through a possible offset AND also affects the definition of insurable income?
- A group plan's 'eligibility waiting period' (probationary period) is:
- A CI policy that is 'convertible' allows the insured to:
Practice the whole Accident & Sickness module
Timed sets weighted like the exam, and review of every question you miss. Free to start.