LLQP Accident & Sickness · Component 2.1 · 30% of the exam
A critical illness policy's 'pre-existing condition' clause typically:
- AReduces the benefit by half for any condition first investigated before the policy was issued
- Excludes claims arising from conditions present before issue, within a stated period
- CExcludes all claims for the first two years regardless of the cause of the condition
- DApplies only to conditions the insured did not know about at the time of application
Correct answer: B) Excludes claims arising from conditions present before issue, within a stated period
Pre-existing clauses are common in simplified-issue and group critical illness, where limited underwriting at issue is balanced by an exclusion that looks back at the insured's history.
Why the other options are wrong
- AThe usual effect is exclusion of the claim, not a partial payment.
- CThe clause targets prior conditions, not every claim in the period.
- DUndiagnosed conditions the insured could not know about are treated differently.
Exam tip
Light underwriting at issue means a pre-existing clause at claim.
Common mistake
Selling simplified-issue coverage without explaining the look-back.
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.