LLQP Accident & Sickness · Component 2.1 · 30% of the exam
A disability policy's 'proof of loss' requirement obliges the claimant to:
- Provide medical and financial evidence at the start of the claim and on a continuing basis
- BProvide proof only for claims that continue beyond the policy's benefit period
- CProvide a single medical certificate, after which no further evidence may be requested
- DProve the disability in a court of law before the insurer is obliged to consider the claim at all
Correct answer: A) Provide medical and financial evidence at the start of the claim and on a continuing basis
Benefits are payable only while the disability continues, so the insurer is entitled to periodic confirmation of the claimant's condition and, for residual claims, of earnings.
Why the other options are wrong
- BProof is required from the outset of the claim.
- CContinuing proof is standard and can suspend benefits if it is not provided.
- DCourt proceedings arise only where a claim has been denied and is disputed.
Exam tip
Proof of loss is initial and ongoing.
Common mistake
Assuming one physician's statement supports an entire claim.
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.