LLQP Accident & Sickness · Component 4.2 · 10% of the exam
A group long-term disability claim normally requires three statements, from the claimant, the physician and:
- AA second physician, providing an independent opinion on the diagnosis
- BThe claimant's spouse, confirming the household's financial circumstances
- CThe insurance agent who arranged the group plan for the employer
- The employer, confirming earnings, job duties and the last day worked
Correct answer: D) The employer, confirming earnings, job duties and the last day worked
The employer's statement establishes the earnings on which the benefit is calculated and the occupational duties against which the definition is applied.
Why the other options are wrong
- AA second opinion is sought only if the insurer decides to examine.
- BHousehold finances are not part of a group disability claim.
- CThe agent assists the claimant but files no part of the claim.
Exam tip
Claimant, physician, employer: three statements.
Common mistake
Submitting a group claim without the employer's portion.
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.