LLQP Accident & Sickness · Component 4.2 · 10% of the exam
A group LTD claimant is approaching the two-year definition change. The agent should tell her:
- The insurer will reassess under the any-occupation test, and her medical evidence should be current
- BNothing changes at two years, since the definition applies for the full benefit period once a claim is approved
- CShe must quit her job before the two-year point, since continuing employment would disqualify her
- DBenefits automatically continue to age 65 once a claim has been paid for two consecutive years
Correct answer: A) The insurer will reassess under the any-occupation test, and her medical evidence should be current
The definition change is the most common point of claim termination. Preparing the claimant with evidence is practical service.
Why the other options are wrong
- BThe definition test changes at two years from own occupation to any occupation.
- CShe is already not working.
- DContinuation depends on the new test.
Exam tip
Prepare group LTD claimants for the any-occ reassessment.
Common mistake
Letting a claimant be surprised by the two-year change.
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.