LLQP Accident & Sickness · Component 2.1 · 30% of the exam
A long-term care policy that pays on a reimbursement basis will:
- APay only after the provincial plan has refused to fund the resident's accommodation
- BPay a fixed monthly amount once the benefit triggers are met, whatever the actual cost of the care
- Pay the eligible costs actually incurred, up to the policy's maximum, on proof of expense
- DPay the insured's income during the period in which care is being received
Correct answer: C) Pay the eligible costs actually incurred, up to the policy's maximum, on proof of expense
A reimbursement contract requires receipts for covered services and pays the lesser of the cost and the benefit maximum, which suits clients using formal providers.
Why the other options are wrong
- APrivate coverage does not wait for a provincial refusal.
- BA fixed payment regardless of cost describes an income-style contract.
- DLong-term care coverage funds care costs, not lost income.
Exam tip
Reimbursement needs receipts; income-style does not.
Common mistake
Promising reimbursement benefits to a client using unpaid family care.
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.