LLQP Accident & Sickness · Component 4.2 · 10% of the exam
A travel medical claim is denied because the client's blood pressure medication was adjusted shortly before departure. The reason is:
- AThe provincial plan's refusal to reimburse any portion of the foreign hospital's charges
- The policy's stability clause, which required the condition to be unchanged for a stated period
- CThe trip length limit, which was exceeded before the medical emergency occurred while he was abroad
- DA failure to notify the insurer of the itinerary before leaving the home province
Correct answer: B) The policy's stability clause, which required the condition to be unchanged for a stated period
A change of medication or dosage inside the stability window brings the condition outside the coverage, which is the commonest cause of denied travel claims.
Why the other options are wrong
- AThe provincial plan's contribution does not determine the private insurer's liability.
- CA trip length limit is a different provision and was not the stated reason.
- DTravel policies do not require an itinerary to be filed in advance.
Exam tip
Review recent medication changes before selling travel coverage.
Common mistake
Selling travel coverage without asking what has changed recently.
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.