LLQP Accident & Sickness · Component 3.1 · 25% of the exam
An applicant's disability policy is issued with an exclusion rider for a knee injury. Some years later the client asks whether it can be removed. The agent should:
- ATell the client the exclusion expired automatically once the contestability period had passed
- BExplain that exclusion riders are permanent terms of the contract and can never be reconsidered
- Submit a request with current medical evidence, since insurers will review an exclusion after a clear period
- DAdvise the client to let the policy lapse and reapply, since a new contract will be issued without the exclusion
Correct answer: C) Submit a request with current medical evidence, since insurers will review an exclusion after a clear period
Insurers will reconsider an exclusion where the condition has remained symptom-free and treatment-free, and the request costs the client nothing but a medical update.
Why the other options are wrong
- AExclusions are contract terms and do not expire with contestability.
- BReconsideration is a routine service request.
- DLapsing and reapplying risks a new exclusion, a higher age and new contestability.
Exam tip
Old exclusions are worth asking about once the history is clear.
Common mistake
Leaving a removable exclusion in place for years.
What this tests
CISRO competency component 3.1 — Implement a recommendation adapted to the client's needs and situation — which is weighted at 25% of the Accident & Sickness module. Written against the published curriculum.
More from component 3
- An underwriter assigns a disability applicant to occupational class 2 rather than class 4. The practical effect is that:
- A disability applicant discloses a back condition that resolved four years ago with no recurrence. The likely underwriting outcome is:
- Financial underwriting for an individual disability application exists to:
- A critical illness applicant's mother and sister both had breast cancer before fifty. The underwriter is likely to:
- An applicant for long-term care coverage is seventy-two. The insurer is most likely to require:
- Group long-term disability coverage within the non-evidence maximum is issued without individual medical questions because:
Practice the whole Accident & Sickness module
Timed sets weighted like the exam, and review of every question you miss. Free to start.