LLQP Accident & Sickness · Component 4.1 · 10% of the exam
An exclusion rider for a knee condition was added three years ago; the client has been symptom-free since. The agent should:
- ADo nothing, since an exclusion rider is a permanent term of the contract that cannot be revisited
- BTell the client to file a claim for the knee, so that the insurer is forced to reconsider the exclusion
- CRewrite the policy with a new application, since that is the only way to obtain coverage without the exclusion
- Ask the insurer to review and remove the exclusion, with medical evidence of recovery
Correct answer: D) Ask the insurer to review and remove the exclusion, with medical evidence of recovery
The curriculum lists 'review or removal of exclusions based on policy timelines'. Periodic review of exclusions is a service duty.
Why the other options are wrong
- AThe exclusion may be removable.
- BNo claim exists because the client has been symptom-free; the issue is the exclusion.
- CRewriting loses the original terms.
Exam tip
Review exclusions for removal once the condition is stable.
Common mistake
Never revisiting an exclusion rider.
What this tests
CISRO competency component 4.1 — 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.