LLQP Accident & Sickness · Component 2.1 · 30% of the exam
The 'legal actions' provision in an A&S policy:
- ARequires all disputes over claims to go to binding arbitration rather than to the courts
- BApplies only to group plans, since individual policies are governed by ordinary contract law
- Sets the window for suing the insurer — after a minimum period, before a limitation period
- DProhibits any lawsuit against the insurer while the insured is still receiving benefits
Correct answer: C) Sets the window for suing the insurer — after a minimum period, before a limitation period
Uniform accident and sickness provisions and provincial limitation statutes govern when a claimant can sue. Agents should know that delay can bar a claim.
Why the other options are wrong
- AArbitration is not mandated.
- BIt applies to individual policies under the statutory conditions.
- DLawsuits are permitted within the window.
Exam tip
Legal action: not before the minimum period after proof, not after the limitation period.
Common mistake
Advising a claimant they can sue at any time.
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.