LLQP Accident & Sickness · Component 1.2 · 35% of the exam
Which of the following is a legitimate reason a group member's LTD claim might be denied even though he cannot do his job?
- AHe is over 40, and the plan's coverage reduces with age until it ends at the normal retirement date
- The definition has moved to 'any occupation' and he could do other suitable work
- CHe has dependent children, which lowers the plan's benefit formula
- DHe has paid premiums for fewer than five years
Correct answer: B) The definition has moved to 'any occupation' and he could do other suitable work
Group plans deny claims under any-occupation definitions and pre-existing condition clauses (for new members). Knowing these provisions is part of assessing whether the group coverage is appropriate.
Why the other options are wrong
- AAge is not a ground for denial in group LTD.
- CDependants have no bearing on LTD eligibility.
- DLength of premium payment is not a claim condition.
Exam tip
Group LTD denials: any-occ definition, pre-existing condition limitations, offsets.
Common mistake
Assuming group LTD pays whenever the member cannot do their own job.
What this tests
CISRO competency component 1.2 — Assess the client's needs and situation — which is weighted at 35% of the Accident & Sickness module. Written against the published curriculum.
More from component 1
- The single most important fact for sizing a client's disability income need is:
- A client's beneficiaries for assets are listed in the fact-finding. Why does this matter for A&S planning?
- A client asks why the agent wants to know how assets are owned (jointly or individually). In the A&S context the answer is:
- A client mentions a back injury five years ago that fully resolved. The agent should:
- Which element of a client's situation most affects the definition of disability that should be recommended?
- Which of the following health facts is most relevant to a client's disability insurance situation?
Practice the whole Accident & Sickness module
Timed sets weighted like the exam, and review of every question you miss. Free to start.