LLQP Ethics & Professional Practice · Component 1.6 · 60% of the exam
A claim under a critical illness policy requires:
- AOnly a diagnosis letter from the family physician, which the insurer must accept as conclusive
- BProof of income loss, since the benefit replaces the earnings the insured cannot generate while ill
- A claim form and specialist evidence that the definition is met, submitted after the survival period
- DEmployer confirmation that the insured has stopped working, since the benefit is conditional on absence from work
Correct answer: C) A claim form and specialist evidence that the definition is met, submitted after the survival period
CI claims are definition-driven and follow the A&S statutory conditions on notice and proof.
Why the other options are wrong
- AEvidence that the policy definition is met is needed.
- BCI does not depend on income loss.
- DEmployer confirmation is not required for individual CI.
Exam tip
CI claim: definition met, specialist evidence, survival period passed.
Common mistake
Filing a CI claim before the survival period ends and treating a hold as a denial.
What this tests
CISRO competency component 1.6 — Integrate into practice the legal aspects of insurance and annuity contracts — which is weighted at 60% of the Ethics & Professional Practice module. Written against the published curriculum.
More from component 1
- An 'assignee' of a life insurance policy is:
- A corporation as policyowner and beneficiary of a policy on a key employee:
- A 'trustee' named to receive proceeds on behalf of a beneficiary:
- The 'automatic premium loan' (APL) provision:
- A life insurance contract 'matures' when:
- The 'assignment' provision typically states that:
Practice the whole Ethics & Professional Practice module
Timed sets weighted like the exam, and review of every question you miss. Free to start.