LLQP Segregated Funds & Annuities · Component 4.2 · 10% of the exam
If a claim is denied or delayed, the beneficiary's recourse includes:
- AThe police, since a delayed insurance payment is treated as a fraud on the beneficiary
- BOnly the agent, who negotiates with the insurer on the beneficiary's behalf until the claim is paid
- The insurer's complaint process, then OLHI, and ultimately the courts within the limitation period
- DNothing, since the insurer's claims decision is final under the terms of the contract
Correct answer: C) The insurer's complaint process, then OLHI, and ultimately the courts within the limitation period
The complaint escalation path is standard for life and health insurance products, including seg funds and annuities.
Why the other options are wrong
- AA claim dispute is not a criminal matter.
- BThe agent cannot resolve disputes; formal channels exist.
- DA beneficiary has a defined complaint and appeal path.
Exam tip
Complaint path: insurer → OLHI → court.
Common mistake
Missing the limitation period.
What this tests
CISRO competency component 4.2 — Provide customer service during the validity period of the coverage — which is weighted at 10% of the Segregated Funds & Annuities module. Written against the published curriculum.
More from component 4
- A client's daughter was born last month and the client wants her added to the segregated fund designation. The agent should:
- A client wants to withdraw part of his segregated fund before maturity. The agent should explain:
- A client's segregated fund contract is approaching its maturity date. The insurer will:
- A client asks to add her adult son as a joint owner of her non-registered segregated fund contract. The agent should explain that:
- A client wants to replace the beneficiary on a contract where the current designation was made irrevocable. The agent must explain that:
- A client who has lost her job asks to pause her pre-authorized monthly contributions for six months. The agent should:
Practice the whole Segregated Funds & Annuities module
Timed sets weighted like the exam, and review of every question you miss. Free to start.