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LLQP (life licence)

LifeLLQP Life Insurance✓A&SLLQP Accident & Sickness Insurance Seg FundsLLQP Segregated Funds & Annuities EthicsLLQP Ethics & Professional Practice (Common Law)

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Accident and Sickness · Component 2: products (30%)

Critical Illness, LTC, Health & Travel

Lump-sum critical illness cover, long-term care benefits triggered by activities of daily living, and the reimbursement products (extended health, dental, travel, AD&D) that fill gaps in provincial coverage.

Analyze the available products2 min read6 sections

Must-know for the exam

Critical illness pays a lump sum after diagnosis of a covered condition and survival of the survival period, commonly 30 days.
A 90-day cancer moratorium commonly excludes cancers with signs or diagnosis in the first 90 days.
Cancer, heart attack and stroke drive most CI claims; the policy's definitions decide payment.
Personally paid CI benefits are generally tax-free; employer-paid group CI premiums are a taxable benefit (ITA s. 6(1)(e.1)).
LTC commonly pays when you cannot do 2 or 3 activities of daily living or have a cognitive impairment.
Reimbursement LTC pays actual costs up to a limit; income LTC pays the set amount once you qualify.
Extended health covers drugs, paramedical and vision care not covered by the province, after deductibles and coinsurance.
Travel medical covers emergencies abroad; check pre-existing stability clauses and trip-length limits.
AD&D pays for accidental death or listed losses only, using a schedule of percentages.

On this page · 6 sections

Traps that cost marks

Treating CI as disability income or life insurance.
Expecting CI to pay when death occurs within the survival period.
Ignoring the moratorium on early cancers.
Expecting chronic conditions to trigger CI.
Assuming any diagnosis of the named condition pays.
Assuming early-stage benefits exhaust the policy.
Thinking CI pays its benefit on death.
Confusing the ROP refund with the CI benefit.

Why it matters on the exam

These products appear in client scenarios about cancer, heart attacks, ageing parents and travel. Know how each pays and what it excludes.

Critical illness

•Lump sum, any use, paid on diagnosis plus survival.
•Partial early-stage benefits on some plans.
•Return of premium riders on death or on surrender/expiry.
•Usually one claim, then coverage ends.

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Exam-style questions

Ben, 58, a plumber in Fredericton, owns a $150,000 critical illness policy and a separate $250,000 term life policy. He suffers a heart attack that meets the CI policy's definition and dies 12 days later. His CI policy has a 30-day survival period and no return of premium rider. What does the CI policy pay?
Lin, 42, a teacher in Saskatoon, bought an individual critical illness policy 60 days ago. She recently noticed a lump, and tests now lead to a breast cancer diagnosis that meets the policy definition. Her policy includes the usual 90-day moratorium on cancer, counted from the policy's effective date. What is the likely result of a cancer claim?
Ahmed, 55, an accountant in Mississauga, owns a critical illness policy that defines heart attack using specific medical criteria, including blood test results and new ECG changes. After chest pain, his cardiologist diagnoses a minor cardiac event that does not meet those criteria, and Ahmed recovers quickly. He files a claim. What happens?

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