CII Certificate in Insurance - Financial Protection (R05) Practice Exam

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Why did Ludmilla not receive a payment for her heart attack claim under her critical illness policy?

The heart attack was not covered

She did not provide sufficient medical evidence

She died before the end of the policy's survival period

Ludmilla did not receive a payment for her heart attack claim under her critical illness policy because she passed away before the end of the policy's survival period. Many critical illness policies have stipulations that require the policyholder to survive a certain period after being diagnosed with a covered condition to receive a benefit. In this instance, even though the heart attack is generally included in critical illness coverage, the requirement to survive for a specified duration is crucial for the claim to be honored. Therefore, her unfortunate passing before meeting this condition leads to the denial of the payment under the terms of her policy.

Her premiums were unpaid

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