Individual Accident & Sickness Insurance Products
Core concepts
Individual A&S products include disability income, accident-only, critical illness, long-term care, and medical expense plans. Candidates must understand the building blocks: benefit amount, benefit period, elimination/waiting period, renewability, and exclusions.
Renewability is a frequent test point. Non-cancellable means the insurer cannot cancel or change premiums; guaranteed renewable means the insurer must renew but may raise premiums by class; conditionally renewable allows renewal subject to conditions; optionally renewable gives the insurer discretion. Accident policies often exclude self-inflicted injury, war, and injuries while committing a crime.
Traps in questions
- Confusing elimination period (waiting before benefits start) with benefit period (how long benefits last).
- Assuming "guaranteed renewable" means the premium is fixed - it does not.
- Overlooking that accident-only policies do not cover sickness.
- Missing that some products pay a lump sum (critical illness) versus periodic income (disability).
Rule of thumb
Match the product to the trigger and payout shape: accident → injury; sickness → illness; disability → income replacement; critical illness → lump sum on diagnosis; LTC → care costs. If the question describes a diagnosis payout, it is critical illness, not disability.
Worked example
A client wants income if they cannot work after a car accident. A disability income policy with a 90-day elimination period and a five-year benefit period fits. An accident-only policy would pay medical expenses but not replace lost income.