06. Selling Life Insurance Flashcards

1
Q
  1. Under Part 7.7 of the Corporations Act, what must providing entities do?
A
  • prepare and provide a FSG
  • provide the general advice warning if only general advice is provided
  • if personal advice is provided, ensure the advice is suitable, provide an SOA and where the advice is incomplete or uses inaccurate information warn the client of this
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2
Q
  1. What is personal advice?
A

It is any financial product advice given or directed to a person where the provider has considered one or more of the clients objectives, financial situation or needs or where a reasonable person would have expected given the circumstances for the adviser to have considered these

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3
Q
  1. What is the purpose of the FSG?
A

To ensure that retail clients are given sufficient information to enable them to decide whether to obtain financial services from the providing entity.

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4
Q
  1. When should an FSG be supplied to the client?
A

Before providing financial services to them (there are some exceptions)

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5
Q
  1. What are the three key documents provided by an adviser to a client and what are their purposes?
A
  • FSG - what financial service am I getting?
  • SOA - What personal advice am I getting?
  • PDS - What financial product am I buying?
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6
Q
  1. Under s945A all personal advice must comply with the ‘suitability’ or ‘reasonable basis for advice’ rule. This means the providing entity must do what?
A
  • Make reasonable inquiries about the clients personal circumstances
  • Reasonably consider and investigate the subject matter of the advice
  • ensure the advice is appropriate to the client.
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7
Q
  1. What must an SOA include?
A
  • the advice
  • the reasoning that lead to the advice
  • all conflicts of interest that may affect the advice.
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8
Q
  1. Why is it important for the adviser to understand the client’s needs, objectives and personal preferences prior to making insurance product information?
A

Only after finding out this information will the adviser be able to advise the client of the appropriate level of insurance cover and products best suited.

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9
Q
  1. What information about existing policies held by a client should an adviser obtain prior to making insurance recommendations?
A
  1. The types of policies held
  2. The sum insured / benefit amount / cash value
  3. Expiry dates, premium payable, length of time the policies have been in place
  4. What company is the insurance policy with
  5. Is it a personal, employer or super policy
  6. Any exclusions or variations that apply
    7 Any policies that have been applied for and declined
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10
Q
  1. Underwriting is the process of assessing the risk and ascertaining what?
A
  • whether the risk falls within the ‘standard’ range and therefore a normal premium is charged
  • the risk is unacceptable and unlikely to improve so decline the application
  • the risk is currently unacceptable so either defer, establish exclusions or higher premiums
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11
Q
  1. What are the areas of risk assessment for a life insurance application?
A
  • health
  • occupation
  • hobbies and pursuits
  • financial, and
  • moral
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12
Q
  1. Why is the adviser often referred to as the field underwriter?
A
  • they choose who applies to the insurance company

* they gain the first impression of the various areas of risk assessment

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13
Q
  1. What areas do applicants not have a duty of disclosure?
A
  • anything that diminishes the risk to the insurer
  • anything that is of common knowledge
  • anything the insurer already knows (or ought to know), and
  • if the insurer has waived the duty of disclosure
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14
Q
  1. What must the adviser ensure they do with regard to the duty of disclosure?
A
  • Ensure that they fully understand it
  • Point it out to the client
  • Ensure it is fully understood by the client.
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15
Q
  1. An adviser should always follow a set routine and script in completing an application form, what does this include?
A
  • Inform of and ensure duty of disclosure is understood
  • Go through questions carefully
  • Allow client to fill out
  • Review questions making notes of anything additional in adviser’s writing
  • Explain declaration and ensure they have reviewed and comfortable before signing
  • Keep a copy for records
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16
Q
  1. Why would an adviser want to have a set routine for the insurance application process?
A

So if their conduct is ever challenged, other clients can testify as to the adviser’s standard procedures

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17
Q
  1. Should the adviser tell the client how to answer any particular question?
A

No, this is directive advice. The pros and cons of each option should be explained, but to protect the adviser, they should not be directive.

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18
Q
  1. What are the options for completing an online insurance application?
A
  • Personally (interview presented by adviser)
  • Remotely (by phone or video link presented by adviser)
  • Remotely (answered by applicant to tele-underwriting service)
  • Through an online application by applicant without assistance and submitted directly.
19
Q
  1. What is a wet signature?
A

A physical signature by the client

20
Q
  1. Having a basic understanding of underwriting risk will assist the adviser to be more effective in their role, this will enable them to do what?
A
  • ensure all documentation is fully completed
  • know when additional info is required
  • identify if a client is not making full disclosure
  • identify whether the client is unlikely to be a standard risk.
21
Q
  1. How does an adviser develop a basic underwriting understanding?
A
  • discussion with other advisers
  • discussion with underwriters
  • reviewing of underwriting assessment material
  • experience over time.
22
Q
  1. How does the adviser gaining an understanding of the underwriting process benefit the client?
A
  • minimises delays in application completion
  • ensures client receives most favourable assessment
  • minimises the chances of becoming involved in a client’s fraud or avoid misrepresentation.
23
Q
  1. Why should advisers maintain good records?
A
  • Enable adviser to ‘know their client’ and provide appropriate advice
  • Enable the adviser to defend themselves if a complaint is made
  • Improve the market value of the business
  • Requirement of Part 7.7 of corps act and the ASIC Reg Guide 175.
24
Q
  1. What should records contain as a minimum?
A
  • client information that has been collected
  • research and analysis undertaking in formulating a recommendation
  • recommendations made by the adviser
  • disclosures made and warnings provided by the adviser
  • actions taken by the client including any waivers when the client has not taken a specific recommendation
  • any miscellaneous actions or conversations taken apart from the recommendation process.
25
Q
  1. What is a summary file note?
A

A record of only the critical facts, treating the file note as a memory jogger in case details need to be recalled.

26
Q
  1. What is a literal file note?
A

These record as much information as possible. They might include the noting of details of a conversation or the circumstances surrounding an event. Useful if they feel they could be being set up.

27
Q
  1. What is a focused file note?
A

These can form an important part of regular business practices and are used to record details of repetitive situations and can be used in the case of a dispute to clarify information.

28
Q
  1. What would a complaints service or court look to understand with a new complaint against an adviser?
A
  • was this a deliberate or careless act on the part of the life insured?
  • was the adviser responsible because of poor interview practices?
29
Q
  1. What questions would the complaints service or court look to answer in order to resolve the dispute?
A
  • who completed the application
  • where the duty of disclosure and consequences of non-disclosure explained and understood?
  • were application questions explained?
  • was the client given the opportunity to review prior to signing?
  • why does the adviser believe the client understood the duty of disclosure?
  • why does the adviser believe the client had the opportunity to review prior to signing?
  • How much time was taken to answer the application?
  • Was anyone else present?
  • What was the date, time and place the application was completed?
30
Q
  1. What are the two contrasting industry opinions in regards to the adviser’s role in the application and management of claims
A
  1. That they are not qualified with matters of claims and therefore should not get involved
  2. The adviser knows the client and are uniquely qualified to act as an intermediary
31
Q
  1. If an adviser is to become involved in the management of a claim, what are the essential two prerequisites?
A
  1. Undertake some formal training to gain understanding of claims process
  2. Aim always to act in the literal role of intermediary, rather than presenting the opinion of only one party.
32
Q
  1. What key functions can the adviser assist with in the management of a claim?
A
  • Communication
  • Arbitration
  • General assistance
33
Q
  1. What is the general process associated with a death claim?
A
  • receipt of advice of death
  • confirmation of date of birth (passport etc)
  • confirmation of the death (death cert)
  • obtaining proof of title (policy documentation)
  • completion of a claim form
  • calculation of the benefit amount by assessor
  • payment of the benefit
34
Q
  1. If the policy owner is the same as the life insured, then where is the insurance payment made?
A

To the deceased’s estate

35
Q
  1. What are some complications with some death benefits?
A
  • death without a known cause - require coroner’s inquest
  • death occurs at sea - registered at next port
  • person disappears longer than 7 years - presumption of death may be granted by courts
  • death occurs in remote area and body not recovered - declarations and evidence are reqd
  • age misstated - benefit may be proportionately reduced.
36
Q
  1. What are the three different versions of TPD contracts relating to the life insured’s occupation?
A
  • Own occupation
  • Any occupation reasonably suited by training, education and experience
  • any occupation at all
37
Q
  1. What is the claims process for TPD and trauma claims?
A
  • Submission of claim form
  • Obtaining medical information by insurer
  • Assessment of the claim
  • Payment of any validated claim
38
Q
  1. What additional information may be required by the claims assessor in determining the claim?
A
  • medical reports
  • independent specialist examinations
  • workers compensation and Veterans Affairs reports
  • financial information
  • interviews, and
  • surveillance.
39
Q
  1. Why should the claimant notify the insurer early in the case of a disability income insurance claim?
A
  • Gives insurer time to retrieve policy and request any additional information
  • Insurer can assess policy conditions prior to end of waiting period and advise if benefit is applicable
  • Reduce risk that the assessment is rushed
40
Q
  1. What is on a disability income insurance claim form?
A
  • whether the claim is for sickness or injury
  • what caused the sickness or injury
  • the impact on the claimant’s ability to work and to earn
  • the name and contact details of the attending doctor
41
Q
  1. What is the principle role of the claims assessor?
A
  • gather information to enable an objective assessment
  • what other evidence is required and when
  • calculation of the claim amount
42
Q
  1. What are the two basic types of business expense insurance policy?
A
  • reimbursement

* indemnity

43
Q
  1. The Life Insurance Act 1995 and Insurance Contract Act 1984 influence the claims process. In Particular they require
A
  • duty of utmost good faith
  • duty of disclosure
  • privacy
  • duty to avoid misrepresentation
  • duty to act promptly and professionally.