chapter 16 Flashcards
the insured must be unable to perform any job for which the insured is “reasonably suited by reason of education, training, or experience.”
any occupation
total disability that requires that in order to receive disability income benefits the insured must be unable to work at the insured’s own occupation.
own occupation
coverage provided by a Disability Income policy that does not provide benefits for losses occurring as the result of the insured’s employment.
nonoccupational
disability income policy benefit that provides that if an insured experiences a specified disability, such as blindness, the insured is presumed to be totally disabled and entitled to the full amount payable under policy, whether or not the insured is able to work.
presumptive disability
Illness or injury preventing insured from performing at least one or more, but not all, of the insured’s occupational duties or the inability to work at that job on a full-time basis, either of which result in a decrease in income.
partial disability
disability income payment based on the proportion of income the insured has actually lost, taking into account the fact that the insured is able to earn some income.
residual amount benefit
unforeseen, unexpected, unintended cause of an accident.
accidental means
required that the result of the injury has to be unexpected and accidental.
accidental results
specified number of days after an insurance policy’s issue date during which coverage is not afforded for sickness.
probationary period
duration of time between the beginning of an insured’s disability and the commencement of the period for which benefits are payable.
elimination period
maximum length of time during which a benefit is paid.
benefit period
a disability income policy provision that allows a certain amount of time after an accident for a disability to result, and the insured remains eligible for benefits.
Delayed Disability Provision
disability income policy provision that specifies the period of time during which the reoccurrence of a disability is considered a continuation of a prior disability
Recurrent Disability Provision
provides for the payment of additional income when the insured is eligible for social insurance benefits but those benefits have not yet begun, have been denied, or have begun in an amount less than the benefit amount of the rider
social security rider
rider available with some policies that provides for an automatic increase in benefits (typically tied to the Consumer Price Index), offsetting the effects of inflation.
cost of living adjustment rider
an arrangement, usually provided by rider, whereby additional insurance may be purchased at various times without evidence of insurability. This rider guarantees the insureds insurability giving them the right to purchase additional amounts of disability income coverage at predetermined times in the future without proof of good health.
guaranteed insurability rider
determines the benefit using a percentage of the insured’s pre-disability earnings and takes into account other sources of disability income.
percent of earnings approach
facilitates vocational training to prepare insured for a new occupation.
rehabilitation benefit
specifies a flat income benefit amount that will be paid if the insured becomes totally disabled. Normally, this amount is payable regardless of any other income benefits the insured may receive. This amount is usually 50% of the full disability benefit.
flat amount approach
allows the insurer to reduce the maximum benefit payable under the policy if the insured switches to a more hazardous occupation or to reduce the premium rate charged if the insured changes to a less hazardous occupation.
change of occupation provision
injuries that may have resulted from an accident but are not necessarily disabling.
nondisabling injuries
These are typically for short-term disability income policies and provide for an optional lump sum payment for certain named injuries.
elective indemnity options
allows the policyowner to waive premium payments during a disability and keeps the policy in force.
waiver of premium rider
proportional disability benefit that one collects while working less than full time and suffering an income loss of at least 20%.
residual disability
