Chapter 3: Life Policy Riders, Provisions, Options, and Exclusions Flashcards
______ define the characteristics of an insurance contract and are fairly universal from one policy to the next.
Provisions
______ are added to a policy to modify provisions that already exist.
Riders
______ offer insurers and insureds ways to invest or distribute a sum of money available in a life policy.
Options
The standard policy provisions adopted by the ______ create uniformity among life insurance policies.
National Association of Insurance Commissioners (NAIC)
The entire contract provision stipulates that the ______ and a copy of the ______, along with any ______ or ______, constitute the entire contract.
- Policy
- Application
- Riders
- Amendments
Entire Contract = ______ + copy of ______ + any ______ or ______.
- Policy
- Application
- Riders
- Amendments
The ______ (or ______) sets forth the basic agreement between the insurer and the insured, stating:
- Insurer’s promise to pay the death benefit upon the insured’s death.
- Who the parties to the contract are.
- Premium to be paid.
- How long coverage is in force.
- Amount of death benefit.
- Insuring Clause
- Insuring Agreement
—Provision
The ______ allows the policyowner a specified number of days from receipt to look over the policy and if dissatisfied for any reason, return it for a full refund of premium. The ______ starts when the policyowner receives the policy, not when the insurer issues the policy.
- Free Look Provision
- Free-Look Period
—Provision
Both parties to a contract must provide some value, or ______, in order for the contract to be valid. The ______ states that the value offered by the insured is the premium and statements made in the application. The ______ given by the insurer is the promise to pay in accordance with the terms of the contract.
- Consideration
- Consideration Provision
- Consideration
—Provision
Only the policyowner has the ______ under the policy, and not the insured or the beneficiary. Among the *______ are naming and changing the beneficiary, receiving the policy’s living benefits, selecting a benefit payment option, and assigning the policy.
Ownership Rights
—Provision
The ______ of a life insurance policy has the right to transfer partial or complete ownership of the policy to another person without the consent of the insurer. However, the owner must notify the ______ in writing of the assignment.
- Policyowner
2. Insurer
Transfer of the life insurance policy does not change the ______ or amount of ______; it only changes who has the policy ownership rights.
- Insured
2. Coverage
The ______ specifies the policyowner’s right to assign (transfer rights of ownership) the policy. The policyowner must advise the insurer in writing.
Assignment Provision
______ involves transferring all rights of ownership to another person or entity. This is a permanent and total transfer of all the policy rights. The new policyowner does not need to have an insurable interest in the insured.
Absolute Assignment
______ involves a transfer of partial rights to another person and is usually done in order to secure a loan or some other transaction. Once the temporary debt or loan is repaid, the assigned rights are returned to the policyowner.
Collateral Assignment
______ is the complete and permanent transfer or ownership rights; ______ is the partial and temporary transfer of rights.
- Absolute Assignment
2. Collateral Assignment
The ______ is the person or interest to which the policy proceeds will be paid upon the death of the insured. It may be a person, class of persons (sometimes used with children of the insured), the insured’s estate, or an institution or other entity such as a foundation, charity, corporation, or trustee of a trust.
Beneficiary
The beneficiary does not need to have a(n) ______ in the insured.
Insurable Interest
Benefits designated to a(n) ______ will either be paid to the guardian, paid to the trustee if the trust is the named beneficiary, or paid as directed by a court.
Minor
The ______ has first claim to the policy proceeds following the death of the insured.
Primary Beneficiary
The ______ (also referred to as ______ or ______ beneficiary) has second claim in the event that the primary beneficiary dies before the insured.
- Contingent Beneficiary
- Secondary
- Tertiary
If none of the beneficiaries is alive at the time of the insured’s death, or if no beneficiary has been named, the insured’s ______ will automatically receive the proceeds of a life insurance policy.
Estate
If NO beneficiary is named, policy proceeds go to the insured’s ______.
Estate
Beneficiary designations may be either ______ or ______.
- Revocable
2. Irrevocable
The policyowner, without the consent or knowledge of the beneficiary, may change a(n) ______ designation at any time.
Revocable
A(n) ______ designation may not be changed without the written consent of the beneficiary. These beneficiaries have a vested interest in the policy; therefore, the policyowner may not exercise certain rights without consent, such as:
- Changing the beneficiary.
- Borrowing against the cash value.
- Assigning the policy to another person.
Irrevocable
The ______ stipulates that if the insured and the primary beneficiary died in the same accident and there is no sufficient evidence to show who died first, the policy proceeds are to be distributed as if the primary beneficiary died ______.
- Uniform Simultaneous Death Law
2. First
The ______, when added to a policy, provides that if the insured and the primary beneficiary died in a common disaster (even if the beneficiary outlived the insured by a specified number of days, usually ______), it is presumed that the primary beneficiary died first, so the proceeds will be paid to either the contingent beneficiary or the insured’s estate, if no contingent beneficiary is designated.
- Common Disaster Clause
2. 14 to 30 Days
Common disaster clause protects the ______.
Contingent Beneficiary
The ______ is the manner or frequency that the policyowner pays the policy premium. Most policies allow for annual, semi-annual, quarterly, or monthly payments.
Premium Mode
If the insured selects a premium mode other than ______, there will be an additional charge to offset the loss of earnings.
Annual
If the insured dies during a period of time for which the premium has been paid, the insurer must ______ any unearned premium along with the policy proceeds.
Refund
The ______ is the period of time after the premium due date that the policyowner has to pay the premium before the policy lapses (usually 30 or 31 days, or one month).
Grace Period
______ protects policyholders from losing insurance coverage if they are late on a premium payment.
Grace Periods
Most life insurances have a(n) ______, which means that the premium remains the same throughout the duration of the contract. ______ policies allow the policyowner to increase or decrease the premium during the policy period.
- Level Premium
2. Flexible Premium
The ______ provision allows a lapsed policy to be put back in force. The maximum time limit is usually ______ after the policy has lapsed; he or she will have to provide evidence of insurability and pay back premiums plus interest.
- Reinstatement
2. 3 Years
A policy that has been ______ cannot be reinstated.
Surrendered
The ______ clause prevents an insurer from denying a claim due to statements in the application after the policy has been in force for ______, even if there has been a material misstatement of facts or concealment of a material fact.
- Incontestability
2. 2 Years
Misstatement of ______ or ______ on the application will result in adjustment of premiums or benefits.
- Age
2. Gender
The ______ option is found only in policies that contain cash value and allows the policyowner to borrow an amount equal to the available cash value.
Policy Loan
—Provision
Policies will not lapse with an outstanding policy loan unless the amount of the loan and accrued interest exceeds the available cash value. However, the insurer must provide ______ to the policyowner that the policy is going to lapse. Insurance companies may defer a policy loan request for up to ______, unless the reason for the loan is to pay the policy premium.
- 30 Days’ Written Notice
2. 6 Months
Policy loans are ONLY available in policies that have ______ (whole life).
Cash Value
The ______ provision is not required, but is commonly added to contracts with a cash value at no additional charge. This is a special type of loan that prevents unintentional lapse of a policy due to nonpayment of the premium.
Automatic Premium Loan
While the insurer may defer requests for other loans for a period of up to ______, loan requests for payment of ______ must be honored immediately.
- 6 Months
2. Due Premiums
______ are types of risks the policy will not cover. The most common found in life insurance policies are ______, ______, and ______.
- Exclusions
- Aviation
- Hazardous Occupation
- War and Military Service
______: Most life insurance will cover an insured as a fare-paying passenger or a pilot on a regularly scheduled airline, but will exclude coverage for noncommercial pilots, or require an additional premium for coverage.
Aviation
—Exclusion Provision
If the insured is engaged in a hazardous ______ or participates in hazardous ______ (such as skydiving or auto racing), death that results from these activities may be excluded from coverage. A higher premium may be charged instead.
- Occupation
- Hobbies
—Exclusion Provision
The ______ excludes all causes of death while the insured is on active duty in the military.
Status Clause
The ______ only excludes the death benefit if the insured is killed as a result of an act of war (declared or undeclared).
Results Clause
The ______ provision in life insurance policies protects the insurers from individuals who purchase life insurance with the intention of committing suicide. If the insured commits suicide within ______ following the policy effective date (issue date), the insurer’s liability is limited to a refund of premium.
- Suicide
2. 2 Years
______ are written modifications attached to a policy that provide benefits not found in the original policy. They help tailor a policy to the specific needs of the insured.
Riders
The ______ rider waives the premium for the policy if the insured becomes totally disabled. Coverage remains in force until the insured is able to return to work. If the insured is never able to return to work, the premiums will continue to be waived.
Waiver of Premium
Most insurers impose a(n) ______ waiting period from the time of disability until the first premium is waived. The waiver of premium rider usually expires when the insured reaches age ______.
- 6-Month
2. 65
______ rider waives the premium for a total disability after a waiting period.
Waiver of Premium
—Disability Rider
In order for the insured to qualify for the waiver of premium benefit, he or she must meet the policy’s definition of ______. This is generally defined as the inability to perform the duties of his/her own occupation for the first 2 years and then any gainful employment for which the insured is reasonably suited by education, training, and experience.
Total Disability
The ______ rider pays all monthly deductions while the insured is disabled, after a(n) ______ waiting period. This rider only pays the monthly deductions, and not the full premium necessary to accumulate cash values.
- Waiver of Monthly Deductions
2. 6-Month