Completing the Application, Underwriting, and Delivering the Policy Flashcards
Insurance is a _______ of risk of loss from an individual or a business entity to an
insurance company
Transfer
What is a contract?
A contract is an agreement between two or more parties enforceable by law
What are the 4 elements an insurance contract MUST have to be legally binding?
- Agreement — offer and acceptance;
- Consideration;
- Competent parties; and
- Legal purpose.
In insurance when is an offer made? And by whom?
the applicant usually makes the offer when
submitting the application
When does acceptance take place?
Acceptance takes place when an insurer’s underwriter
approves the application and issues a policy
What is consideration?
Consideration is something
of value that each party gives to the other
What is the consideration on part of the insured?
the payment of premium and the representations made in the
application
What is the consideration on part of the insurer?
the promise to pay in
the event of loss
What are competent parties?
must be capable of entering into a contract in the eyes
of the law. Generally, this requires that both parties be of legal age, mentally
competent to understand the contract, and not under the influence of drugs or
alcohol.
What is needed for a life insurance policy to have legal purpose?
insurable
interest and consent
What is a contract that is prepared by the insurer accepted or rejected by the other party?
contract of adhesion
A contract in which there is an exchange of unequal amounts or values is?
Aleatory contract
In what type of contract is only one of the parties legally bound to do anything?
Unilateral Contract-The insured makes no legally binding promises. However, an insurer
is legally bound to pay losses covered by a policy in force
What is a conditional contract?
a conditional contract requires that certain conditions must
be met by the policyowner and the company in order for the contract to be
executed, and before each party fulfills its obligations
What is a warranty?
an absolutely true statement upon which the validity of the
insurance policy depends. Breach of warranties can be considered grounds for
voiding the policy or a return of premium. Because of such a strict definition,
statements made by applicants for life and health insurance policies, for
example, are usually not considered warranties, except in cases of fraud.
What are representations?
statements believed to be true to the best of one’s
knowledge, but they are not guaranteed to be true. For insurance purposes,
representations are the answers the insured gives to the questions on the
insurance application.
Untrue statements on the application are considered _____ and could void the contract.
Misrepresentations
A statement that if discovered, would alter the underwriting decision of the insurance company are?
Material Misrepresentations
If a material misrepresentation is intentional this is considered what?
Fraud
What is the starting point and basic source of information used by the company in the risk selection process?
The Application
What are the basic components that make up the application?
Part 1 - General Information Part 2 - Medical Information
What part of the application will contain the name, age, address, birth date, gender, income,
marital status, and occupation? It will also inquire about the existing policies and if
the proposed insurance will replace them
General Information
Medical information is?
prospective insured’s medical background, present health, any medical visits in
recent years, medical status of living relatives, and causes of death of deceased
relatives
Whose responsibility is it to make certain that the application is filled out completely, correctly, and to the best of the applicant’s knowledge?
The Agent’s
Who is the field underwriter?
the agent/producer
What is the purpose of the agent’s(producer’s) report?
t provides the agent’s personal observations
concerning the proposed insured. The insurer may inquire whether the agent
knows of any adverse information about the applicant, or ask the agent to express
an opinion about the applicant’s character, financial standing, and environment.
When an answer to a question on the application needs to be corrected, agents
have what two options?
correcting the
information and having the applicant initial the change, or completing a new
application. An agent should never erase or white out any information on an
application for insurance.
What should an insurer do if they receive an incomplete application?
the insurer must return it to
the applicant for completion
What happens If a policy is issued with questions left unanswered?
the contract will be interpreted as if the insurer waived its right to have an answer
to the question. The insurer will not have the right to deny coverage based on any
information that the unanswered question might have contained.
What is a conditional receipt?
A receipt used only when an applicant submits a prepaid application. The conditional receipt says
that coverage will be effective either on the date of the application or the date of
the medical exam, whichever occurs last, as long as the applicant is found to be
insurable as a standard risk, and policy is issued exactly as applied for. Intended to provide proof of coverage on a date prior to when policy was received.
If an agent collects the initial premium from an applicant and gives the applicant a
conditional receipt, and the applicant dies the next day what will happen?
, the underwriting process
will proceed as though the applicant were still alive. If the insurer ends up
approving the coverage, then the applicant’s beneficiary will receive the death
benefit of the policy. If, on the other hand, the insurer determines that the
applicant was not an acceptable risk and declines the coverage, the premium will
be refunded to the beneficiary, and the insurer is not required to pay the death
benefit.
________ is a practice of terminating an existing policy or letting it lapse, and
obtaining a new one
Replacement