Insurance4 Flashcards
■ Entire contract (remember “AIR”)
– Application of insurance
– Insurance Policy
– Riders
■ Time limit on contesting application information
– Two years after application
– Fraud in the application can void the policy when discovered
■ Grace period following due date of premium
– Insurance still in force during grace period
– 7 days if premium paid weekly
– 10 days if premium paid monthly
– 31 days if premium paid annual, semi-annual or quarterly
– Unpaid premiums deducted from a claim
■ Reinstatement
– Application and receipt
– Must deny within 45 days after application or policy is in effect
– Accident claims covers immediately
– Sickness claims covered 10 days after reinstatement, a probationary period will apply
Notice of claim
20 days after loss
– If continuing disability can only be required to provide proof every 6 months
Claim forms
Must be furnished to insured within 15 days of notice of loss
Proof of loss
Within 90 days
Time payment of claims
Immediately
At least monthly if disability or long term care insurance
Payment of claims
Any death benefits
■■ Beneficiary
■■ Insured’s estate
Facility of payment
– $1,000 to a family member
Medical exams and autopsy
If company requires and state law allows
– Company pays all costs
Legal action against insurer
Earliest 60 days after proof of loss
– Maximum three years after proof of loss
Change of beneficiary
Any time by owner if revocable
– Permission of beneficiary needed if irrevocable
Optional provisions
Change of occupation
– More hazardous
■■ Reduction of benefits
– Less hazardous
■■ Refund of excess premiums
■ Misstatement of age
– Younger than stated in application
■■ Benefits increased
– Older than stated in application
■■ Benefits reduced
Other insurance with this insurer
Total of all polices exceeds maximum
■■ Benefits reduced
■■ Excess premiums refunded
Insurance with other insurer
Each company pays a proportionate share
– Excess premiums are refunded
