Legal Concepts Flashcards
Who complete the application form for life insurance? What is the process?
The application for insurance is completed by the life, insurance agent, and the client
The life insurance agent must collect the clients information and recorded accurately on the application form
The insurance company, through a process, called underwriting, evaluates, the risk that the client represents.
The risk assessment results in the assignment of a premium for a policy
The application is based on a good faith of the applicant for life insurance. Also, the insurer representative’s objectivity in asking The client questions is important.
What is a TIA?
Temporary insurance agreement
The process for applying for insurance can take several weeks. If a client has no insurance in place and has an identified need for life insurance, a temporary insurance agreement can be put into place by the life insurance agent to qualify for temporary insurance, the applicant must answer a short health questionnaire and pay the first month premium on his life insurance application .
How do you qualify for a TIA?
If the client does not have life insurance, and has a current need for one, and while, waiting for the insurance application, a TIA can be put in place.
For this, the client must answer a short health questionnaire, and pay the first premium.
What is a contract renewal?
The renewal is evidenced by a certificate of renewal, or the issuing of a new policy, after the expiry of the initial contract
What happens when a contract ends?
The contract ends either by termination or cancellation, but it can also be renewed
Is a termination of contract and cancellation the same thing?
No
The termination of a contract means that the contract does not exist anymore, as if it had never existed
The main reason of termination are false representations, fraud, concealment, a.k.a., not telling all the truth, and insurable interest
Termination is done by the insurer.
On the other hand, cancellation means that the contract is cancelled based on present circumstances, without questioning the policy, since it was in effect, cancellation of the contract can be caused by: nonpayment of premiums, an attempt to end the insure life, cancellation without cause by policyholder
There is no blame for this sort of contract ending
What is a grace period?
This is the time limit that the insurance company grants to the policyholder to pay his premium. There is no grace period for the first premium payment. For subsequent premiums, the grace period is 30 days.
If the policyholder were to die during the Grace period, the beneficiary would be entitled to the face amount, less the overdue premium
Define lapsed contract and reinstatement
A lapsed contract is simply a contract that is no longer in effect. A Policyholder can reinstate a lapsed contract by satisfying the following conditions:
1) make a request: the reinstatement request must be made within two years of the lapse date
2) provide evidence of insurability: the insured must provide evidence that he represents the same insured risk as the original contract
3) pay overdue premiums: the policyholder must pay the overdue premiums and the interest accrued
4) repay premium loans: the policyholder must repay any premium loans plus interest he received from the insurer before the contract lapsed.
What are two common life insurance clauses?
- Suicide clause
- Incontestability clause
- Grace period
- Lapse contract and reinstatement clause
- Beneficiary designation
- Revocable or irrevocable beneficiary of a life insurance contract
- Payment of death benefits
- Policy assignment
- Components of an insurance contract
> insurable interest
> benefit
> premium
> risk
What is the incontestability clause?
An insurer cannot contest a policy after it has been enforced for two years, unless there is evidence of fraudulent misrepresentation.
It is considered a fraudulent misrepresentation when the applicant knowingly withhold material information from the introvert at the time of application, and the information withheld, could impact the decision to approve the application.
If fraudulent misrepresentation is proven, the contract can be cancelled
What does the suicide clause say?
If the suicide occurs less than two years, after the effective date of the life insurance, the face amount will not be paid, and the premiums paid from the beginning of the contract will be refunded to the beneficiary.
If the suicide occurs more than two years, after the effective date of the policy, the face amount will be paid.
The two-year period applies to increases in the face amount as well. So if there is an increase in coverage two years after the original contract date, there is another two year waiting period to pay out that increase.
Example
If suicide occurs eight months after a $50,000 increase to the original contract of $100,000, a contract that has been in effect for four years, the insurer will pay a death benefit of $100,000 to beneficiaries, not $150,000.
Can you put more than one beneficiary in the life insurance contract?
Yes
If you want to revoke an irrevocable beneficiary, what would need to happen?
You need written consent of the beneficiary
Does the beneficiary have to be someone alive when you designate them?
No, for example, a child who has been conceived, but is not yet born, or a future spouse.
Do beneficiaries have to pay taxes on insurance benefits?
Insurance benefits are always received tax-free by the beneficiaries.
However, beneficiaries must be the age of majority in order to receive the death benefit. If the beneficiary is a minor, the death benefit is paid to his parents or his legal guardian, or trustee if a person is over the age of majority, but in capable of caring for himself, the death benefit is paid to the individual’s guardian or trustee.
Can a policy be reassigned to another person?
Under the policy assignment clause, the owner of a life insurance policy can transfer ownership to another person with an interest in the insured person’s life or health.
For example, a parent purchases life insurance on the life of his son and transfers the ownership of the contract at the child’s age of majority.
What are the four components of an insurance contract?
Insurable interest
Benefit
Premium
Risk
What does it mean to have insurable interest?
The policyholder must have an incurable interest in the life or health of the insured person
Examples of insurable interest:
- A policyholder with a financial or moral interest
- A person who supports the policyholder
- an employee of the policyholder
- A descendant of the policyholders spouse
- The policyholders spouse
- The policyholder
Can an employee of the policyholder have insurable interest
Yes, they could have insurable interest in the life or health of the insured person
Can a descendant of the policyholders spouse have insurable interest?
Yes, they could have insurable interest in the life or health of the insured person
Could you ensure someone who is not part of the insurable interest list?
If there is no insurable interest, the insured must provide written consent for the contract to be valid
Would there be a way to ensure the life of a famous person?
That person must consent to be insured and provide written consent for the contract to be valid. Only then, is insurable interest determined
When is the benefit paid?
The benefit is paid by the insurer when the covered risk occurs
What is the premium?
The policyholder pays the premium to the insurer in return for benefit that the insurer will pay when a covered risk occurs
What is risk?
The occurrence of a risk causes financial loss from which the policyholder wishes to be protected
The risk must be uncertain. It is a possible and future event that does not depend on the wheel of the parties. A risk cannot be impossible, nor can it have already occurred.
What is the Canada health act?
The Canada health act is the federal act that governs health insurance. It facilitates access to health services by providing that some of them be offered free of charge.
The act is based on five principles that the provinces must comply with to receive cash transfers from the federal government.
These principles are:
- Public administration
- Portability
- Comprehensiveness
- Accessibility
- Universality
What are the five principles that provinces must comply with based on the Canada health act?
Public administration, portability, comprehensiveness, accessibility, and universality
What are the four plans that make up the income security programs?
OAS, old age security pension
GIS guaranteed income supplement
Spouses allowance
Survivor allowance
What is OAS?
Old age security pension
How do you qualify for OAS?
Canadian citizens who have lived in Canada for at least 10 years after the age of 18 and who are age 65 and older are eligible to receive the old age security pension OAS
What is the GIS?
Guaranteed income supplement
Who qualifies for GIS?
The guaranteed income supplement is for individuals who have a low annual income, and who received the old age security pension