Life Insurance Flashcards
Peril
Cause of loss
Insurer agrees to cover losses covered by a specified peril
What is peril for life insurance?
Death
What is peril for health insurance?
Accidents or illness
Law of large numbers
The larger the group the more accurate losses can be predicted.
Allows carriers to charge each insured a premium that polled together will cover all claims and operating costs.
Stock insurance companies
Issues non-participating or non-par policies
Non-participating or non-par policies
Profits are paid as dividends to shareholders
Mutual insurer
Owned by policyholders
Board of directors chosen by policyholders
Profits returned to policyholders as no taxable dividends
Issues participating policies
Participating or par policies
Pay dividends to policyholders
Whole life policies
Domestic
The state where a company has its home office
Foreign
Any state other than home office state
Alien
Home office is in any country other than USA
Financial strength rating
Report card of the company
Legal contract (LACC)
Insurance policies are legal contracts
Legal purpose-risk transfer doesn’t violate law
Agreement-offer and acceptance
Consideration-giving something of value
Competent parties-insured age 18 and sane
What is insured consideration?
What is insurance companies consideration?
Insured gives info and premium
Company gives promise to pay (policy)
Adhesion
Contract is written by company and insured must adhere or abide by entire policy-policy itself, riders, application
If ambiguous courts will side with insured
Aleatory
Not equal value-small premium for large amount of coverage
Unilateral
Only one promise made
Company promises to pay covered loss
Insured does not promise to pay premium
Conditional
Insured must pay premium for coverage and file a claim if a loss occurs
Representation
Statement that is believed to be true
All answers on application are considered to be representations
Misrepresentation
Representation that is actually false
Material misrepresentation
Misrepresentation that has determining factor in insurer’s acceptance of the risk.
Insurer has 2 years to discover
Underwriting
Process of evaluating risk to determine if it is acceptable based on established insurance company guidelines
Changes in application
Must be initialed by applicant
Backdating
Used to save person’s age
Most state laws allow 6 months backdating
Applicant must pay any additional premium
Required signatures
Insured
Producer/agent
Applicant or owner of policy
Producers report
Only seen by agent and underwriter
Conditional receipt
Premium paid with application.
Effective on date of application or date of medical examination whichever is later.
It is the date of the application as long as the applicant is found to be insurance under the company’s standard underwriting rules.
Binding receipt
Temporary, 30-60 days
Not common in life insurance
Eff date is date of app
Attending Physician’s Statement (APS)
Underwriter can ask current doctor to find applicant’s current medical condition and medical history
2 types of medical examinations
Paramedical-nurse
Complete physical-by insurance company doctor
Medical Information Bureau
Non-profit insurance trade association
Maintains underwriting info on applicants
To reduce misrepresentation and fraud
4 classifications of risk
Standard
Preferred
Substandard
Declined
When does COD policy become effective
Policy issued
Client accepts policy
Client pays
Statement of continued good health
Statement of good health
Required if no premium with application
If health changed, agent can’t deliver policy
Effective date of coverage
Conditional receipt-eff date is date of app if premium collected at the time of application
Substandard and pays additional premium-eff date is date policy issued
No receipt-eff date is policy issue date if premium paid at delivery
Fair Credit Reporting Act
Third party information
Notice to applicant required
Consumers have rights and can dispute information in files
Penalty: fines max $5k and imprisonment max 1 year
Insurable Interest
Risk of loss: person applying for the policy must be at risk of suffering a significant loss if the insured dies. Loss may be emotional or economic.
Assumed in one’s self and relationships (spouse, children)
When must insurable interest exist?
At time of application
Survivor Protection
Survivors are protected financially
Human Life Value
Purpose of life insurance is to replace an individual’s economic value.
Calculation: individual’s annual income X number of years until retirement
Needs Approach
Looks at financial situation the survivors will face.
2 categories of financial needs: cash needs and income needs
Blackout Period
Social Security Administration provides benefits to spouse and children until youngest turns 16 and does not resume until spouse turns 60
Buy-Sell Funding
Buy-sell agreements provide for the sale of business interest at the death or disability of an owner.
Buy-Sell Entity plan
Purchaser of deceased owner’s business interest is the business entity.
When funded by life insurance, business entity owns policy
If business is corporation plan is called stock redemption plan
Buy-Sell Cross-Purchase Plan
Surviving owner(s) purchase deceased owner’s interest. Each partner owns a policy on the lives of each other partners.
Key Person Coverage
Business owns, pays for, and is the beneficiary of the policy on the key person’s life. Insurance proceeds used to offset direct financial losses.
Individual Life Insurance Plans
Individual always gets policy
Group Life Insurance Plans
Individual never gets policy
Premium Elements
Mortality - relative frequency of death in a specific population, death rate
Interest - earnings on premium dollars btw time collected and time paid
Expenses - insurer’s operation costs
Net Premium
Mortality - Interest
Gross Premium
Mortality - Interest + Expenses
Premium Payment Mode
Annual - lowest
Semi-annual
Quarterly
Monthly
2 Basic Classes of Life Insurance
Term
Permanent
Term Insurance
Simplest type
Only offer death benefit
Remains in force for a specified period of time
Length is variable
Level Term
Death benefit is level
Premium is level for the term
Decreasing Term
Death benefit decreases
Premium remains level
Cheapest
Protects against debt (mortgage)
Increasing term
Death benefit increases
Premium increases
Used as rider on permanent cash building policy
Purpose is to have death benefit keep pace w/ inflation
Return of Premium Term
Returns all or part of premium paid at end of term if insured is still alive.
Premium is higher than a regular term policy.