OVERVIEW (LLQP Flashcards)
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What are the documents that constitute the entire agreement between the parties of an individual life insurance contract?
- Application
- Policy
- Any document attached to the insurance policy when issued
- Any amendment (also called rider, endorsement, or addendum) to the policy agreed to in writing after the policy is issued.
(Refer to Section 2.6.1.1)
Insurance companies, also known as insurers, can be incorporated in two different ways. What are the ways in which they can be incorporated?
Federally or provincially.
Federally incorporated companies are able to carry on business across the country, and provincially incorporated companies can only operate in the province in which they are incorporated.
(Refer to Section 4.1.1)
Which organization is an association of insurers conducting business in Canada that has prepared a series of 18 guidelines for the guidance of its members to promote consistent practices and standards for the life and health industry?
The Canadian Life and Health Insurance Association (CLHIA).
(Refer to Section 2.6.5)
Which organization is responsible for determining the financial soundness of federally incorporated life insurance companies?
The Office of the Superintendent of Financial Institutions (OSFI).
(Refer to Section 4.1.1)
What are the legal requirements for an agent to sell insurance in Canada?
- Be licensed
- Enter into an agency contract
- Practice the highest standards of conduct
- Acquire errors-and-omissions (E&O) insurance.
(Refer to Chapter 1)
Which Act regulates insurers at the federal level?
The Insurance Companies Act.
(Refer to Section 4.1.1)
Over the years, the insurance acts of all the common-law provinces have become very similar. Collectively, the provincial acts are referred to as the Uniform Insurance Act. Québec, however, has a different insurance act. Why?
The provinces’ laws are based on common law, and therefore have a uniform act. Québec’s laws, however, are based on civil law and so it has a different insurance act.
(Refer to Section 1.2)
Which body is responsible for governing the marketing of life insurance policies?
The provincial insurance acts are responsible for the marketing of life insurance products and are therefore regulated by provincial insurance regulators.
(Refer to Section 4.1.1)
What type of law applies to the interpretation of a life insurance contract?
The law of the province or territory where the policy was contracted.
(Refer to Section 1.2)
Civil fault is an action or omission which causes someone loss or harm for which the wrongdoer is liable. A breach of the privacy obligations of an agent could lead to a civil action against the agent in torts. A client claiming to be the victim of civil wrongdoing could initiate civil litigation against an agent. How can insurance agents protect themselves against a claim against them under tort law?
Life insurance agents protect themselves from claims by carrying errors and omissions (E&O) insurance.
Note: E&O insurance does not protect agents from intentional acts, misappropriations, fraud, or criminal activities such as forgery.
(Refer to Section 4.2.5.1)
Assuris is a not-for-profit organization that protects Canadian policyholders if their life insurance company should fail. How does Assuris provide protection for insurance policyholders?
If a member insurance company becomes insolvent, Assuris facilitates the transfer of its policies to a solvent company and ensures benefits are continued under the original terms of the policy.
(Refer to Section 4.1.4.3)
According to provincial insurance legislation, what is considered the minimum age for individuals to have the capacity to contract for insurance on their own behalf?
16 years
Provincial insurance legislation says that, for contracting a policy, a person 16 years of age or older has the capacity to contract for insurance on its own behalf.
(Refer to Section 1.2.3)
Emma was filling out her insurance application and accidentally filled in the year of her birth as 1988 instead of 1989. Is this considered a mistake or a misrepresentation, and what is the difference?
This would be a mistake. Emma did not do this intentionally. Furthermore, there would be no benefit to the client to inform the insurance company that she is older than she really is, as this would result in a higher premium.
A mistake is not a conscious act, whereas a misrepresentation may not be a conscious act.
(Refer to Section 2.4.1.1)
Clark is healthy, exercises regularly, and maintains a healthy diet. He works in an office as a graphic designer. However, Clark also likes to skydive a few times a year for fun. While meeting with his insurance agent, Clark decides not to mention the fact that he skydives. He has heard that he might have to pay a higher premium for having a “risky lifestyle” if he tells the insurance company about his hobby. Since he only does this a few times a year, he prefers not to tell them about it.
What type of misrepresentation is this, and how might it affect the policy?
Clark’s failure to disclose his skydiving hobby is considered material misrepresentation.
Material misrepresentation is a misrepresentation of a fact, which, if the truth had been known, might have resulted in the insurer refusing to issue the policy, or charging a higher premium for it.
(Refer to Section 2.4.1)