Risk Management Flashcards
What is the difference between static and dynamic risks?
Static - result from factors other than changes in the economy and occur w/ regularity and can be insured
Dynamic - result of economic changes, not typically covered by insurance
what is a fundamental risk?
risk that affects a large group of people, possibility of loss/no loss
what is pure risk?
involves only the chance of no loss or loss, not a chance of gain
what is speculative risk?
involves both chance of loss and gain (gambling)
not insurable
what is the most common element in most definitions of risk?
outcome is indeterminate
what are the 4 elements to an insurable risk?
- sufficiently large and similar sample of individuals or events (homogeneous exposure units) to make the losses reasonably certain
- loss produced by risk must be measurable and definite, occurring in a clear time, place, and form. The risk of loss must be uncertain, but the amount of the loss must be certain.
- loss must be accidental and not intentional
- loss cannot be catastrophic to society
sometimes 5. the need to avoid adverse selection
what is an insurable interest?
relationship in which the person applying for insurance will incur a loss from the destruction, damage, or death of insured subject
In life insurance, insurable interest must exist when the contract was purchased but does not need to exist at the time of death.
Insurable interest for property insurance must exist both when the policy is purchased and at the time of the loss.
what are the insurable interest requirements for life and P&C?
P&C - exists at time of contract purchase and time of loss
life - exists at contract inception
What are the 5 steps for the risk management process?
- clarify objectives
- identify risk
- measure risk
- manage risk
- monitor risk
What are the 5 ways to treat risk?
- risk transfer (insurer)
- risk reduction (safety)
- risk avoidance (don’t do something)
- risk acceptance (self insure)
- risk diversification (several alternatives)
What are the 5 elements of a legal contract?
offer acceptance consideration legal purpose signatories w/ legal capacity legal form
Define indemnity
policyowner will be reimbursed by insurer only up to actual loss and cannot make a profit (except life insurance)
Define adhesion
policyowner can only accept or reject the contract and cannot modify, alter, or negotiate its terms
what are unilateral contracts?
only the insurance company legally promises to perform and there is no legally enforceable promise to pay the premiums by the policyowner
what are aleatory contracts?
only insurance company legally promises to perform and the dollars collected by parties are usually unequal
what are contracts of utmost good faith?
both parties must disclose all facts truthfully or the contract may either be reformed or rescinded
define subrogation
policyowner is required to assign the right of recovery against a third party to the insurance company if the company pays for a loss caused by the third party
define collateral source rule
damages assessed against a negligent party should not be reduced simply because the insured party has insurance protecting against the specific peril
what is a tort?
private wrong, occurring when a person infringes on the rights of another person in a way that gives the injured person the right to sue for damages
Torts include all civil wrongs not based on contracts and are a broad residual classification of many private wrongs against another person or organization.
Torts occur independently of contractual obligations and can result from intentional acts or omissions, strict liability imposed by law, or negligence.
what is vicarious liability?
when a person is liable for the torts committed by someone else
i.e. employer liable for acts of employee
What are the defenses to negligence?
assumption of risk (bars recovery for damages if a person understands and recognizes the danger inherent in a particular activity) last clear chance contributory negligence (cannot recover damages if own negligence contributed to other's injuries) comparative negligence (damages adjusted to extent which injured party's own negligence contributed to injuries)
what is strict liability?
holds the party committing a tort liable for damages sustained by their action or products whether or not they were “at fault”
what is a special damage?
designed to compensate injured person for measurable losses
what is a general damage?
compensate injured person for intangible losses
what are punitive damages?
not designed to compensate victim, but to punish wrongdoer (typically when wrongdoer acted intentionally or recklessly)
what duties does the agent owe the principal?
performance notification loyalty obedience accounting
what duties does the principal have to an agent?
compensation
reimbursement and indemnification, if needed
cooperation
safe working conditions
express authority
actual authority an insurance company gives to its agents, typically spelled in writing and contained in contract
implied authority
authority reasonably necessary for agents to carry out their duties
apparent authority
insured led to believe that agent has authority
define the McCarran-Ferguson act of 1945
insurance regulated by states through insurance commissioner
what does it mean that an insurer is obligated to compensate the insured only if certain conditions met?
conditional
what is a promissory warranty?
owner will not do something during the time of the warranty (i.e. not using security system)
what is the test of materiality for an insurance misrepresentation?
if the insurer had known the truth, would it have affected the underwriting decision to where the policy would not have been issued?
what are the 3 ways property insurance policies value losses?
- replacement cost (new material of like kind and quality)
- actual cash value (replacement cost minus depreciation)
- agreed-upon value
what are the two major types of insurance companies and differences?
mutual company - owned by policy holders, participating policies that share in profits of company
stock company - owned by stockholders and offer nonparticipating policies
What are the 3 methods for determining the life insurance needs analysis?
capital retention method
human life value method
financial needs or insurance needs analysis method
define capital retention method
uses interest or earning only to furnish the continued support of the family. original principal/capital saved by the client still remains at the end of the period
define human life value method
uses individual’s income-earning ability as basis for determining the required amount of life insurance
what tax rate should be used for the human life value method calc?
effective - true percentage of insured’s income, which must be allocated for taxes
define financial needs analysis method/insurance needs method
analyzes all recurring expenses of dependent survivors and any unusual expenses resulting from insured’s death, then funds the difference between current assets and needed assets
what is the social security blackout period?
SS benefits cease as youngest dependent child at least 16yrs and surviving spouse not net 60yrs
what is a non-qualified annuity?
purchased w/ after-tax dollars
what is a unique characteristic of deferred income annuities?
future income start dates are chosen at contract issuance, rather than some point in the future
What are the key provisions of final regulations covering the qualified longevity annuity contracts (QLACs)?
maximum age at commencement of income (no later than 85)
maximum allowed investment (use of to 25% of account balance or $125k to buy QLAC)
allowing return of premium death benefit (premiums paid but not received as annuity payments will be returned to their accounts and paid to beneficiaries)
protection against unintentional excess payment of premiums (allowed to correct excess without disqualification)
allowing more flexibility (contract must specifically state it is intended to be QLAC
define superannuation
risk of running out of money
what are the 2 main rules to follow when selling a variable annuity?
FINRA rule 2111 (suitability)
FINRA rule 2320 (members’ responsibilities regarding deferred variable annuities)
what are the key negative elements from a tax perspective for VA’s vs. mutual fund?
taxed as ordinary income w/ 10% penalty if withdrawn before 59.5
no step up in basis at date of death
what is a qualified annuity?
that purchased through a retirement plan to satisfy an obligation to provide a pension to the retirement plan participant
distributions treated as ordinary income
what is the exclusion ratio?
money invested in nonqualified annuity is recovered tax-free (contribution portion)
(investment in contract / expected return)
every dollar paid under annuity consists of premium payments and earnings of annuity (ordinary income tax)
how are payments beyond projected life expectancy treated for tax purposes?
fully taxable
how is annuitant taxed if they die before life expectancy and have not recovered basis?
unrecovered basis is deductible on final tax return as misc. itemized deduction (2% AGI floor)
what is the variable annuity exclusion ratio calc?
investment in contract /
annuitant’s life
what is the main insurance exchange not allowed under a 1035?
variable annuity for life insurance
If the distribution from the nonqualified annuity is not annuitized over the owner/annuitant’s lifetime, what tax rule applies?
the last in, first out (LIFO)
The type of annuity that provides the maximum income per dollar of premium is referred to as
straight life annuity
what is the main advantage and disadvantage of annual renewable term insurance?
no evidence of insurability required to renew
premiums recalculated at end of each year and increase with age of insured
what is the accidental death benefit?
life insurance policy rider paying out 2x if insured dies accidentally
what type of insurance was traditionally used as mortgage protection insurance?
decreasing term life insurance
is unrecovered basis tax deductible?
no
what are paid up additions In life insurance?
insurer uses policy dividends to purchase incremental amounts of paid up whole life
what is the net amount at risk?
difference between the cash value and the death benefit
what are option A and B death benefits? and what happens to the NAR?
A - level (NAR decreases)
B - increasing death benefit (NAR constant)
what is the difference in premiums between variable and UL insurance?
fixed, level premium flexible premium (as long as the CSV can support the monthly deductions for mortality and admin expenses)
what are the important factors an agent/producer should consider when evaluating an existing insurance policy for replacement?
existing policy’s relative fair value
issuing company’s ratings
appropriateness of policy for client’s needs
any possible changes in the client’s insurability
client’s risk tolerance level
financial cost of starting over with new policy
what type of life insurance premiums are generally tax deductible?
employer’s paid premiums for group term life provided to employees
premium considered as alimony payments
how are life insurance dividends treated for tax purposes?
not taxable to the extent they do not
exceed the premiums paid to date
treated as return of premium and reduces basis in policy
anything in excess would be taxed as ordinary income
if policyowner leaves dividends with insurance company, any interest earned is also taxed as ordinary income in the year earned
how are life insurance withdrawals/loans treated for tax purposes?
income tax free until owner’s investment in contract (premiums) has been recovered or paid out
what is the 7 pay test?
test used to determine which life insurance policies are modified endowment contracts subject to 10% penalty for withdrawals/loans (if below age 59.5)
What do we know about MECs?
once a MEC, always a MEC
What are the 5 instances when transfer of a policy will not result in loss of exclusion treatment?
Transfer to:
the insured
a partner of the insured
a partnership in which the insured is a partner
a corporation in which the insured is an officer or shareholder
a transferee whose basis in the policy is determined by reference to the transferor’s basis
what is a viatical settlement
sale of life insurance policy by terminally ill person to investor to obtain the cash in the settlement to pay ongoing medical expenses (usually 60-90% of policy’s value)
buyer continues to pay premiums until insured death
proceeds received from sale are tax-free and gain also tax-free if used for long-term care
what are the typical rules investors in viatical settlements use?
insured owns policy for 2+ years to avoid contestability
insured must be terminally ill with life expectancy 2- yrs
insured signs release of medical record access to investor
insured signs waiver releasing investor of any liability associated w/ changing beneficiary designations
why is traditional net cost method of life insurance policy cost comparison not recommended?
does not take into account TVM
how is the increase in cash value of a life insurance policy treated?
not taxable as long as it remains in the policy
how is basis of cash value life insurance calculated?
total premiums paid - outstanding loans - dividends received
how is gain of cash value life insurance calculated?
net cash value - basis
how are loans from modified endowment contracts treated?
LIFO basis recovery, meaning loans considered to consist of taxable earnings until all taxable earnings have been withdrawn
how are dividends from participating life insurance policies treated?
considered return of premium and not taxable
what is a main disadvantage of a HMO plan?
cost of medical care generally not covered if subscriber uses outsider provider
what is a health reimbursement arrangement?
participating employee is reimbursed medical expenses by an employer
employees do not need to be covered by any other health insurance plan
unused amounts may be carried forward for reimbursement in later years and contributions are unlimited
deposits are deductible by employer
reimbursements tax free by employees
not allowed for self-employed persons
how are health insurance premiums paid by an employer through a group plan treated for tax purposes?
deductible business expense to employer
benefits not included in employee’s gross income
how may an employee who itemizes deductions deduct medical/dental expenses?
to extent they pay their own health insurance premiums and other eligible medical/dental expenses, these can be deductible to extent they exceed 10% of AGI
how are costs of health insurance treated for self-employed tax purposes
deductible from AGI for federal tax
what is COBRA?
program where employer must continue to offer health insurance coverage to employee for certain period after qualifying event (18 mo. for termination) and the former employee only liable for up to 102% of previous cost of coverage with employer
continuation of coverage must be elected by terminating employee (includes individuals who leave on their own accord too)
employers must provide if 20+ employees (govt and church exempt) - 1/2 time employees count as 1/2 person for this total
What is HIPAA (health insurance portability and accountability act of 1996)
preexisting medical condition clause unenforceable if:
an employee covered by prior employer’s health insurance plan for at least 12 mo.
fewer than 63 days have elapsed since the loss of coverage under prior employer’s plan
how does HIPAA define a preexisting condition?
medical condition treated/diagnosed within 6 mo before enrolling in new group health plan
what are main components of patient protection and ACA?
dependents on plan until 26
essential health care benefit coverage lifetime and annual limits prohibited
preventive services must be provided without charging deductible, copay, coinsurance
coverage cannot be cancelled after insured gets sick
higher coverage expenses cannot be applied for emergency services provided out of network
plans must provide in network OBGYNs and pediatricians
cannot discriminate based on employee’s pay or preexisting conditions for children under 19
credits for low income earners
state based health insurance exchanges
what is the penalty for not having health insurance coverage?
2.5% of annual household income above tax filing threshold
who is covered under medicare?
65 yrs +
individuals receiving SS disability benefits for at least 24 mo
individual on kidney dialysis and in end-stage renal failure
railroad retirement program individuals
what are the 4 parts of medicare?
A - hospital insurance
B - medical insurance
C - Medicare Advantage Plans
D - outpatient prescription drug coverage
How is the medicare program financed?
2.9% payroll tax - 1/2 paid by employee, other 1/2 paid by employer
FICA not deductible by employee, but deductible by employer as necessary and ordinary business expense
Additional .9% tax levied to employee share for higher earners ($250k MFJ, $200k S)
No cap on tax paid
what is included with medicare part A?
hospital care limited to 90 days/yr
lifetime reserve of 60 additional hospital care days
skilled nursing care (only if condition expect to improve)
home health services (80% paid by insurance, 100 visits covered)
care in hospice for terminally ill (life expectancy < 6 mo, 210 days covered)
cost of blood (after first 3 pints paid for by insured)
typically do not pay premium if they or spouse have 40+ quarters of medicare-covered employment