Insurance Clauses

elements of legal contract

1. aggrement - offer and acceptance, 2. consideration, 3. Competent parties, 4. Legal purpose

the information gathered in the course of the investigation cannot be shared. and what is of information practices must include the type of information that may be collector the type and the source of investigative techniques that may be used and that information may be disclosed to other parties and the description of rights of the party being investigator Insurance are not required to disclose any of the actual information to the applicant

I thought into a state regulation, and notice of information practices that insurance provide to applicants and policy owners must include all of the following except 1.a description of the rights of the party being investigator 2. the information gathered in the course of the investigation 3.that the information may be disclosed to other parties 4. the type and the source of investigative techniques used

entire contract

Policy with riders and amendments and copy of the application

contract of adhesion

a contract of adhesion is prepared by one of the parties (insurer) and accepted by all rejected by the other party (insured) a contract of adhesion is prepared only by the insurer; the insureds the only option is to accept or reject the policy as it is written.

proof of insurability is not required

a couple owns a life insurance policy with a children's term Rider. their daughter is reaching the maximum age of dependent coverage, so she will have the car parked apartment Insurance in the near future. which of the following will she need to provide for proof of insurability

reinstatement

a policy can be restored within a specified period of time with proof of insurability

accidental means provision

a policy that uses accidental bodily injury definition will provide daughter college than a policy that uses next instruments definition

assignment

absolute or collateral

they must be part of the contract an illustration may not be altered by an Asian and most clearly stated that it is not part of the contract it is legal to list non-guaranteed values in the contract but they must be specifically labeled as projector and not guaranteed values an illustration is not part of the contract.

all of the following are requirements for life insurance illustrations except 1. identify a non-guaranteed values 2. they must have differentiate between guaranteed and projected amounts 3. they must be part of the contract 4. they may only be used as approved

skilled care customer care respite Care Home Health Care another day care or used to reduce the necessity of admission to a care facility. almost provided in an institutional setting

all of the following long-term care coverages would allow an insured to receive Care at home except 1. Home Health Care 2. skilled care 3. custodial care in Insured house 4. respite care

skilled care custodian care, respite care, home health care and adult care at all coverage is used to reduce the necessity of admission into a care facility. skilled care is almost always provided in an institutional setting

all of the following long-term long-term care coverages would allow an insured to receive Care at home except what? Home Health Care, skilled care, custodial care in Insured's house, respite care

information obtained from an insurance institution responsible for a previous adverse underwriting decision an agent may receive information from an insurance institution responsible for the previous adverse underwriting decision that enhances his or her decision to make an adverse underwriting decision. if the decision is to make an adverse underwriting decision, he or she must you commission notice

an adverse underwriting decision may be based on which of the following

30 days every license agent convicted of a felony and are any administrative action taken against him or her in another jurisdiction or by other governmental agency in this Commonwealth must report all the facts and circumstances to the commission within 30 days

an agent is convicted in another jurisdiction within what period Of time must the agent report the felony charge to the commission

ask her to sign a statement of good health Eva premium is not collector until the policy is that a word agent must receive a statement of good health, which I acknowledge is that the insurance health status has not changed since the policy was approved

an agent is ready to deliver a policy to an applicant but has not yet received payment, upon delivery, the agent collects the applicant's premium check, answers any questions the applicant may have and then leaves what did he forget to do

ask her to sign a statement if the premium is not character until the policies delivered agent must receive a statement of good health workshop knowledge that the insurance health status has not changed since the policy Auto customization delivers a last-minute change the pharmacy dragon in forms the customer all this change and we accept what must he isn't doing now how to change in the policy with a January 10th at 3 on baby must had a customer sign in their statement on the change alien should I ask the customer to sign a statement that is a variable change nothing after ex machina

an agent is ready to deliver a policy to an applicant but has not yet received payment. upon delivery, cancel premium check, answers any questions that application may have, and then leaves. what did he forget to ask the applicant to sign a statement that acknowledges that the policy has been delivered collect late payment fee ask her to sign a statement of good health offered her a secondary policy

rebating

an agent offer his client free tickets to a sporting event in exchange for the purchase of a insurance policy the agent is guilty of

May that approve the application not issued a policy when the agent receives the application and issue set conditional received the insurer has not yet approved the application and issue the policy

an applicant for the health insurance policy returns a completed application to her agent, along with the check for the first premium. she receives a conditional receipt two weeks later which of the following has the insurer done by this point?

no, dad's really apply, since the injury could have been foreseen. an accidental means clause states that if an insured meant to do whatever caused the injury, no coverage applies since the resulting injury should have been foreseen.

an insured is covered by a disability income policy that contains an accidental means clause. the insured exits a bus by jumping down the steps and breaks an ankle what coverage will apply?

500 once a primary insurer has paid the full level it would benefit the secondary insurance will cover what the first company will not pay such a delectable or co-insurance

an insured is covered under to group Health plans under his own and his paws has he has suffered a lot of 2,000 and the insurer paid a total of 500 and irritable and coinsurance the primary insurance cover $1,500 of medical expenses what amount if any would be paid by the secondary insurance

viatical settlement

an insured under a life insurance policy has been diagnosed with terminal illness and has 6 months to live. the insured knows that his financial state Will worsen even more with the upcoming medical expenses what option code the ensure that utilize viatical statement allows an insured with a life-threatening condition to sell the existing policy in order to receive benefits when they are most needed. viators typically receive a percentage of the policies face value from the person who purchases the policy

Halo couple if a husband is named as a revocable beneficiary the insured would be the policy owner and could make changes to the contract her husband would receive any death benefit

an insured wants to name her husband as a beneficiary of her health department. she also wishes to retain all of the rights of ownership. The insurer should how has been named as what type of beneficiary

the capital amount in a lump sum accidental death and dismemberment policies pay a capital amount (that is a percentage of the principal amount ) for the loss of one limb or loss of sight in one eye the principal amount is paid for the death but often for the loss of the two limbs are the loss of sight in both eyes. benefits are paid in lump sum

an insured who has accidental death and dismemberment policy loses her left arm in an accident what type of benefit will she most likely receive from this policy

an insurer cannot terminate coverage under an existing policy during their policy year in which the interest rate increased and subsequent cause the policy to lapse the insurer will notify the policyholder of the initial interest rate at the time of the first policy loan and any change in the interest rate at least annually

an insurer detects a policy loan from a whole life policy. during repayment, the interest rate changes significantly question. which scenario is most accurate

revocable beneficiary if her husband is named as the revocable beneficiary oh, they insured would be at the policy order and me and could make changes to the contract her husband would receive a death benefit benefits benefits trailers for individual short-term disability policies continue from

and insured wants to name her husband as the beneficiary of her health policy. Ensure that should have her husband named as what type of beneficiary? contingent irrevocable revocable primary

NAIC, a long-term care insurance shoppers guide must be provided in the format the rapper by the national association of insurance commissioners and I see. The shoppers guide must be presented to the applicant prior to the completing the application

and long-term care insurance shoppers guide must be provided in the format developed by which of the following

universal life policy and universal life policy has two compliments and insurance competent and the cash account the insurance component of a universal policy is always annually renewable term insurance

annually renewable term policy with the cash value account

changes to the application

any changes to the application must be initialed by the applicant and not agent

had any business time in three years immediately following the relevant transactions the card must be kept available and open to inspection by the commission, at any business time during the three years immediately following the complete your transaction

at what time is insurance commissioner expected records pertaining to Insurance transactions

exclusions

aviation, non-commercial, hazardous occupation, war or military Service, suicide within a specific time period

insuring

basic agreement between the insurer and the policy owner

basic expense a basic expense policy will provide coverage on a first dollar basis that is no deductible after the limits of the basic policy are exhausted her the insured must pay corridor deductible before major medical coverage will pay benefits

coverage on a first dollar basis

misstatement of age or gender

death benefit is adjusted according to the correct age and gender at policy issue

they both have a guaranteed minimum interest rate while equity-indexed annuities higher interest rates than fixed annuities, both yours of annuities guarantee a specific mineral interest rate

equity indexed annuities and fixed annuities

a dread disease policy

example of limited accident and health insurance policy

6 months any open enrollment. is a six-month period that grin guarantees the applicants the right to buy Medigap one step first sign up for Medicare part B

how long is an open enrollment. for Medicare supplement policies

six months open enrollment. is a six-month. that guarantees the applicants the right to buy Medigap once they sign up for Medicare part B

how long is the open enrollment. for Medicare supplement policies

at least once every 5 years

how often must HMOs be examined by the commission

within 90 days are as soon as reasonably possible but not to exceed 1 year the proof of loss provision states that the claimant must submit a proof of loss within 90 days however if that is not possible to comply the time parameter is extended to one year the one year limit does not apply if the claimant is not legally competent to comply with this provision

how soon following the occurrence of a covered loss must an insured submit written proof of such loss to the insurance company

within 90 days are as soon as it is possible but not to exceed one year

how soon the proof of loss need to be submitted

3 months the present group coverage may continue for 12 months email play fall in the date of insurance eligibility determination if the individual has been insured under the group and doing the entire three month. immediately preceding termination of eligibility

if an insurance eligibility for group health insurance terminates and the person is not eligible to receive medicare, Kota can be extended for 12 months if the person was covered under the plan for at least

I just a benefit in accordance with the increased risk it part of the premium rating concerns the hazard of occupation

if an insured under a disability income insurance policy changes to a more hazardous occupation after the policy has been issued and the claim is filed the insurance company should do the following

I guess that benefit in accordance to the increase risk a part of the premium rating concerns the hazard of occupation

if an insured under a disability income policy changes to a more hazardous occupation after the policy has been issued a claim is filed what should the insurance company in dude which of the following 1.I'm just a benefit in accordance with the increased risk 2. cancel the policy 3. increase the premium 4 exclude coverage for on-the-job injury

firt dollar first dollar coverage do not require the insured to pay a deductible

if an insurer is not required to pay a deductible, what kind of coverage does he or she have

accidental death rider

if the insured dies from an accident, death benefit is multiple of the face amount

group Health policy , probationary period

in group health policy a probationary period is intended for people who join the group after the effective date the probationary. is the waiting. New employees must satisfy before becoming eligible for benefits

cost of living Rider

increase the death benefit to keep Pace with inflation

Aleatory Contract

insurance contracts are a aleatory, which means there is an exchange of unequal amounts are values. The premium paid by the insured is small in relation to the amount that would be paid by the insurer in the event of loss

incontestability

insurer cannot contest Miss statements on the application after the time period

conditional receipt

it is intended to provide coverage on the date prior to the policy issue

consideration consideration is the value offered by the insured to the insurance and vice-versa. The insured makes accurate statements in the application and premium payments. In exchange the insurer provides the benefits as stipulated in the contract

parties to the contract exchange something of value, payment of premium and representations on the application

payor benefit Rider

payor benefit Rider does not increase death benefit., it only pays the premium if the pair is disabled or dies.

free look

policy can be returned for a refund of premium within a specified time period

payment of premiums

premiums are paid in advance

premiums are deductible and benefits are taxed the premiums paid for BYU Insurance are tax-deductible to the business as a business expense however the benefits are received are taxable to the business as received

regarding the taxation of business overhead policies

premiums are deductible and the benefits are taxed.

regarding the taxation of business overhead policies

straight life

straight whole Life policies have a level guaranteed face amount and a level premium for the life of the insured

restoration may not be altered by an agent and must clearly state that it is not part of the contract it is legal to list non-guaranteed values in the contract but they must be specifically labeled as projector and not guaranteed values

the following are requirements for life insurance illustrations except

Impairment Rider

the impairment Rider exclusive specified condition from coverage, therefore, reducing benefits. And insurance company will not charge extra for my light on. reduces benefits.

a list of available doctors the insuring clause listing sure, the insurance company, what kind of losses are covered, and for how much the losses would be compensated

the insuring clause not specify

other insured Rider

the other insured Rider is useful in providing insurance for more than one family member, the type of insurance offered by this Ryder is usually term insurance with the right to convert apartment insurance

Other Insured Rider

the other insured drivers is useful for providing insurance to more than one family member, the type of insurance offered by this rider is usually Term paper insurance with the right to convert to a common insurance

the policy contains sufficient cash value to cover the cost of insurance in universal life insurance, the policy owner May skip the a premium payment without lapsing the policy as long as a policy contain sufficient cash value and the time to cover the cost of insurance for. premium period.

the policy owner of a universal life policy May skip paying the premium and the policy will not lapse as long as

a non-qualified annuity plan

the president of a manufacturing company has offered one of the company's officers as a special individual annuity plan that is unavailable to lower echelon employees. this plan would be funded before with before-tax corporate dollars and it does not meet government approval standards. this annuity plan is non-qualified plans are a perfectly legal way for selected employees to receive certain types of benefits. before tax corporate dollars can be used for this plant and they are not subject to government standards. because of this, however, non-qualified plan contributions are not tax-deductible unlike with qualified plans

need

the primary eligibility requirement for Medicaid benefits is based upon

reinstatement provision

the reinstatement provision allows a lapsed policy to be put back in force the maximum time limit for reinstatement is usually three years after the policy has lapsed. if the policy owner elects to reinstate the policy he or she would have to provide evidence of insurability and is required to pay all back premiums plus interest

insuring clause the insuring clause is a provision on the first page of the policy that states the coverage and when it applies

the section of a health policy that states that the cause of eligible laws under which an insured is assumed to be disabled is

insuring clause insuring clause is a provision on the first page of the policy that states that cover it and when it applies

the section of the health department that states that causes of eligible laws under which an insured is assumed to be disabled is

Grace Period

time period after the premium is due during which the policy will not lapse

physical exam and autopsy provision

under the physical exam and autopsy provision how many times can an insurer have the insured examined headed to own expense while the claim is pending : unlimited

viatical settlements

viatical settlements allow someone living with a life-threatening condition to sell their existing life insurance policy and use the proceeds when they are most needed before their death. 1. the insured's are referred to as viators 2. viatical settlement provider means a person other than the viator that enters into a viatical settlement contract 3. viatical producers represents the providers 4. viatical brokers represent the insured's. Viators usually receive a percentage of the policies face value from the person who purchases the policy. the new owner continues to maintain premium payments and will eventually collect the entire death benefit

any policy that has a death benefit must also have a change of beneficiary provision this allows the policyowner to change beneficiaries without the original beneficiary is concerned, unless that person was designated as an irrevocable beneficiary

what describes accurately the change of beneficiary provision

insurance is a mechanism whereby an insured is protected against loss by a specified future contingency or pedal in return for the present payment of premium mama

what do individuals use to transfer the risk of loss to a larger group

30 young adults under age 30 and individuals who cannot obtain affordable coverage may be able to purchase individual catastrophic plans

what is the maximum age for qualifying for a catastrophic plan

18

what is the minimum age for obtaining an agent's license in Virginia

2 a small employer and price and average of at least two but not more than 50 on business days during the preceding calendar year and who implies at least two

what is the minimum number of employees a small employer can have

31 days every policy providing coverage for dependent child until a specified age will not terminate. college if the child is dependent upon the insured and he's incapable of self-support because of physical or mental handicaps. proof of the dependency is required within 31 days of the child attending the maximum age

when an disabled dependent child reaches the age limit for coverage, how long does the policy owner have to provide proof of dependency in order for the defendant to remain covered under the policy?

recurrent disability recurrent disability is a period of time usually within 3 to 6 months during which the reccurrence of a injury or illness will be considered as a continuation of a prior period of disability

when an insurer combines two periods of disability, the insured must have suffered a

conditional

when both parties to a contract must perform certain duties and follow rules of conduct to make a contract enforceable, the contract is

the commission if the commission determines that the appointment is invalid it will notify the insurer within 5 business days of receipt of notice what is top if the appointment is about it the commission will issue an acknowledgement of appointment to the agent and the insurer within 5 business days

which of the following are the artists biderman's whether an insurance appointment of an agent is valid

what is a level term insurance annually renewable term music, Louisville, insurance. was the most insurance with the lowest cost which of the following premium payment modular car for the lowest overall payment which statement accurately describes the change of beneficiary provision

which of the following describes annually renewable term insurance

those who have been insured under the plan for at least five years

which of the following employees insured under a group Life plan would be allowed to convert to individual insurance of the same courage once the plan is Terminated? those who have two dependents those who have no history of claims those who have been insured under the plan for at least 5 years those who have walked in the company for at least 3 years

those who have been insured under the plan for at least five years if the master contract is terminated, every individual who has been on the plan for at least five years will be allowed to convert to individual insurance have the same coverage

which of the following employees insured under the group Life plan would be allowed to convert to individual life insurance of the same coverage once the plan is terminated

only Insurers, not agents can legally bind coverage

which of the following entities can legally bind coverage

it begins when policy is delivered the 10-day free-look. provision is a mandatory provision that allows the insurer to examine the policy, and if dissatisfied for any reason, return the policy for a full refund of any premiums paid

which of the following is true about a 10-day free-look. In a life insurance policy

funds exceeding the premium paid are taxable as ordinary income the insurance surrender the policy at its current cash value, only any excess of value is taxable as income. once the policy order apps for the cash there under the policies immediately inactive.

which of the following is true about cash surrender nonforfeiture option

universal life option A if this Carta daughter is not maintain the policy is no longer defined as life insurance for tax purposes and consequently loses most of the tax tax advantages that would have been associated with the life insurance

which of the following policies would have an IRS required corridor or gap between the cash value and the death benefit

universal life option A universal life option with a level death benefit option policy must maintain a specified a corridor or a gap between the cash value and the death benefit as required by the IRS if this car. is not maintained the policy long he's no longer defined as life insurance are for tax purposes and consequently losses from most of the tax advantages that have been associated with the life insurance

which of the following policies would have an IRS required corridor or gap between the cash value and the death benefit equity indexed universal life variable universal life universal life option A universal life option b

payment of claims the payment of claims provision states that the claims must be paid to the policy owner, unless the death proceeds need to be paid to a beneficiary

which of the following provisions would prevent an insurance company from paying a reimbursement claim to someone other than the policy holder

payment of claims the provision payment of claims states that the claim must be paid to the policy owner, unless the death proceeds need to be paid to the beneficiary

which of the following provisions would prevent an insurance company from paying a reimbursement claim to someone other than the policy holder

payment of claims the payment of claims provision states that the claims must be paid to the policy owner unless the death

which of the following provisions would prevent an insurance company from paying a reimbursement claim to someone other than the policy owner

Payor Benefit Rider payor benefit Rider does not increase the death benefit. it only pays the premium if the payor is disabled or dies.. with a guaranteed insurability rider, the policy owner can increase the death benefit at specified ages or events, that is marriage or birth of a child, cost of living Rider increase the death benefit to keep Pace with inflation, in accidental death rider if the insured dies from an accident, that the benefit is there are multiple of the face amount

which of the following riders would not cause the death benefit to increase? guaranteed insurability cost of living Rider accidental death rider payor benefit Rider

special risk policy that special risk policy will cover unusual risks major types of risks that are not normally covered under AD&D policies. it covers only the specific hazard or risk identified in the policy such as a race car driver test driving a new car

which of the following special policies covers unusual risks that are not normally included under accidental death and dismemberment coverage

life expectancy life expectancy is important concept in life settlement contracts. it refers to a calculation based on the average number of months the insured is projected to live due to medical history and mortality factors (arithmetic mean)

which of the following terms means a result of calculation based on the average number of months the insured is projected to live due to medical history and mortality factors

all licensees all licensees, including agents and brokers are required to keep records have all their insurance transactions. these must be maintained for 3 years for buying a computer transaction

who is legally required to keep records pertaining to Insurance transactions

guaranteed insurability rider

with guaranteed insurability rider, the policy owner can increase death benefit at specified ages or events example marriage , birth of a child