Life Insurance policy

अब Quizwiz के साथ अपने होमवर्क और परीक्षाओं को एस करें!

Nonrenewal

termination of an insurance policy at its expiration date by not offering a continuation of the existing policy or replacement policy

Field underwriter

the agent is usually the one who has solicited the potential insured.

Death benefit

the amount paid upeon the death of the insured in a life insurance policy

policyowner

the person entitled to exercise the rights and privilieges in the policy

Underwriting

the risk selection and classification process

Alien Insureer

incorporated outside the United States

Health Insurance Portability and Accountability Act (HIPAA)

is a federal law that protects health information

Sickness

is definied as either a sickness or disease contracted after the policy has been in force at least 30 days.

Part 2- Medical Information

medical background, present health, and medical visits in recent years. medical status of living relatives, and causes of death of deceased relatives

Foreign insurer

operating in a state other than the one they are incorporated in

Mutual Companies

owned by the policyowners and issue participating policies

Premium

the money paid to the insurance copany for the insurance policy

FSA

exempt from federal income taxes, Social Security (FICA) taxes and, in most cases, state income taxes, saving 1/3 or more in taxes

Consumer Reports

include written and/or oral information rearding a consumer's credit, character, reputation, or habits collected by a reporting agency from employment records, credit reports, and other public sources.

Insurable interest

insurable interest must exist between the policyowner and the insured at the time of the application; however once a life insurance policy has been issued, the insurer must pay the policy benefit, whether or not an insurable interest exists.

Domicile

location of incorporation

Agents report

provides the agents personal observations concerning the proposal insured

Comprehensive Coverage

Health insurance that provides coverage for most types of medical expenses

Investigative Consumer Report

Information is obtained through an investigation and interviews with associates, friends and neighbors of hte consumer.

NAIC

National Association of Insurance Commisioners, an Organization composed of insurance commisioners from all 50 states, the district of columbia and the 4 US territories, formed to resolve insurance regulatroy issues

hospital indemnity

Provides a specific amount on a daily, weekly, or monthly basis while the insured is confined to a hospital

Insurer-

The company who issues an insurance policy

4 essential elements of Legal Contract

1. Agreement-offer and acceptance 2. COnsideration 3. Competent parties 4. Legal purpose

Deductible

A specified dollar amount that the insured must pay first before the insurance company will pay the policy benefits

PArt 1- General Information Part2- Medical Information

What 2 parts make up a life insurance application?

Agreement, COnsideration, Competent Parties, Legal Purpose

What are the 4 required elements of an insurance contract?

Irrevocable beneficiary

a beneficiary who has a vested interest in the policy and therefore, the policyowner may not exercise certain rights without the consent of the beneficiary

Flexible Spending Account (FSA)

a form of cafeteria plan benefit funded by salary reduction and employer contributions.

Elimination period

a waiting period that is imposed on the insured from the onset of disability until benefit payments commence

Part 1- General Information

name, age, address, birth date, gender, income, marital status, and occupation. Identifies type of policy applied for and amount of coverage

Substandard risk

not acceptable at standard rates because of physical condition, personal or family history of disease, occupation, or dangerous habits.

tax exempt

not subject to taxation

Intermediate care

occasional nursing or rehab care provided for stable conditions that require daily medical assisstance ona less frequent basis than skilled nursing care.

lapse

policy termination due to nonpayment of premium

Insurance policy

a contract between a policyowner (and/or insured) and an insurance company which agees to pay the insured or the beneficiary for loss caused by specific events

Aget/Producer

a legal representative of an insurane company; the classification of producer usually includes agents and brokers; agents are the agents of the insurer

Stranger-originated life insurance (STOLI)

a life insurance arrangement in which a person with no relationship to the insued purchases a life policy on the insured's life with the intent of selling the policy to an investor and profiting financially when the insured dies.

Guaranteed renewable

a policy that is written on a noncancellable basis with the right to renew guaranteed

Replacement

a practice of terminating an existing policy or letting it lapse and obtaining a nw one.

Policy summary

a written statement describing the features and elements of the policy being issued. Must include name and address of agent, full name and home office or administrative office adress fo the insurer, and generi name of the basic policy and each rider.

Riders

added to the basic insurance policy to add, modify or delete policy provisions

Contract

agreement between two or more parties enforceable by law.

Warranty

an absolutely true statement upon which the validity of the unsrance policy depends

Investor-owned life insurance (IOLI)

another name for a STOLI, where a third-party investor who has no insurable interst in the insured initiates a transaction designed to transfer the policy ownership rights to someone with no insurable interest in the insured and who hopes to make a profit upon the death of the insured or annuitant.

Life insurance

coverage of human lives

Special Risk policy

covers only the specific hazard or risk identified in the policy

Skilled care

daily nursing and rehab care that canonly be provided by medical personnel, under the direction of a physician.

Injury

defined using either the accidental bodily injury definiteion, or the accidental means definition.

Limited Risk Policy

defines the specific risk in which accidental death or dismemberment benefits will be paid.

Respite care

designed to provide relief to the family caregiver, and can include a service such as someone coming ot the home while the caregiver takes a nap or goes out for a while.

Disability income insurance

designed to replace lost income in the event of this contingency, and is vital component of a comprehensive insurance program.

Point-of-service plan

do not have to be locked into one plan or make a choice between the two plans. A different choice can be made every time a need arises for medical services

Fair Credit Reporting Act

established procedures that consumer-reporting agencies must follow in order to ensure that records are confidential, accurate, relevant, and properly used.

Health Maintenance Act of 1973

forced employers with more than 25 employees to offer the HMO as an alternative to their regular health plans.

Dividends

generated when the premiums and the earnings combined exceed the actual costs of providing coverage, creating a surplus.

PPO

group of physicians and hospitals that contract with employers, insurers, or third party organizations to provide medical care services at a reduced cost

Preferred Risks

individuals who meet certain requirements and qualify for lower premiums than the standard risk. Superior physical condition, lifestyle, and habits.

unilateral contract

only one of the parties to the contract is legally bound to do anything

Stock Copanies

owned by the stockholders who provide the capital necessary to establish and operate the insurance company who share in any profits or losses.

Contract of Adhension

prepared by one of the parties (insurere) and accepted or rejected by the other party (insured).

Long term care policies

provide coverage for individuals who are no longer able to live an independent lifestyle and require living assistance at home or in a nursing home facility

Home convalescent care

provided in the insured's home under a planned program established by his or her attending physician.

Residential Care

provided while the insured resides in a retirement community or a residential care facility for th eelderly (RCFE).

Basic Medical expense coverage

provides coverage for nonsurgical servies a physician provides.

Presumptive disability

provision that is found in most disability income policies which specifies the conditions that will automatically qualify the insured for full disability benefits.

Medical Information Bureau (MIB)

receives adverse medical information from insurance companies maintains confidential medical impairment information on individuals.

Benefit period

refers to the length of time over which the monthly disability benefit payments will last for each disability after the elimination period has been satisfied.

Probation period

refers to the length of time over which the monthly disability benefit payments will last for each disability after the elimination period, but is in addition to it; often 10-30days

Consolidated Omnibuc Budget Reconsciliaton Act of 1985 (COBRA)

requires any emplloyer with 20 or more employees to extend group health coverage to terminated employees and their families after a qualifying event.

Conditional contract

requires that certain conditions must be met by the policyowner and the company in order for the contract to be executed, and before each party fulfills its obligations

Underwriting

risk selection and classification process

Application

starting point and basic source of information used by the company in the risk selection process

material misrepresentation

statement that, if discovered would alter the underwriting decision of the insurance company

Representations

statements believed to be true to the best of one's knowledge, but they are not guaranteed to be true

Taxable

subject to taxation

Cancellation

termination of an in-force insurance policy, by either the insured or the insurer, prior to the expiration date shown in the policy

The higher the premium

the higher the risk

Aleatory contracts

there is an exchange of unequal amounts or values

Cafeteria Plan

type of employee benefit plan that allows insureds to chooose between different types of benefits

misrepresentation

untrue statements on the application

Supplementary Major Medical Policies

used to supplement the coverag payable under a basic medical expense policy

Conditional receipt

used when the applicant submits a prepaid application.

Underwriting

whena group policy is written every elgibile member of the group must be covered regardless of physical condition, age, sex or occupation

At the time of application

When must insurable interest exist in life insurance?

Lump sum

a payout method that pays the beneficiary the entire benefit in one payment

Applicant or proposed insured

a person implying for insurance

Beneficiary

a person who receives the benefits of aninsurance policy

Basic Surgical expense coverage

pay for the costs of surgeons' fees, anesthesiologist, and the operating room when it is not covered as a misc medical item

Insured

person covered by the insurance policy; may or may not be the policyowner

Standard Risks

persons who according to a company's underwriting standards, are entitled to insurance protection without extra rating or special restrictions.

sickness

an illness, which first manifests itself while the policy is in force

Accidental Bodily injury

an unforeseen and unintended injury that resulted from an accident rather than a sickness

Custodial Care

care for meeting personal needs such as assistance in eating, dressing, or bathing which can be provided by nonmedical personnel, such as relatives or home health care workers.

Home health care

care provided by a skilled nursing or other professional services in one's home.

Adult day care

care provided for functionaly impaired adults on less than a 24-hour basis.

Adverse Selection

insuring of risks that are more prone to losses than the average risk


संबंधित स्टडी सेट्स

chapter 3 review (legal aspects)

View Set

International Business Transactions -- Chapter 2 International Business Treaties

View Set

Introduction to Business chp 1 review

View Set

Skin and Subcutaneous Tissue infections

View Set

Lecture 2: Sustainability: Definitions, Principles, and Examples

View Set

T4L 4th Grade LA Chapter 5 Lesson Quiz: Using Evidence to Support Ideas About a Text

View Set