Life Policy Provisions, Rideers & Options

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KNOW THIS! Common Diaster Clause

Common Disaster Clause protects the contingent beneficiary

KNOW THIS! Dividends

Dividends are a return of excess premiums; therefore, not taxable when paid to the policyowner (mutual policy)

What life insurance policy provision states that both the policy and a copy of the application form the contract between the policyowner and the insurer?

Entire Contract

KNOW THIS! Extended Charge

Extended term is the automatic nonfordeiture option: same face amount, shorter term of coverage

KNOW THIS! Grace Period

Grace periods protect policyholders from losing insurance coverage if they are late on a premium payment

Hazardous Occupation or Hobby Exclusion

If the insured dies or is injured as a result of a hazardous occupation or hobby, the insurer will not pay the claim, or option to charge higher premium

NAIC

National Association of Insurance Commissioners, an organization composed of insurance commissioners from all 50 states, the District of Columbia and the 4 U.S territories, formed to resolve insurance regulatory issues.

KNOW THIS! Nonforfeiture Options

Nonforfeiture options are triggered by policy surrender or lapse

Parial Surrentder or Withdrawal

ONLY on Universal Life Policies - may be a charge - limits on withdrawal amount - interest may be taxable

KNOW THIS! Policy Loans

Policy Loans are ONLY available in policies that have cash value (whole life)

Living Needs Rider

Provides for the payment of part of the policy death benefit if the insured is diagnosed with a terminal illness that will result in death within 2 years.

What are policy dividends?

Return of unused premiums

Waiver of Monthly Deductions

Rider pays all monthly deductions while the insured is disabled, after a 6-month waiting period. usually on universial & variable universal life

KNOW THIS! Settlement Options

Settlement Options are triggered by the insured's death or age 100

What does the term double indemnity mean?

The insurer will pay a benefit of twice the face amount

What happens to the proceeds of a life insurance policy if there is no named beneficiary?

The proceeds are paid to the insureds estate

Uniform Simultaneous Death Law

This law stipulates that if the insured and the primary beneficiary died in the same accident and there is no sufficient evidence to show who died first, the policy proceeds are to be distributed as if the primary beneficiary died first.

Long-Term Care (LTC) Rider

This life policy rider provides funds to help pay the costs of long-term medical and nursing care. Like the accelerated benefits provision, the LTC rider allows a portion of the life policy's face amount to be paid out should the insured require long-term care. With the LTC rider, benefits become payable if the insured requires long-term care and meets the conditions for payment.

What is the purpose of a free look period?

To allow the insured to return the policy with a full refund

KNOW THIS! Under Life-Income Settlement Option

Under life-income (straight life) settlement option, the recipient cannot outlive the benefit payments

To meet the requirement of the entire contract policy provision, an insurance policy must contain what?

a copy of the orginial insurance application

Minor

a person under legal age

activities of daily living (ADLs)

a person's essential activities that include bathing, dressing, eating, transferring, toileting, continence

Indemnity

a principle of reimbursement on which insurance is based; in the event of loss, an insurer reimburses the insureds or beneficiaries for the loss

Which of the 2 types of policy assignments requires transfer of all ownership rights in the policy to a third party?

absolute assignment

Absolute Assignment

all ownership rights in the policy are transferred to a new owner

Reinstatement

allows a lapsed policy to be put back in force. Max is typically 3 yrs. Policy that has been surrendered CANNOT be reinstated

What happens to a policy's cash value under an extended term nonforfeiture option?

cash value is converted to the same face amount as in the whole life policy

What type of assignement is used to secure the payment of a debt with an existing life insurance policy?

collateral assignment

What type of beneficiary is next in line after the primary beneficiary?

contingent beneficiary

KNOW THIS! Entire Contract

entire contract = policy + copy of application + any riders or amendments

What required provision protects against unintentional policy lapse?

grace period

Life Income Joint & Survivor Option

guarantees an income for two or more recipients for as long as they live

Primary Beneficiary

has first claim to the proceeds following the death of the insured

KNOW THIS! If NO Beneficiary

if NO Beneficiary is names, policy proceeds go to the insured's estate

Return of Premium Rider

implements using increasing term insurance; when added to a whole life policy, it provides that at death prior to a given age, an amount equal to all premiums previously paid is also payable to the beneficiary (such as age 60)

What life insurance policy provision prevents an insurer from disputing or denying a claim due to misstatements on the application after a certain period of time?

incontestability

The sole beneficiary of a life insurance policy dies before the insured. If the policyowner does not amend the beneficiary designation, what will happen to the policy's death benefit?

it will be paid to the insured's estate

If a settlement option is not chosen by the policy owner or the beneficiary, what option will be used by the insurer?

lump sum payment

Per Capita

meaning by the head, evenly distributes benefits among the living named beneficiaries

KNOW THIS! Misstatement of Age

misstatement of age on the application will result in adjustment of premiums or benefits

KNOW THIS (Children's Term Rider)

one premium for all children

Irrevocable Beneficiary

one that cannot be changed without the beneficiary's consent

What is the name for a life insurance policy rider that provides coverage on the insured's family members?

other insured rider

What dividend option can increase the death benefit of the existing life policy?

paid up additions

What dividend option is automatically selected by the company if not chosen by the policyowner?

paid up additions

Aviation Exclusion

will cover fare-paying passenger or pilot but exclude noncommercial pilots or charge higher premium with a rider

Premium Mode

Annual, semi - annual, quarterly, monthly -annual is the lowest

Contingent Beneficiary

(Also referred to as secondary or tertiary beneficiary) has second claim in the event that the primary beneficiary dies before the insured.

Fixed Period Installment Option

(alos called period option), a specified period of years is selected, & equal installements are paid to the recipient (beneficiary)

Per Stirpes

(meaning by the bloodline) In the event that a beneficiary dies before the insured, benefits from that policy will be paid to that beneficiary's heirs.

Insuring Clause

(or insuring agreement) sets forth the basic agreement between the insurer & the insured - parties to the contract - length of coverage - premium to be paid - amount of death benefit

Riders Affecting the Death Benefit Amount

* Accidental Death Benefit (Double or Triple Indemnity) * Accidental Death and Dismemberment * Guaranteed Insurability * Return of Premium * Term Riders

KNOW THIS! Absolute & Collateral Assignment

- Absolute asssignment is the complete & permanent transfer of ownership rights - collateral assignment is the partial & temporary transfer of rights

Riders that Cover Additional Insureds

- Family term (spouse or children) - coverage for 1 or more family members other than the insured - level term attached to the base policy - usually expires at age 65 for the spouse or 10 or 21 for the children

Riders Covering Additional Insureds

- Spouse - children - family - nonfamily

What are the dividend options in life insurance policies?

- cash - reduced premium - accumulation at interest - paid up additions - paid up option - one year term - acceleration of endowment

Dividend Options (6)

- cash - reduction of premium - accumulation at interest - paid up additions (automatic) - paid up insurance - one year term

Settlement Options (5)

- cash (automatic) - life income - interest only - fixed period - fixed amount

What are the 3 nonforfeiture options in life insurance policies?

- cash surrender - reduced paid up - extended term

Beneficiaries

- individuals - classes (all children) - minors - estates - trusts

What settlement options are available in life insurance policies?

- lump sum / cash - fixed period - fixed amount - life income - interest only

Accidental Death Benefit Rider

- pays multiple of the face amount - death must occur w/i 90 days of an accident - principal sum (face amount) or accidental death - usually double or triple

Automatic Premium Loans (APL)

- prevents unintentional lapse - automatically taken from cash value due at the end of grace period - will be deducted from death benefit if not repaid - insurer honors immediately

Nonforeiture Options (3)

- reduces paid up - extended term (automatic) - cash

Assignment

- transfer of rights of policy ownership - 2 types Absolute & Collateral

Disability Riders (5 types)

- waiver of premium - waiver of monthly deduction - payor benefit - disability income - accelerated (living) benefit

Waiver of Premium (KNOW THIS!)

- waiver of premium rider waives the premium for a total disability after a waiting period (typically 6 mo) Continuation of life insurance coverage if the insured becomes totally disabled and is unable to pay the premiums.

Disability Income Rider

-Pays a monthly income benefit to the insured in the event he or she becomes disabled -Pays benefits for life or until a disability ends once a waiting period has passed from the date of the insured's disability - amount paid is based on a % of the face amount

War or Military Service Exclusion

-status type: death occurs while in the military regardless of the reason -results type: death occurs related to the military

Guaranteed Insurability Rider

Allows insured to purchase additional coverage at specified future dates (usually every 3 years) or events (such as marriage or birth of a child), without evidence of insurability, for an additional premium

An insurer has discovered a representation on a life insurance policy application regarding the insured's age. The insured is 10 years older than he stated on the application. What will the insurer do regarding the death benefit?

pay a reduced death benefit

Lump Sum

payment of the entire benefit in one sum

Fixed Amount Installements Option

pays a fixed, specified amount in installments until proceeds (principal & interest) are exhausted.

Accidental Death and Dismemberment Rider

pays the principal (face amount) for accidental death, and pays a percentage of that amount, or a capital sum, for accidental dismemberment

Accelerated (Living) Benefits Rider

permits the insured to use benefits before death if the insured is terminally ill. Qualified early payments are received tax-free by the insured (death w/i 2 yrs) reduces death benefit - KNOW THIS! early payment of part of the death benefit to the insured from the insurer for qualifying medical expenses

What is the advantage of reinstating a Life insurance policy as oppsoed to applying for a new one?

policy premium in a reinstatment policy will be set according to the insured's original age

With the interest only settlement option, what happens to the policy's death benefit?

policy proceeds are retained by the insurance company; only the interest is paid to the beneficiary

Who controls changes in premium payments, face values, and loans in a life insurance policy?

policyowner

Who has the right to the cash value of a life insurance policy?

policyowner

Incontestability Clause

prevents an insurer from denying a claim due to statements in the application after the policy has been in force for 2 years

Payor Benefit Rider

primarily used with juvenile policies (any life insurance written on the life of a minor); otherwise, it functions like the waiver of premium rider. If the payor (usually a parent or guardian) becomes disabled for at least 6 months or dies, the insurer will waive the premiums until the minor reaches a certain age, such as 21. This rider is also used when the owner and the insured are two different individuals.

What beneficiary designation has first claim to the death proceeds of a life insurance policy?

primary beneficary

Common Disaster Clause

provides that if the insured and the primary beneficiary died in a common disaster (even if the beneficiary outlived the insured by a specified number of days), it is presumed that the primary beneficiary died first, so the proceeds will be paid to either the contingent beneficiary or to the insured's estate, if no contingent beneficiary is designated. (usually 14-30 days)

Free Look Provision

provision allows policyowner a specific # of days (typically 10) & could recieve refund, starts when receives policy

What nonforfeiture option provides coverage for the longest period of time?

reduced paid up

What provision allows the policyowner to reactivate a lapsed life insurance policy within a specific period of time with proof of insurability?

reinstatement

What type of beneficiary can be changed at any point by the policyowner?

revocable

Consideration

something of value that each party gives to the other (binding force in any contract)

An applicant for life insurance misstated her age on the policy application. How will this affect the death benefit?

the death benefit will be adjusted to the amount that the insured could obtain for her correct age

With the reduction of premium dividend option, how is the dividend used?

the dividend is applied to the nexts years premium (it reduces the next years premium)

Principal

the face value of the policy; the original amount invested before the earnings

Interest Only Option

the insurance company retains the policy proceeds and pays interest on the proceeds to the recipient (beneficiary) at regular intervals

Revocable Beneficiary

the policyholder reserves the right to change the beneficiary designation without the beneficiary's consent

Life Income with Period Certain Option

the recipient is provided with the "best of both worlds" in terms of a lifetime income and guaranteed installment period

What is the purpose of settlement options in life insurance policies?

to determine how the death benefit will be paid to the beneficiary

What is the purpose of the Automatic Premium Loan Provision?

to prevent the unintentional lapse of a policy because of non payment of the premium

Collateral Assignment

transfer of partial rights to another person

What life policy rider allows the company to forgo collecting the premium if the insured becomes disabled?

waiver of premium

When can an insurance company use suicide as a defense against paying a death claim?

when a suicide is committed within a specific period of time after the policy is purchsaed (usually 2 yrs)


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