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Reserves
Funds held by an insurance company to help fulfill future claims
Stock Company
insurance companies owned and controlled by a group of stockholders
Non-participating plan
plan in which the insured is not entitled to share in the divisible surplus of the company (dividends)
Mutual Company
Company that is owned by its policy owners and usually issues participating insurance
Participating Plan
Plan in which policy owners receive shares of the company's divisible surplus (dividends)
Reinsurer
A company that provides financial protection to insurance companies. They handle risks too large for the insurance company to handle on its own.
Fair Credit Reporting Act
A federal law that established procedures that consumer-reporting agencies must follow in order to ensure that records are confidential, accurate, relevant and properly used.
Policy Summary
A Summary of the terms of the insurance policy; including conditions, coverage limitations, and premiums.
Life Insurance
insurance against loss due to the death of a specific person (insured) upon whose death the insurance company agrees to pay a stated sum to the beneficiary.
Term Insurance
Life insurance coverage for a specified period of time, expires without value if the insured survives the stated period. Designed to provide temporary protection in case a person dies during a specified period of time.
Whole Life Insurance
permanent, level insurance protection for a person's "whole of life"
Characterized by: level premiums, level benefits, and cash values
Group Life Insurance
life insurance that provides a master policy for a group; each eligible group member receives a certificate of insurance
Consideration
Part of an insurance contract that sets forth the amount of the initial and renewal premiums and frequency of future payments
Disability Insurance
A type of insurance that insures the insured's earned income against the risk that a disability renders the insured unable to complete the core functions of their work.
Entire Contract Provision
States that the policy document, the application (which is attached to the policy), and any attached riders constitute the entire contract
Notice of Claim
Describes the policy owner's obligation to provide notification of loss to the insurer within a reasonable amount of time
Reinstatement
Act of putting a lapsed policy back in force by producing satisfactory evidence of insurability and paying any past-due premiums
Peril
The immediate specific event causing loss and giving rise to risk
Loss
loss of assets resulting from a pure risk
Hazard
Any factor that gives rise to a peril.
Morale Hazard
Hazard arising out of an insured's indifference to loss because of the existence of insurance.
Loss Exposure
Any condition or situation that presents a possibility of loss, whether or not an actual loss occurs.
risk
The probability of loss occurring for an insured or prospect
Pure Risk
a risk that presents the chance of loss but no opportunity for gain; this is insurable
Speculative Risk
a risk that presents the chance of both loss and gain; it is not insurable
Risk Retention
Being aware of the risks involved and taking precautions for financial protection.
Risk Reduction
when the chances of loss are lessened
Ex) Changing one's lifestyle to minimize a known risk
Risk Avoidance
when individuals avoid risk entirely
Ex) If you never get into a car, you can never be in a car accident
Indemnity Contract
agreement by one person, for consideration, to pay another person a sum of money in the event that the other person sustains a specified loss
Law of Large Numbers
the larger the number of individual risks combined into a group, the more certainty there is in predicting the degree or amount of loss that will be incurred in any given period
Moral Hazard
Arises when people behave recklessly because they know they will be saved if things go wrong
Adhesion
The contract has been prepared by one party with no negotiation between the applicant and the insurer
Applicant "adheres" to the terms on a "take it or leave it" basis
Unilateral
Only one party (the insurer) makes any kind of enforceable promise
Legal Purpose
To be valid, the object of the contract and the reason the parties enter into the contract must be legal
Competent Parties
To be valid a contract must be entered into by competent parties:
Competent Insurer: has been licensed and authorized by the state in which it conducts business
Applicants are considered competent unless:
they are a minor
they are mentally infirm
under the influence of alcohol or narcotics
Offer and Acceptance
To be legally binding, a contract must be made with a definite, unqualified proposal (offer) by one party and the acceptance of the exact terms by the other (acceptance).
Concealment
failure by the applicant to disclose a known material fact when applying for insurance
Representation
A statement of fact or opinion made by the insured when applying for insurance, usually in response to a question from the insurer.
Insurable Interest
a person's right to take out insurance on another person because that person can show he or she would suffer financial loss or hardship in the event of the death of the insured or a loss of property
Fraud
when someone knowingly lies to obtain a benefit or advantage to which they are not otherwise entitled or someone knowingly denies a benefit that is due and to which someone is entitled
Elements of a legally binding contract (4)
1) Competent Parties
2) Consideration
3) Legal Purpose
4) Offer & Acceptance
Aleatory
A contract with an element of chance and potential for unequal exchange of value or consideration for both parties
Free Look Provision
gives policyowners the right to return the policy for a full premium refund within a specified period of time if they decide not to purchase the insurance.
Policy Loan
The policy owner is entitled to borrow an amount equal to the available cash value
*If not repaid by the time the insured dies, the loan balance and any interest accrued are deducted from the policy proceeds at the time of the claim
Grace Period
a defined amount of time after the premium is due in which a policyholder can make a premium payment without coverage lapsing
Consideration Clause
states that the policyowner's consideration consists of completing the application and paying the initial premium
Contestable period
The incontestable clause allows an insurer to contest a claim during this period (usually within the first two years of the policy's life)
Incontestable Clause
states that the insurer can no longer contest the validity of the policy after it has been in force for a specified period of time (typically two years)
Suicide Provision
protects the insurer against the purchase of a policy in contemplation of suicide (suicide period is typically within 2 years of policy's inception)
Misstatement of Age
-This clause protects the insurance company against an applicant who lies about his age
-The insurance company has the right to adjust your face amount up or down to coincide with the face amount or policy limit the correct premium would have purchased if you had not lied about your age
Accelerated Benefits Provision
provides for the early payment of some portion of the policy's face amount should the insured suffer from a terminal, critical, or chronic illness or critical injury. The remaining portion of the policy is payable as a death benefit
Nonforfeiture Options
-Cash Surrender
-Reduce Paid-Up option
-Extended Term option
Absolute Assignment
A transfer by the policyholder of all control and rights to a third party- it is absolute and irrevocable
Payor Provision
typically attached to Juvenile Insurance Policies, provides that in the event of death or disability of the adult premium-payor, the premiums will be waived until the insured child reaches a specified age or until the maturity date of the contract which ever comes first.
Policy Dividends
are paid out by Participating Companies only, If fewer insureds have died than was estimated, a surplus results and the company can return to the policyowners a part of the premiums paid. are a return of part of premiums already paid and as such are not taxable income
Return of Premium Rider
Provides that in the event of the death of the insured within a specified period of time, the policy will pay, in addition to the face amount, an amount equal to the sum of all premiums paid to date.
Waiver of Premium Rider
prevents a policy from lapsing for nonpayment of premiums while the insured is disabled and unable to work, policyowner is relieved of paying premiums for as long as the disability continues
Extended Term Option
use the policy's cash value to purchase a term insurance policy in an amount equal to the original policy's face value for as long a period as the cash value will purchase.
Cash Surrender Options
Policyowners may request an immediate cash payment of their cash values when their policies are surrendered
Insuring Clause
A general statement that identifies the basic agreement made by the insurance company to pay benefits upon the insured's death, usually located on the first page of the policy.
Policyowner
The person who has the right to exercise the privileges and rights in the policy contract.
Owner's right provision
Defines the person who may name and change beneficiaries, select options available under the policy and receive any financial benefits from the policy
Automatic Premium Loan Provision
Authorizes insurer to automatically pay any premium in default at the end of the grace period and charge the amount against the life insurance policy as a policy loan.
general exclusions
-War (referred to as the results clause)
-Private Aviation
-Commission of a Felony
-Hazardous Occupation or Hobbies
-Suicide (first 2 years)
Nonforfeiture Option (Definition)
Allows a policy owner to stop paying premiums and not forfeit any of the equity in the policy
Policy Dividend Options (5 Types)
-Cash Dividend Option
-Accumulation at Interest Option
-Paid-Up Additions Option
-Reduce Premium Option
-One Year Term Option
Guaranteed Insurability Rider
Permits Insured to buy specific amounts of additional insurance at specified intervals without evidence of insurability
Accidental Death Rider
doubles the face amount of life insurance if death occurs as a result of an accident
(Death must occur within a specified time after the date of accident-usually 90 days)
beneficiary
the party designated to receive the policy's proceeds upon the insured's death
Mortality Factor
A measure of the number of deaths in a given population. Insurance companies use mortality tables to help predict the life expectancy and probability of death for a given group.
Interest Factor
when policyowners pay premiums to a life insurance company the funds do not sit idle in the insurers vaults, they are combined with the other funds and invested to earn interest.
*Interest is one of the ways that an insurance company can lower premium rates
Factors that Impact Premium Amounts (5 Types)
-Age
-Gender
-Health
-Occupation
-Hobbies
Premium Mode
the manner or frequency that the policyowner pays the policy premium
*The higher the frequency of payments, the higher the premium
Premium Modes (4 Types)
-Monthly
-Annually
-Semi-Annually
-Quarterly
Death Benefit Payment Options (5 Types)
-Lump Sum
-Interest Only
-Fixed Period
-Fixed Amount
-Life Income
Viatical Settlement
the sale of a life insurance policy by a terminally ill insured to another party, typically to investors or investor groups, who hope to profit by the insured's early death
Tax Treatment of benefit proceeds
Policy Premiums- Not tax-deductible
Lump Sum death benefit- typically tax free
Death Benefit Installments- Principal-tax free/ Interest-taxable
1035 Exchange
An existing life insurance policy is assigned to another insurer for a new contract
*Enables postponement of tax consequences
Beneficiary Order of Succession
1) Primary
2) Secondary
3) Tertiary
Revocable Beneficiary
the policyholder reserves the right to change the beneficiary designation without the beneficiary's consent
Irrevocable Beneficiary
one that cannot be changed without the beneficiary's consent
Underwriting
Process of reviewing the characteristics that make up the risk profile of an applicant to determine insurability
Insurable Interest Exists (Types)
-Unlimited insurable interest in oneself
-Husband/ Wife can insure spouse
-Parents can insure children
-Children can insure parents
-Business can insure key employees
-Business partners can insure each other
-Creditor can insure debtor for term of the debt
Medical Information Bureau (MIB)
An information database that stores the health histories of individuals who have applied for insurance in the past.
Warranties
Statements in the application that are guaranteed true in all respects.
Conditional Receipts
indicates that certain conditions must be met in order for the insurance coverage to go into effect. There are 2 types: insurability receipt or an approval receipt.
Binding Receipts
- States that the effective date of policy is the date of receipt of the initial premium
-Should the applicant die before it is fully processed
• The benefits are full payable
• Will pay this whether or not they would have been approved
Policy Effective Date
it identifies when the coverage is effective, but also it establishes the date by which future annual premiums must be paid. The policy will not be truly effective until it is delivered to the applicant, the first premium is paid, and a statement of continued good health is obtained.
Backdating
purpose is to use premiums based on an earlier age
-make the policy effective at an earlier date than the present
Group Insurance
way to provide insurance coverage to a number of people under one contract
*Typically written for employee-employer groups and is most often written as an annually renewable term policy
Contributory Plan
Employee group insurance plan in which employees share the cost
Noncontributory Plan
The employer pays the entire cost of the plan
*Master policy is issued to employer who is policyholder
*Individual does not own policy- they are issued a certificate of coverage/insurance
Rate Classes
-Preferred-Low Risk-Low Premiums
-Standard- Average Risk
-Substandard-High Risk-Higher Premiums
-Declined-Not insurable
Group conversion to individual insurance
If a member's coverage is terminated, member may convert group coverage to individual whole life coverage, without having to show proof of insurability
Conversion Period
Individual must apply for individual coverage within 31 days after the date of the group coverage termination
Annuitant
Income recipient of an annuity
Single Premium Annuity
An Annuity purchased with one lump-sum payment, generally with after tax dollars.
Deferred Annuity
provides income payments at some future date
Periodic Payments
premiums are paid in installments over a period of time
Immediate Annuities
designed to make its first benefit payment to the annuitant at one payment interval from the date of purchase.(can start taking money out after 1 month) These are funded with one single payment and are often called SPIAs