Section 5 - Life Insurance Policy Provisions, Options, and Riders

Provisions

Things that are built into the policy, sometimes required by state law

Options

Things that are built into the policy, which are actually protecting the insurance company

Riders

Things that modify the contract and make it better for the insured
Usually are purchased at the time of application
Have to pay an extra premium for them
They provide extra coverage

Standard Provisions:
Ownership

The policyholder is the owner, all the owner's rights accrue to them

Absolute Assignment

A permanent transfer of ownership rights
Irrevocably transfers all of your rights of ownership to the insured
Insured now has to pay premiums
NOT binding upon the insurance company unless it is notified in writing

Collateral Assignment

Designation of a policy's death benefit or its cash-surrender value to a creditor as security for a loan. If the loan is not repaid, the creditor receives the policy proceeds up to the balance of the outstanding loan, and the beneficiary receives the rema

Per Capita designation

Equal shares all around
Per-capita beneficiary designations also provide that your primary beneficiary's share will go to his/her heirs; should your primary beneficiary predecease you, his/her share would be divided equally among your successor heirs.
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Per Stirpes designation

Percentage originally bequeathed passed on to sub-heirs and split between them
In the event your primary beneficiary predeceases you, a per-stirpes beneficiary designation provides that the share he/she would have received goes to his/her heirs

Entire Contract

The policy, when it is issued, plus whatever is attached, including the application is contestable in court if it ever goes to court
The application and anything else that's relevant have to be attached when the policy is issued

Modifications

Once issued, the policy may not be modified (changed) in any way without the mutual
consent of the parties

Right to Examine (Free Look)

Refund provision
This provision allows the policyowner a specified number of days from receipt to look over the policy and if dissatisfied for any reason, return it for a full refund of premium. The free look period starts when the policyowner receives th

Premium Payment Mode

How frequently you pay your premium
the more frequently you pay your premium, the higher your cost will be

Grace period

A period of time from when your premium is due that they will extend coverage
Grace period starts the day your premium is due and you don't pay it
If you have a claim during your grace period, they will pay your claim minus your overdue premium

3 Grace periods

28 days - Industrial Life
30 days - all other types of life insurance (including annuities)
31 days - Group Life and Group Health

Reinstatement

Reinstatement allows a previously terminated policy to resume active coverage
The life insurance company gives you an opportunity to reinstate the policy usually within 5 years by
1) You must take a physical exam,
2) Meet all company underwriting requirem

Advantages of Reinstatement

1) Age--since you get your original policy back, you will still be paying future premiums based on your original age
2) Your original policy may have had loan interest rates much lower than a new policy may currently offer

Incontestability

New life-insurance policies are contestable for the first two years of the policy--the insurance company may "contest" the claim and void or rescind the contract--no coverage would exist
After two years, regardless of any false answers the applicant may h

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 y

Exclusions

Things that are never covered, i.e. war, intentional acts, terrorism, dangerous hobbies, etc.
Exclusions may only be added at the time the new policy is first underwritten

Suicide Exclusion

Most states permit insurers to exclude death by suicide up to two years from the inception of the policy
However, after two years, suicide is covered
Insurance companies will refund premiums paid to the beneficiary

Designation Options:
Individuals (Per Capita and Per Stirpes)

Under a Per Capita designation (individual), each child shares equally in the death benefit
Each child, grandchild, etc., moves up as necessary to replace beneficiaries ahead of them who have died

Designation Options:
Classes

Should be used when you want a specific group to share the proceeds equally, such as "all my children," rather than naming them individually

Designation Options:
Estates

If you fail to name anyone or if all of your named beneficiaries have died before you do, your final beneficiary is considered to be your estate
If no primary or contingent beneficiary is named, the policy
proceeds will automatically go to the insured's e

Designation Options:
Minors

A minor may be named as beneficiary as long as a guardian is appointed to receive the funds on his behalf

Designation Options:
Trusts

A trust, either
inter vivos
(that is, set up while the insured is still alive), or
testamentary
(created upon the insured's death according to his will), may also be designated as beneficiary
A trustee (often a bank) will administer the funds in accordanc

Succession

A life insurance policy can have up to three categories of beneficiaries

Primary Beneficiary

The first one named by the policy owner to receive the policy proceeds in the event of the insured's death

Contingent Beneficiary

The second one named to receive the policy proceeds in the event that the primary beneficiary has predeceased the insured

Final Beneficiary

The insured's estate

Revocable

These are additions you put on your designations
The policyholder has the right to designate any
beneficiary he wants and to change it anytime he wishes

Irrevocable

This means the beneficiary can NEVER be
changed without her consent, nor could a policy loan be taken without her consent, since it would affect the amount payable in the event of the insured's death

Common Disaster Clause

Only goes into effect if the primary beneficiary dies within a certain number of days

Uniform Simultaneous Death provision

states that if both the insured and the primary beneficiary die as a result of the same accident, then it is always assumed that the insured died last
This provision ensures that the insured's contingent beneficiary would receive the policy proceeds, rath

Spendthrift Clause

A clause that prevents the debtors of a beneficiary from collecting the benefits before he/she receives them
does NOT apply to proceeds that are payable in one lump sum
This keeps the beneficiary from losing the proceeds to his creditors or from spending

Settlement Options:
Cash

Most beneficiaries select this option and receive a lump-sum payment from the insurance company

Settlement Options:
Interest Only

If the beneficiary selects this option, the money remains with the insurance company to accumulate additional interest over a period of time--pays the beneficiary interest at least annually
The beneficiary can change her mind and elect to take the money a

Settlement Options:
Fixed-Period Installment

The beneficiary advises the company to pay out the policy proceeds to her over a set period of time, say 10 or 20 years
The unpaid balance continues to earn interest during this fixed period

Settlement Options:
Fixed-Amount Installments

If the beneficiary wants a certain amount to be paid to her
monthly
However, payment of a fixed amount to the beneficiary
over a period of time will eventually deplete the principal balance, if the amount paid exceeds the interest earned on the unpaid bal

Settlement Options:
Annuity

A financial product sold by financial institutions that is designed to accept and grow funds from an individual and then, upon annuitization, pay out a stream of payments to the individual at a later point in time
If the beneficiary wants a lifetime incom

Three non-forfeiture options

Cash Surrender Value
Extended Term
Reduced Paid-Up
These options required by law
Apply to cash value policies only
If you do not pay your premium when due and your policy does lapse, the company will wait 60 days from your due date to hear from you regard

Cash Surrender Value

You surrender your original policy and the company must send your accumulated cash value to you within six months of your request

Extended Term

An automatic option
If the company does not hear from you within 60 days of your due date, it must automatically give you this option
The company will give you a new Term insurance policy with the same face amount as your original policy had
The Term poli

Reduced Paid-Up

Present cash value is used to buy a single premium,
permanent paid-up policy of a reduced face amount, the longest period of coverage provided by a nonforfeiture option
Immediate cash value will approximate the cash value you gave up
This option is design

Test question

Which of the following policies does not have forfeiture provisions? any
term
policy

Cash Loans

Policyholder can borrow on cash value at any time
Insurance company has up to 6 months to defer a loan request
Insurance Company can charge interest on loan amount - up to 8% fixed
Insurance company can limit percentage of cash value loan
At your death, a

Automatic Premium Loans

Usually free
Policy owner must select this option by checking the proper
block on the application
If you do not pay your premium when due, on the last day of the grace period the policy will automatically borrow from its own cash value to pay it for you
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Withdrawals

Clients with cash-value policies may withdraw their
money at any time
Most companies have the right to defer a request for a loan or a cash surrender up to six months

Partial Surrenders

Many companies selling Annuities, Universal, or Variable Life will charge you a penalty for early surrender, usually during the first seven years of a policy
Penalty charges must be stated clearly in the policy and/or the prospectus
Usually written on a d

Cash

Company sends check to policy owner

Reduction of Premium Payments

Company retains dividend and applies it toward
next premium due

Accumulation at Interest

Company retains dividends and pays interest
to policy owner (interest is taxable)

One-Year Term Option

Company creates new, one-year Term policy
for policyholder (nonrenewable)

Paid-Up Additions

Company uses dividend to create new, small
paid-up Whole Life policy for policy owner

Paid-Up Option

Company uses interest accumulated and/or cash
values of additional Whole Life policies to pay-up
original policy

Waiver of Premium Rider

A form of disability insurance attached to a life-insurance
policy to pay the premium on behalf of the insured in case he becomes totally disabled
The insured's sickness or disability must last for at least six months, during which time the insured must p

Disability Income Benefit

If purchased, this rider will pay your loss of net earned income if you are totally disabled as per the definition in the
rider
There is usually a short waiting period before monthly benefits start

Payor Benefit Life/Disability

similar to Waiver of Premium rider
It will pay the premium on the childs policy if the payor (usually a parent) becomes disabled or dies
Premiums will be paid by the insurer until the child reaches either age 18 or age 21, depending upon the company, at w

Accelerated (Living) Benefit Provision Rider

This rider allows a policy owner to "accelerate" receipt of a portion of the policy's death benefit upon the insureds occurrence of a terminal illness, a catastrophic illness, or eligibility for long-term care
Future benefits payable upon death will be re

Family policy

Combination of Whole Life on the breadwinner and a Level Term Rider on the spouse and children
The term coverage for both the spouse and children is renewable up to a certain age and convertible to Whole Life

Other Insured rider

Used to add coverage to your whole life policy for a new spouse, subject to insurability

Family Maintenance Policy

A policy that combines Whole Life insurance and a Level Term Rider, but both cover the same person

Family Income Policy

Combines Whole Life insurance with a Decreasing Term
Rider also written on the same person

Accidental Death

It will pay your beneficiary double or triple only in the event you die as a result of an accident
You must die within 90 days of the accident or the insurance company does not consider it to be accidental death

Guaranteed Insurability Rider

Protects the insured's right to buy more coverage in the future without the need to prove good health
The extra premium does not go toward cash value accumulation

Cost of Living

Adjusts the face amount of your policy up or down to coincide
with the rate of inflation, to assure the policyholder that the Death benefit will be adequate to cover family expenses at all times

Return of Premium Rider

An increasing amount of Term insurance that always equals the total amount of premiums paid to date

Return of Cash Value Rider

A form of Increasing Term coverage that will pay an amount equal to your cash value along with your face amount if you die