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Questions and Answers

What is the maximum claim amount that the Insurance Commission (IC) has the power to adjudicate against an insurance company for a single claim?

  • ₱ 500,000.00 (correct)
  • ₱ 100,000.00
  • ₱ 250,000.00
  • ₱ 1,000,000.00

Which statement accurately describes the renewal of an insurance agent's license?

  • An insurance agent's license is valid for the agent's lifetime.
  • An insurance agent's license will be renewed when the commissioner is satisfied with the accuracy of the application and fulfillment of all requirements. (correct)
  • An insurance agent's license is valid for only one month.
  • An insurance agent's license will be renewed upon receipt of the application and fee by the Insurance Commissioner.

Why is the insurance industry subject to government regulations?

  • Because insurance companies pay high taxes
  • Because it is a charitable institution
  • Because insurance companies are required to account for money spent in company operations
  • Because it affects public interest (correct)

Which statement accurately describes commission sharing for insurance agents?

<p>An agent is allowed to share commissions with another licensed agent or agents, but with no one else. (A)</p> Signup and view all the answers

Which of the following statements is correct regarding insurance practices?

<p>Rebating of premium by an insurance agent is prohibited. (C)</p> Signup and view all the answers

What is the practice of persuading a policy owner to surrender an existing policy and replace it with a new one from another company called?

<p>Twisting (A)</p> Signup and view all the answers

Which of the following defines rebating in the context of insurance?

<p>Premium discrimination against policy holders (D)</p> Signup and view all the answers

What does 'Knocking' typically refer to in the insurance industry?

<p>The practice of disparaging or making critical remarks about another insurance company to undermine its reputation and attract clients. (A)</p> Signup and view all the answers

An insurance agent is permitted to perform which of the following actions?

<p>Providing comprehensive comparisons between the policies they sell and those offered by competitors. (C)</p> Signup and view all the answers

Inducing a policyholder to lapse or forfeit their insurance is generally considered:

<p>An offense in the majority of cases. (D)</p> Signup and view all the answers

For what period of time is a suicide clause typically in effect after a life insurance policy is issued?

<p>The first 2 years. (D)</p> Signup and view all the answers

Which of the following correctly lists the three non-forfeiture values available in a permanent life insurance policy?

<p>Cash surrender value, paid-up insurance, and extended term insurance. (B)</p> Signup and view all the answers

If a policyholder elects the paid-up insurance non-forfeiture option, what happens to their life insurance coverage?

<p>The premiums cease, and protection continues with a reduced amount of coverage. (A)</p> Signup and view all the answers

Which of the following lists represents the basic settlement options available in life insurance policies?

<p>Fixed amount, fixed period, interest income, and life income. (A)</p> Signup and view all the answers

In the event of a misstatement of age on a life insurance application, what action will the insurance company typically take?

<p>The amount of insurance is adjusted to reflect what the premiums paid would have purchased at the correct age. (C)</p> Signup and view all the answers

Which of the following is considered a settlement option for a life insurance policy?

<p>Interest payments on the insurance proceeds. (A)</p> Signup and view all the answers

According to standard insurance practices, which combination of factors would classify a risk as substandard?

<p>Mortality risk, occupational hazards, and considerations of moral character. (A)</p> Signup and view all the answers

Which of the following describes a hazardous occupation in the context of insurance risk assessment?

<p>All of the above. (D)</p> Signup and view all the answers

In insurance applications, statements made by the applicant are considered to be what?

<p>Representations (B)</p> Signup and view all the answers

Mr. Roel Reyes was hospitalized three years before applying for insurance. What specific details should he provide in his application?

<p>Name of attending doctor, diagnosis, and date of confinement. (C)</p> Signup and view all the answers

Life insurance companies utilize a specific resource for confidential medical details about insurance applicants; what is this resource?

<p>Medical Information Bureau (C)</p> Signup and view all the answers

An agent is completing the Agent’s Confidential Report. What type of information is essential to include in this report?

<p>All relevant information known to the agent that is material to the insurance application. (D)</p> Signup and view all the answers

What is the primary purpose of an annuity plan?

<p>Purchasing a guaranteed future income stream. (A)</p> Signup and view all the answers

In an annuity plan, what is the term used to describe the individual who purchases the plan?

<p>Annuitant (D)</p> Signup and view all the answers

Under what circumstances can an insurance agent's license be revoked?

<p>Any or all of the above. (D)</p> Signup and view all the answers

Which action exemplifies ethical practices and procedures for an insurance agent?

<p>Maintaining the confidentiality of policyholders' information. (C)</p> Signup and view all the answers

What does the insurance term 'knocking' refer to?

<p>Making disparaging remarks about competing underwriters or companies. (B)</p> Signup and view all the answers

Which of the following is generally considered an ethical practice in insurance solicitation and procurement?

<p>Accurately representing the terms and benefits of an insurance policy. (A)</p> Signup and view all the answers

What does the term 'twisting' refer to in the context of insurance sales?

<p>Replacing a policy from one company with a new policy from a different company, often to the policyholder's detriment. (D)</p> Signup and view all the answers

What is the term for a false or misleading statement made by either party during insurance contract negotiations?

<p>Misrepresentation (A)</p> Signup and view all the answers

What is the term for selling a client more insurance coverage than is appropriate for their needs and financial situation?

<p>Overloading (C)</p> Signup and view all the answers

Which of the following actions might lead to charges of misrepresentation?

<p>Exaggerating the potential returns of a variable annuity. (D)</p> Signup and view all the answers

Which of the following best describes a single premium policy?

<p>A policy that requires only one premium payment for the entire coverage period. (D)</p> Signup and view all the answers

What is the term for a fixed charge added to the premium of an insurance policy, irrespective of the policy's face value?

<p>Policy fee (D)</p> Signup and view all the answers

What information is essential for an insurance agent to accurately calculate the premium for a specific policy?

<p>All of the above (D)</p> Signup and view all the answers

How is the premium calculated for modes other than annual payments (e.g., monthly, quarterly) derived from the annual premium?

<p>Multiplying the annual premium by a mode-specific conversion factor. (B)</p> Signup and view all the answers

What types of benefits are commonly covered under health insurance policies?

<p>All of the above (D)</p> Signup and view all the answers

In employer-sponsored group insurance, what document does an employee typically complete instead of a full personal insurance application?

<p>An enrolment card (B)</p> Signup and view all the answers

If an employee leaves a company with group insurance coverage, what mechanism allows them to switch their group policy to an individual policy?

<p>Conversion privilege (B)</p> Signup and view all the answers

Which of the following is a requirement for a contract to be legally binding?

<p>Parties to the contract must be legally competent. (B)</p> Signup and view all the answers

Under what condition does a life insurance policy typically go into effect?

<p>In accordance with the legal stipulations outlined in the Insurance Code, potentially involving policy approval and premium payment. (B)</p> Signup and view all the answers

Which parties are directly involved in a life insurance contract?

<p>The insurance company and the insured. (C)</p> Signup and view all the answers

Under what circumstance might insurance law prevent a common-law spouse from being designated as a beneficiary?

<p>If the insured's legal spouse is still living and the previous marriage has not been legally dissolved, potentially creating conflicting claims. (B)</p> Signup and view all the answers

Which of the following provisions in a permanent life insurance policy is most likely to lapse due to non-payment of premiums?

<p>Automatic Premium Loan provision, using the policy's cash value to cover missed premiums. (D)</p> Signup and view all the answers

What does the convertible feature of a term insurance policy allow the policyholder to do?

<p>Change the term policy to a permanent insurance policy without providing evidence of insurability. (D)</p> Signup and view all the answers

If a life insurance policyholder dies in an accidental car crash within two years of purchasing the policy, how will the insurance company likely respond?

<p>Pay the face amount of the policy. (D)</p> Signup and view all the answers

How can a policyholder access funds from their life insurance policy while still maintaining coverage?

<p>By taking out a policy loan against the cash value, allowing continued coverage. (C)</p> Signup and view all the answers

A man, age 27, purchased a life insurance policy on his wife, age 26, but mistakenly stated their ages as 26 and 27, respectively, on the application. Five years later, his wife passes away. How will the insurance company likely handle the claim?

<p>Pay the face amount adjusted to reflect the correct ages at the time of application. (C)</p> Signup and view all the answers

Flashcards

Single Premium Policy

A life insurance policy that requires only one premium payment for the entire coverage period.

Policy Fee

A uniform charge added to the premium, irrespective of the policy's face amount.

Premium Calculation Factors

Age, choice of plan, and desired face amount are needed to calculate premiums.

Premium Mode Conversion

Annual premium is multiplied by a conversion factor to calculate premiums for other modes of payment (e.g., monthly, quarterly).

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Health Insurance Benefits

Health insurance policies provide benefits for accidental death, dismemberment, expense reimbursement, and disability income.

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Group Insurance Enrollment

In group insurance, employees complete an enrolment card rather than a full application.

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Conversion Privilege

When an employee leaves a company, they can convert their group coverage to an individual policy through the conversion privilege.

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Legal Contract Requirement

For a contract to be legally binding, all parties must be legally competent.

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Substandard Risk

Factors like hazardous jobs or poor morals increasing risk.

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Hazardous Occupation

Work exposing the insured to injury or unhealthy conditions.

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Representations

Statements applicants make on insurance applications.

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Prior Hospital Confinement

Give details about past hospital stays for insurance applications.

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Medical Information Bureau (MIB)

A confidential source of medical info on insurance applicants.

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Agent's Duty

Complete honesty and disclosure of all relevant details.

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Annuity Plan

A contract for purchasing future income.

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Annuitant

The person who owns the annuity plan

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IC Claim Limit

The Insurance Commissioner (IC) can adjudicate claims up to this amount.

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Insurance Agent's License Renewal

It's renewed if the application is accurate and requirements are met.

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Regulation of Insurance Industry

Because it impacts the financial security and well-being of the public.

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Commission Sharing Rules

An agent can share commissions with other licensed agents only.

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Rebating Prohibition

Premium rebates are prohibited by insurance agents.

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Twisting

Replacing a policy from one company with another, negatively.

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Rebating

Unfair premium discrimination against policy holders.

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License Revocation

An insurance agent's license can be revoked for fraudulent practices, violation of the Insurance Code, or misrepresentation in the license application.

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Confidentiality

Maintaining the confidentiality of policyholder information is a key ethical practice.

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Knocking

Making derogatory remarks about competing underwriters or companies.

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Unethical Insurance Practices

Unethical practices include misleading dividend estimates, inducing policy lapses for another company, misrepresenting policy terms, and obtaining a license by fraud.

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Misrepresentation

Misstatement of facts by either party during insurance contract formation.

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Overloading

Selling someone more insurance than they need or can afford.

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When does life insurance go into force?

Life insurance typically goes into force when the agent gives a binding receipt.

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Who are the parties in a life insurance contract?

The parties involved in the life insurance contract are the insurance company and the insured.

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When can a common-law spouse be a beneficiary?

According to insurance law, a common-law spouse cannot be designated a beneficiary if his/her legal partner is still living and the previous marriage has not been legally dissolved.

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Which provision CANNOT lapse for non-payment?

The Guaranteed Insurability option in a permanent life insurance policy may NOT lapse for non-payment of premium, unlike Automatic Premium Loan, Settlement Options, or the Reinstatement Provision.

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What does 'convertible' mean in term insurance?

The convertible feature allows changing a term policy to permanent insurance without proving insurability.

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Accidental death within two years?

The insurance company will still pay the face amount, even in accidental death (not suicide) within the contestability period.

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How to get money and stay insured?

A policyholder can take a policy loan and still remain insured.

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What if age is misstated?

The insurance company will pay the face amount adjusted for misstatement of age.

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Agent Policy Comparisons

Making fair comparisons of policies, even with competitors, is permitted.

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Inducing Policy Lapse

Convincing a client to lapse or forfeit existing insurance is often unethical and illegal.

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Suicide Clause Duration

The suicide clause is typically in effect for the first two years of a life insurance policy.

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Non-Forfeiture Options

Cash surrender value, paid-up insurance, and extended term insurance.

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Paid-Up Insurance Option

The premium payments stop and the policy continues with a reduced amount of coverage.

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Basic Settlement Options

Fixed amount, fixed period, interest only, and life income options.

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Misstatement of Age

The death benefit is adjusted to reflect what the premiums paid would have purchased at the correct age.

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Cash Surrender Value

A way to receive the policy's cash value.

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Study Notes

  • Makati Mock Examination Study Notes

Single Premium Policy

  • Requires only one premium payment
  • Does not necessarily mean a policy that requires a single premium each year
  • Is not only available to single individuals
  • Payments can be made in advance

Policy Expenses

  • A policy fee is a fixed amount added to the premium, regardless of policy size

Required Information for Agent

  • An agent needs to know the applicant's age, the plan being chosen, and the face amount desired to calculate premiums for a given policy

Premium Calculation

  • To calculate premiums for other modes of premium payment, the annual premium is multiplied by a conversion factor for the mode of payments desired

Healthcare Coverage

  • Benefits payable under health insurance policies cover accidental death and dismemberment, expense reimbursement, and disability income

Enrollment Cards

  • For employer-employee groups, employees fill out an enrollment card instead of a personal insurance application

Group Coverage Conversion

  • If an employee leaves a company with a group insurance policy, their coverage can be changed to an individual policy using a conversion privilege
  • To be legal and binding, parties to the contract must be legally competent

Life Insurance Applicant

  • When a father enters into a life insurance contract on behalf of his child, the father is the applicant-owner

Valid Life Insurance Coverage

  • For life insurance coverage to be valid, insurable interest must exist only at the inception of the policy

How Insurance Code Takes Effect

  • According to the insurance code, contracts don't take effect unless the policy is delivered to the insured, assignee, or agent, or to a beneficiary
  • Contracts do not take effect unless payment of the first premium is made to the insurer or its authorized agent
  • Contracts do not take effect unless there has been no change in the insurability of the life to be insured between the time of application and the time the policy was delivered

Practicable Beneficiaries

  • Anyone can be a beneficiary, except for someone who owes you money

Life Insurance Law

  • Under the law pertaining to life insurance, any person with insurable interest can be named an irrevocable beneficiary

Life Insurance Proceeds and Interest

  • When life insurance policy proceeds are left with the company to earn interest, income tax is levied on the interest earnings of the proceeds

Insurable Interest

  • A person has an insurable interest in the life of their child or grandchild
  • A person has an insurable interest in anyone who depends on them or from whom they receive support or education
  • A person has an insurable interest in any person in whom they have pecuniary interest

Beneficiary Designation Restrictions

  • Anyone can be designated a beneficiary except for minors and those expressly prohibited by law from receiving donations

When Life Insurance Takes Force

  • The common practice of most life insurers goes into force when the agent gives a binding receipt

Parties Involved in Life Insurance

  • The parties involved in a life insurance contract are the insurance company and the insured

Common-Law Spouse Beneficiary

  • According to insurance law, a common-law spouse cannot be designated a beneficiary if their legal partner is still living and the previous marriage has not been legally dissolved

Lapse Due to Non-Payment

  • An automatic premium loan is a a provision in a permanent life insurance policy that may lapse for non-payment of premium

Convertible Policy

  • The convertible feature of a term insurance policy allows it to be changed to a permanent insurance policy without evidence of insurability

Insurance Policy and Accidental Death

  • Insurance companies will pay the face amount of the policy in the event of accidental death (not suicide within 2 years of buying the policy)

Remaining Insured

  • Retaining insurance coverage is possible, by taking a policy loan

Misstatement of Age

  • The insurance company will pay the face amount adjusted for misstatement of age

Dividends and Guarantees

  • Dividends are not guaranteed

Grace Period for Life Insurance Policy

  • The typical grace period provision obligates the life insurance company to the face amount of the policy minus unpaid premiums

Automatic Premium Loan

  • Automatic premium loans go into effect requiring no separate action from the policyowner

Assigning a Policy

  • When a policy is assigned absolutely the assignee acquires all the rights and interests of the original policyholder

No Named Beneficiary

  • If a policy doesn't contain the name of a beneficiary, the beneficiary will be the insured's estate

Premium Non-Payment

  • If a policyowner does not pay a premium on the due date, the policy will continue in full force for a period of grace

Irrevocable Beneficiary

  • If a policyowner, whose wife is the irrevocable beneficiary, wishes to cash in his policy, he must have the wife's consent

Incorrect Statement

  • Any verbal statement made by the agent to the applicant is generally not considered part of the contract

Loan Dividends

  • If a policy is taken on a participating policy, dividends for that policy while there is a loan against the policy will go unaffected

Charged Interest

  • Interest is charged on policy loans to replace investment income the insurer cannot earn since a loan has been granted

Insurance Plan

  • An insurance plan, which offers both protection and savings is called a Permanent Plan

Moderate Means

  • A man with moderate means can have maximum protection through Term Insurance

Mr. Valdez's Recommendations

  • Mr. Juan Valdez should purchase a Participating Plan to annually receiving dividends

Longest Protection

  • An Ordinary Life insurance policy can give someone the longest protection

Policy Purchase at Age 35

  • An individual purchasing a policy at age 35 will receive the face amount in 20 years. This is a 20 Yr. Endowment

20 Pay Life Policy

  • Insures protection until the age of 100 while protection is for 20 years.

Participating Plan

  • Entitles the policyowner to receive a return of excess premiums through Dividends

Rose Cortez's Policy

  • Mrs. Rose Cortez owns a Level Term insurance policy which does not provide for the build up of cash values and whose premiums' remain level

Term Insurance

  • Two attractive features of a Term Insurance are Convertibility and Renewability.

Policyowners

  • A term insurance allows policyowners to convert it to a permanent insurance within a specified period without evidence of insurability contains Convertibility.

Term Policy

  • Only offers Protection

Term and Permanent Plans

  • Permanent polices provide both protection and savings while term plans offer protection only

Savings Element

  • The saving element of permanent plans allows for the build up of cash values

Term Rider

  • A term insurance added to a permanent plan

Waiver of Premium

  • An optional rider can be attached to a policy stopping further premium payments in the event of disability

Waiver of Premium Requirement

  • Effectivness comes through both disability must be total

Accidental Death Rider

  • If a policy with the rider becomes paid up the rider ceases

Disability Benefits

  • Disability benefits cease for self-inflicted injuries

Pedro Cruz, Suicide Attempt

  • Mr. Pedro Cruz would receive neither disability income nor a waiver of premiums

Term Insurance Rider

  • A person desiring greater coverage for the least amount of premium has the option of adding a term insurance rider in their permanent life policy

Payor's Benefit

  • Provides a waiver of premium benefit in the event of death or disability of the person paying the premiums

Dividends

  • If an insured is disabled and his life insurance policy is being continued in force through the waiver of premium, the dividends of the policy would continue as if the owner is paying the premium

Juvenile Policy

  • A policy with a minor as the proposed insured

Rated Policies

  • It's where life insurance policies are said to payable

Comprehensive

  • Certain standards of health and occupation

Least Effect on Premium

  • Income has the least effect on a premium charged

Anti-Selection

  • Occurs when persons in poor health wish to buy insurance

Defining Insurance Risk

  • Risk means hazard on people's lives

Application Disclosure

  • Must include every fact in his knowledge that is material to the insurance

Sources of Insurance

  • Insurance companies have various sources these include all of the above

Insurance Risk

  • Are classified as standard substandard and declined

Substandard Risk

  • Risk is considered substandard based on occupation, moral character, and family health history

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