Life Insurance Fundamentals
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Questions and Answers

What occurs when Alice passes away after receiving a conditional receipt for her life insurance policy?

  • The insurer pays the claim based on the conditional receipt. (correct)
  • The claim is denied unless Alice’s beneficiaries contest it.
  • The insurer denies the claim because the policy was not issued.
  • The claim is partially paid due to the conditional nature of the receipt.
  • What happens to Mark's life insurance policy after he is diagnosed with a permanent disability and holds a waiver of premium rider?

  • The policy lapses due to non-payment of premiums.
  • Mark must pay premiums until the end of the policy term.
  • The premiums are waived, and the policy remains active. (correct)
  • The insurer cancels the policy as Mark’s risk profile has changed.
  • What unethical practice is exemplified by an agent persuading Julia to replace her whole life policy without informing her of surrender charges?

  • Rebating
  • Churning
  • Twisting (correct)
  • Sliding
  • In John's health insurance application, what is the underwriting action called when he is approved with a higher premium due to health risks?

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

    What regulation is violated when an agent shares a client’s medical history with an unauthorized third party during the application process?

    <p>Health Insurance Portability and Accountability Act (HIPAA) (A)</p> Signup and view all the answers

    What characteristic of insurance contracts is demonstrated when Peter pays $1,000 annually and receives $200,000 for a claim after three years?

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

    Which scenario indicates that Alice was given a conditional receipt for her life insurance application?

    <p>She was informed that her coverage would begin after the underwriting review. (A)</p> Signup and view all the answers

    What action must Mark take regarding premiums after his permanent disability, considering he has a waiver of premium rider?

    <p>Premium payments are suspended, and no further action is needed. (D)</p> Signup and view all the answers

    Which unfair practice involves an agent charging a client for an additional rider without their knowledge?

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

    What is the reason that Jane's application for life insurance on her elderly neighbor is likely to be denied?

    <p>There is no insurable interest between Jane and her neighbor. (D)</p> Signup and view all the answers

    What unethical practice does the agent demonstrate by convincing Robert to switch policies without disclosing higher premiums?

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

    Which type of insurance is most likely to assist Susan, who is unable to work due to a workplace injury?

    <p>Workers’ Compensation (D)</p> Signup and view all the answers

    How does the Florida guaranty fund ensure Betty receives protection after her insurer goes bankrupt?

    <p>It ensures claims are paid up to certain statutory limits. (C)</p> Signup and view all the answers

    What fiduciary responsibility has an agent violated by depositing premium payments into a personal account?

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

    What action can David take if he decides to cancel his life insurance policy under the free-look provision?

    <p>Cancel the policy and receive a refund of the premium paid. (B)</p> Signup and view all the answers

    What additional step must Linda take when replacing her health insurance policy?

    <p>Obtain the client’s written acknowledgment of the replacement. (A)</p> Signup and view all the answers

    What aspect of the FCRA is violated if Alex is not informed of the source of the credit report after a denial?

    <p>Disclosure of credit report source (D)</p> Signup and view all the answers

    How much will Tom receive per month if he has a disability income insurance policy that pays 60% of his $5,000 salary?

    <p>$4,000 (A)</p> Signup and view all the answers

    Flashcards

    Conditional Receipt

    A receipt issued to an applicant who pays the initial premium for a life insurance policy, but the policy is not yet issued. It guarantees coverage if the applicant passes away before the policy is issued, subject to the insurer's approval.

    Waiver of Premium Rider

    A rider added to a life insurance policy that waives premium payments if the policyholder becomes permanently disabled. The policy remains active without any premium payments.

    Twisting

    An unethical practice where an agent persuades a client to replace their existing life insurance policy with a new one, often with higher fees, without disclosing the potential disadvantages.

    Underwriting

    The process of an insurer evaluating an applicant's risk before issuing a policy. This involves assessing various factors, including health, lifestyle, and occupation, to determine the appropriate premium or even if coverage should be granted.

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    HIPAA Compliance

    A regulation in the United States designed to protect the privacy of health information. It restricts the disclosure of protected health information (PHI), which includes medical history and treatment records, by healthcare providers and insurance companies.

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    Aleatory Contract

    A characteristic of insurance contracts where the amount paid by the insured is disproportionate to the amount received from the insurer in the event of a claim. The insured pays a relatively small premium, but the insurer potentially pays a much larger amount in case of a covered loss.

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    Underwriting

    The process of evaluating an applicant's health and risk factors to determine if they qualify for insurance coverage and at what premium rate. This involves reviewing the applicant's medical history, lifestyle habits, and other relevant factors.

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    Twisting

    A practice where an agent sells a new insurance policy to a client, often without fully disclosing the potential disadvantages of the new policy, and without considering the client's existing insurance needs. This can be done by misrepresenting or exaggerating the benefits of the new policy, leading to the client switching policies unnecessarily.

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    What is "sliding" in insurance?

    An insurance agent adds an extra coverage to a client's policy without the client's knowledge or consent. This unethical practice is considered illegal and can have serious consequences for the agent.

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    What is "Insurable Interest"?

    A person or entity must have a financial interest in the insured object or person to be eligible for insurance. This ensures there's a valid reason for covering a potential loss.

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    What is "twisting" in insurance?

    An agent persuading someone to switch insurance policies to a new one with different terms, often without fully disclosing the downsides of the new policy. This can lead to higher premiums or fewer benefits.

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    What is "Workers' Compensation"?

    A government-run insurance program that protects workers against injuries or illnesses that occur on the job. Benefits include medical expenses, lost wages, and rehabilitation.

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    What is the "Florida Guaranty Fund"?

    A state-established fund in Florida designed to protect policyholders in case an insurance company goes bankrupt. It ensures that policyholders receive some benefits instead of losing everything.

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    What is "Premium Accountability" in insurance?

    Agents have a fiduciary responsibility to act in the best interest of their clients. They must manage funds ethically, including premiums, and ensure proper accounting practices are followed.

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    What is the "Free Look Period" in insurance?

    A period after receiving an insurance policy during which the insured can choose to cancel it without any penalties, usually for 10 days. This allows for review and reflection before being fully bound by the policy.

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    What is "Replacement Documentation" in insurance?

    A formal documentation process that must be completed when replacing an existing insurance policy with a new one. It ensures that the client is aware of the changes and differences between policies.

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    What does the "Fair Credit Reporting Act" (FCRA) mandate?

    An insurance company is legally required to inform an applicant if their application was denied based on a credit report, and must disclose the source of the credit report.

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    What is an "Adhesion Contract" in insurance?

    An insurance contract where the terms are set by the insurer without negotiation. The insured must accept the contract's terms

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    Study Notes

    Conditional Receipt

    • Alice applied for a $500,000 life insurance policy and received a conditional receipt.
    • She died before the policy was issued, and underwriting confirmed she would have been approved.
    • The insurer is obligated to pay the claim based on the conditional receipt.

    Policy Riders

    • Mark had a life insurance policy with a waiver of premium rider.
    • He became permanently disabled and could no longer work.
    • The premiums are waived, maintaining the policy's activity.

    Replacement Policy

    • Julia was persuaded to replace a whole life policy with a term life policy.
    • The agent failed to disclose surrender charges and cash value loss.
    • This is an example of twisting.

    Underwriting

    • John, with a history of smoking and heart disease, applied for health insurance.
    • The insurer approved but with a higher premium.
    • This is a substandard rating.

    HIPAA Compliance

    • An agent shared a client's medical history with an unauthorized third party.
    • This violates the Health Insurance Portability and Accountability Act (HIPAA).

    Aleatory Contract

    • Peter's homeowner's insurance policy had no claims for three years.
    • A hurricane devastated his home.
    • The insurer paid $200,000. This illustrates an aleatory nature where the payout is disproportionate to the premium paid.

    Sliding

    • An agent sold a policy and added an accidental death rider without client knowledge or consent.
    • This is considered sliding.

    Insurable Interest

    • Jane applied for a life insurance policy on her elderly neighbor.
    • This applcation is likely to be denied due to a lack of insurable interest.

    Twisting

    • Robert was convinced by an agent to cancel a policy and switch to a new one.
    • The agent failed to disclose higher premiums and fewer benefits.
    • This is twisting.

    Social Insurance

    • Susan was injured at work and couldn't return to her job.
    • She applied for benefits.
    • Workers' Compensation is likely to assist.

    Florida Guaranty Fund

    • ABC Insurance Company went bankrupt, affecting Betty's active policy.
    • The Florida Guaranty Fund ensures claims are paid up to certain limits.

    Fiduciary Responsibility

    • An agent deposited client premiums into a personal account before remitting them to the insurer.
    • This violates premium accountability.

    Free Look Period

    • David purchased a life insurance policy and decided to cancel within a week.
    • The free-look provision allows cancellation for a refund.

    Replacement Documentation

    • Linda replaced a health insurance policy.
    • The agent completed a replacement notice and submitted it.
    • The client's written acknowledgment is required.

    Fair Credit Reporting Act

    • An insurer denied Alex's application based on a credit report without disclosure.
    • This violates the FCRA's disclosure requirement.

    Medical Exam Requirements

    • Michelle applied for life insurance.
    • The insurer requested a medical exam and a conditional receipt.
    • Coverage begins after the medical exam and underwriting approval.

    Coercion

    • An agent pressured a business owner to purchase a policy by threatening unrelated services.
    • This illustrates coercion.

    Adhesion Contract

    • Rachel purchased an auto insurance policy.
    • She couldn't negotiate the terms.
    • This shows an adhesion contract.

    Disability Insurance

    • Tom's disability income insurance pays 60% of his $5,000 monthly salary.
    • He is now unable to work.
    • He will receive $3,000 a month.

    Insurer Authorization

    • XYZ Insurance, operating in Florida, lacked a certificate of authority.
    • It's an unauthorized insurer.

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    Description

    This quiz explores key concepts related to life insurance, including conditional receipts, policy riders, underwriting processes, and compliance issues like HIPAA. Understanding these elements is crucial for anyone involved in the life insurance industry or studying insurance principles.

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