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Introduction to Life Insurance

AN OVERVIEW

CSC Proprietary 07/09/11 12:52 PM 008_fmt_wht

Introduction to Life Insurance

Objective of this presentation


To provide a brief knowledge of : Life Insurance Industry Meeting Needs of individuals and business Introduction to Risk & Insurance Underwriting Pricing Life Insurance Term Life Insurance Permanent Life Insurance Group Life & Annuities Supplementary Benefits Policy Beneficiaries Life Insurance Policy Provisions Policy Proceeds ( Claims, Dividends etc.)

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Introduction to Life Insurance

Chapters
Life Insurance Industry Meeting Needs of individuals and business Introduction to Risk & Insurance Underwriting Pricing Life Insurance Term Life Insurance Permanent Life Insurance Group Life & Annuities Supplementary Benefits Policy Beneficiaries Life Insurance Policy Provisions Policy Proceeds ( Claims, Dividends etc.)

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Introduction to Life Insurance

Life Insurance Industry


Insurance Companies as Business Organizations
Each business organization is structured in one of three ways : Sole Proprietorship The Owner reaps all profits, & Personally Responsible for all the debts of the business Partnership The Partners reaps all profits & are responsible Partnership dissolves if the partner dies Corporation A legal entity, separate and distinct from the people who own it Continues beyond the death of any or all of it owners

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Introduction to Life Insurance

Life Insurance Industry


Laws in America and Canada require Insurance Companies to operate as Corporation only.

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Introduction to Life Insurance

Life Insurance Industry


Type of Insurance Company Organisation
Stock Insurance Companies Stock holders are the owner Operating profits are distributed as dividend Mutual Insurance Companies Owned by the policyowners Operating profits are distributed as policy dividend Mutualization & Demutualization Occurs when a stock insurer converts to a mutual insurer and vice a versa.

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Introduction to Life Insurance

Life Insurance Industry


Type of Insurance Company Organisation ( Cont..)
Fraternity Benefit Societies Society shares a common ethnic, religious, or vocational background Insurance benefits to its members must have a representative form of government Operate thru a lodge system, where lodge members own insurance

Banks

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Introduction to Life Insurance

Life Insurance Industry


Organizational Operations
Home Office or head office Regional Office Field Office or branch office or agency office

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Introduction to Life Insurance

Next Chapter
Life Insurance Industry Meeting Needs of individuals and business Introduction to Risk & Insurance Underwriting Pricing Life Insurance Term Life Insurance Permanent Life Insurance Group Life & Annuities Supplementary Benefits Policy Beneficiaries Life Insurance Policy Provisions Policy Proceeds ( Claims, Dividends etc.)

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Introduction to Life Insurance

Meeting Needs of Individual and Business


Personal Needs met by Life Insurance Products Business Needs met by Life Insurance Products Life Insurance as an Employee Benefit

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Introduction to Life Insurance

Meeting Needs of Individual and Business


Personal needs met by Life Insurance Companies

Estate Plan

Final Expenses and Estate Planning

Dependents Support

Education Retirement Costs Income


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Introduction to Life Insurance

Meeting Needs of Individual and Business


Business needs met by Life Insurance Products
A business generally purchase life Insurance products to ensure that the business continues in the event of the death of an owner a partner a shareholder, or, a key person

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Introduction to Life Insurance

Meeting Needs of Individual and Business


Buy Sell Agreement
In United States, if an individual dies, all the assets and liabilities become part of his/her estate. An executor or administrator is assigned to settle the deceaseds estate The administrator then distributes the remaining property to the deceased persons heirs. Many a times, the administrator may have to sell the assets for a price much less than if they could be sold in a more leisurely manner.

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Introduction to Life Insurance

Meeting Needs of Individual and Business


Buy Sell Agreement ( Cont.)
A buy-sell agreement is an agreement in which one party agrees to purchase the financial interest that a second party has in a business following the second partys death, and the second party agrees to direct his estate to sell his interest in the business to the purchasing party. Available for any closely held business Sole Proprietorship Buy-sell Agreement Partnership Buy-sell Agreement Closely held corporation Buy-sell Agreement

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Introduction to Life Insurance

Meeting Needs of Individual and Business


Sole Proprietorship Buy-sell Agreement
Employee purchase an Insurance policy on the life of proprietor Employee owns the policy, pays the premium and is the named beneficiary.

EMPLOYE E

Pays the cost of an insurance policy on the life of the proprietor

SOLE PROPRIETOR
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Introduction to Life Insurance

Meeting Needs of Individual and Business


Partnership & Corporation Buy-sell Agreement

1. Cross-Purchase Method
PARTNER B PARTNER A PARTNER C

2. Entity Method

BUSINESS

Each partner purchases a life insurance policy on the life of each other partner

The partnership purchases a life insurance policy of the life of each partner
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Introduction to Life Insurance

Meeting Needs of Individual and Business


Key Person Life Insurance

BUSINESS

Purchases, owns, and is the beneficiary of a life insurance policy on the life of

A person whose death would cause financial loss to the business


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Introduction to Life Insurance

Meeting Needs of Individual and Business


Life Insurance as an Employee Benefit
Split Dollar Life Insurance Plan The employer and employee share the cost of an insurance policy on the life of the employee. Employee is given the right to name the policy beneficiary Deferred Compensation Plan

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Introduction to Life Insurance

Next Chapter
Life Insurance Industry Meeting Needs of individuals and business Introduction to Risk & Insurance Underwriting Pricing Life Insurance Term Life Insurance Permanent Life Insurance Group Life & Annuities Supplementary Benefits Policy Beneficiaries Life Insurance Policy Provisions Policy Proceeds ( Claims, Dividends etc.)

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Introduction to Life Insurance

Introduction to Risk & Insurance


The Concept of Risk
Speculative Risk :- Gain, Loss or no-loss Pure Risk :- Loss or no-loss The purpose of Insurance is to Compensate for financial loss and not to provide an opportunity for financial gain.

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Introduction to Life Insurance

Introduction to Risk & Insurance


Risk Management
Avoiding Risk - Refrain from doing something
No air travel

Controlling Risk - Taking preventive actions


Install Smoke detectors

Accepting Risk - Ready to face the implications Transferring Risk - Transfer the risk to other parties
Property Damage Risk Liability Risk Personal Risk

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Introduction to Life Insurance

Introduction to Risk & Insurance


Characteristics of Insurable Risks
The Loss must occur by chance. The loss must be definite, in terms of time and amount. The loss must be significant. The loss rate must be predictable.
The law of large number ( Refer next slide )

The loss must not be catastrophic to the insurer.

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Introduction to Life Insurance

Introduction to Risk & Insurance


The Law of Large Number

The more times we observe an event ...

The more likely it is that our observed results will approximate the true probability that the event will occur

COIN TOSSED 1,000 TIMES

HEADS 50%

TAILS 50%
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Introduction to Life Insurance

Introduction to Risk & Insurance


Concept of Insurable Interest

If the policyowner

Is likely to benefit if the insured continues to live AND Is likely to suffer loss or detriment if the insured dies then

The policyowner has an insurable interest in the insured

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Introduction to Life Insurance

Introduction to Risk & Insurance


Insurable Interest & Beneficiaries
Most insurance companies require that the beneficiary have an insurable interest in the life of the insured when a policy is issued

Must have an insurable interest in


BENEFICIARY INSURED

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Introduction to Life Insurance

Introduction to Risk & Insurance


Insurable Interest & Family Members
Certain family relationships are deemed by law to create insurable interest

Spouse/Spouse

Parent/Child

Brother/Sister

Grandparent/ Grandchild

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Introduction to Life Insurance

Introduction to Risk & Insurance


Demonstrating Insurable Interest

Before policy is issued:

After policy is in force:

Life Policy
INSURANCE AGENT

Insurable interest must be present

Insurable interest is not relevant


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Introduction to Life Insurance

Next Chapter
Life Insurance Industry Meeting Needs of individuals and business Introduction to Risk & Insurance Underwriting Pricing Life Insurance Term Life Insurance Permanent Life Insurance Group Life & Annuities Supplementary Benefits Policy Beneficiaries Life Insurance Policy Provisions Policy Proceeds ( Claims, Dividends etc.)

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Introduction to Life Insurance

Definition
What
Underwriting or selection of risks, is an insurance function that is responsible for assessing and classifying the degree of risk a proposed insured represents.

Why
To be financially healthy and able to pay contractual benefits, every insurer must have a way of measuring the level of risk each proposed insured presents so it can charge a premium rate that is adequate to pay policy benefits.

Who
An insurers employee who evaluates risks, accepts or declines applications and determine the appropriate premium, is known as Underwriter.

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Introduction to Life Insurance

Antiselection
An important concept which forces people to seek insurance

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Organisation of Underwriting
Chief Underwriter
The highest ranking underwriter in an insurance company

Medical Underwriting Director


In-charge of medical experts who provide medical information and guidance

Underwriting Executives and Supervisors


Each of whom is responsible for one of more individual or group insurance products

Underwriters
Technically qualified professionals who assess the risks

Agents also known as field underwriters


Gather initial information and screen applicants

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Introduction to Life Insurance

Underwriting Objective
Effective underwriting ensures that the insurance policies are :-

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Introduction to Life Insurance

Individual Life Insurance Underwriting


Risk Classes
Preferred Class Standard Class Substandard Class also called Special or Impaired risk Declined Class

LIKELIHOOD OF LOSS
Less than Average
PREFERRED CLASS

Averag e
STANDARD CLASS

SUBSTANDARD CLASS

Greater than Average

Too Great Uninsurabl to be Insured e


DECLINED CLASS
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Individual Life Insurance Underwriting


Risk Assessment Factors
Medical Risk Factors Personal Risk Factors Financial Risk Factors

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Individual Life Insurance Underwriting


Medical Risk Factors
Build - Persons body shape including height and weight Personal Medical History Family Medical History - Hereditary disease

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Introduction to Life Insurance

Individual Life Insurance Underwriting


Personal Risk Factors
Occupation - Mining industry Tobacco Use Alcohol and substance Abuse - Abuse of alcohol or drug Moral Hazard - Attempt to conceal or misrepresent information Avocation and hobbies - Skydiving, hang gliding, racing etc. Aviation activities - Pilots International Residence - obtaining accurate information can be difficult Driving History - Drivers with risky driving habits Military Status - Insurance only when they are not in military operations.

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Introduction to Life Insurance

Individual Life Insurance Underwriting


Financial Risk Factors
Insurable Interest The proposed beneficiary has an insurable interest in the proposed insureds life Insurable interest is required only at the time of policy issue, but not after the policy is in force.

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Introduction to Life Insurance

Group Life Insurance Underwriting


Risk Assessment Factors
Proposed Coverage
Eligibility Requirements - Only full time permanent employees Benefit Levels - Affordable for employer and reasonable for employees Administration Method - Willingness and ability of a group policyholder to support the administration of the plan Mode of Commission payment - Agents commission be spread out over a number of years.

Reason for the groups existence - Usually for employees, not for groups formed solely for the purpose of group life insurance

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Group Life Insurance Underwriting


Risk Assessment Factors ( Cont..)
Size of the group - Larger groups preferred Nature of the groups business - Potentials hazards and economics prospects of the industry in which the group operates Geographic Location of the Group - regions can differ in natural disasters, quality of living and economic conditions, availability of health care. Stability of the group - steady flow of younger members Age and Sex distribution of Group Members - group of younger and female members preferred

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Introduction to Life Insurance

Group Life Insurance Underwriting


Risk Assessment Factors ( Cont..)
Level of Participation - minimum participation requirement helps prevent Antiselection ( Contributory Plan). Classes of Employees - Classification by occupation, salary, length of service etc. Expected Persistency - Policy for longer duration is preferred Prior Experience - Group insurance information for past 3 years, is analyzed.

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Introduction to Life Insurance

Group Life Insurance Underwriting


Factors considered in Renewal business
Claim Experience - If the claims were less than expected, the renewal premium may go down and vice a versa. Level of Participation - For contributory plans, the level of employee participation must meet the required minimum.

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Introduction to Life Insurance

Regulatory Requirements and Underwriting


Unfair Discrimination
Underwriting decision cannot be based on insureds sex, race, marital status, national origin, or religion. Only unfair discrimination is prohibited.

Consumer Privacy
Fair Credit Reporting Act ( FCRA) - Applicant be notified that
a consumer report will be used. Nature and scope of the investigation if any adverse decision is taken based on that information

NAIC Model Privacy Act


Establishes standards for the collection, use and disclosure of information gathered

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Introduction to Life Insurance

The Underwriting Process


Application Received Underwriter Reviews application Need additional info Obtain & review additional info Send application with substandard rating to policy issue Policy issue sends Policy to Agent Agent offers policy to applicant Standard Risk Insurable at sub-std risk

Approve Application Application sent to policy issue Policy issue sends Policy to Agent or Policyonwner

Decline Application

Policy in force

Applicant accepts rated policy

No Policy in force
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Introduction to Life Insurance

Gathering Additional Information


Additional Medical Information Additional Personal Information Additional Financial Information

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Introduction to Life Insurance

Gathering Additional Information


Additional Medical Information
Attending Physicians Statement ( APS ) Report by a physician who has treated or currently treating the proposed insured. Specialized Medical Questionnaire A specialized medical questionnaire is requested from the proposed insureds attending physician MIB Report MIB members may request information to find out whether proposed insured has any significant impairments or other risk, not disclosed by him. Laboratory Tests May also order such tests if they are deemed necessary to make a sound underwriting decision.

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Introduction to Life Insurance

Gathering Additional Information


Additional Personal Information
Motor Vehicle Record Persons driving history including traffic violations, arrests and convictions for driving related incidents. Inspection Report Information collected from a consumer reporting agency, which can be on insureds personal life, occupation, hobbies, health and financial status. Personal Questionnaires A specialized personal questionnaire is requested from the proposed insured

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Introduction to Life Insurance

Gathering Additional Information


Additional Financial Information
Inspection Report Information collected from a consumer reporting agency, which can be on insureds financial status including investments, income, assets and liabilities. Credit Report Credit History from Credit Reporting agency

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Introduction to Life Insurance

Making an Underwriting Decision


Approve the Coverage as applied for Rate the Application
By modifying the coverage or charging a higher premium

Decline the Application

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Introduction to Life Insurance

Next Chapter
Life Insurance Industry Meeting Needs of individuals and business Introduction to Risk & Insurance Underwriting Pricing Life Insurance Term Life Insurance Permanent Life Insurance Group Life & Annuities Supplementary Benefits Policy Beneficiaries Life Insurance Policy Provisions Policy Proceeds ( Claims, Dividends etc.)

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Introduction to Life Insurance

Pricing Life Insurance


Methods of Funding Life Insurance
Mutual Benefit Method - Post-death assessment
Problems in collecting money size of group become smaller each members cost increases each year

Assessment Method - Annual assessment


Anticipated death claims and administrative expenses

Legal Reserve System


Death benefit should be specified Money should be collected in advance Premium should be related to the risk

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Introduction to Life Insurance

Pricing Life Insurance


Premium Rate Calculations
Factors to be considered : Rate of Mortality Investment earnings Expenses ( also known as loading )

Premium = Cost of Insurance + Expenses - Investment Earnings

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Pricing Life Insurance


The 1980 Commissioners Standard Ordinary (CSO) Mortality Table Male
AGE 0 1 45 46 98 99 Number Living 10,000,000 9,958,200 9,210,289 9,168,382 31,450 10,757 Number Dying 41,800 10,655 41,907 45,108 20,693 10,757 Mortality Rate per 1000 4.18 1.07 4.55 4.92 657.98 1,000.00 AGE 0 1 45 46 98 99

Female
Number Living 10,000,000 9,971,100 9,409,244 9,375,747 89,200 30,698 Number Dying 28,900 8,675 33,497 35628 58,502 30,698 Mortality Rate per 1000 2.89 0.87 3.56 3.80 655.85 1,000.00

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Introduction to Life Insurance

Pricing Life Insurance


Level Premium Pricing System
It allows the purchaser to pay the same premium amount each year the policy is in force. This pricing system is widely used for whole life, term life covering more than one year and endowment insurance

Level Premium System


$1,500

Premium Amount

$1,000 $500 1 5

Years Policy is in Force

10

15

20

25

30
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Pricing Life Insurance


Policy Dividend
Participating Policy also known as Par Policy
the policyowner shares the divisible surplus of Insurance company.

Non-participating Policy also known as Non-par Policy


the policyowner does not share in the insurers surplus.
Insurers Divisible Surplus

Policy Dividend

Policy Dividend

POLICY OWNER

POLICY OWNER
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Pricing Life Insurance


Life Insurance Reserve
Policy Reserve - To pay due policy benefits
Net amount at risk = Face Value - Policy Reserve

Contingency Reserve - For unusual conditions that may occur

NET AMOUNT AT RISK


POLICY RESERVE

POLICY FACE AMOUNT

POLICY RESERVE

NET AMOUNT AT RISK


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Next Chapter
Life Insurance Industry Meeting Needs of individuals and business Introduction to Risk & Insurance Underwriting Pricing Life Insurance Term Life Insurance Permanent Life Insurance Group Life & Annuities Supplementary Benefits Policy Beneficiaries Life Insurance Policy Provisions Policy Proceeds ( Claims, Dividends etc.)

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Introduction to Life Insurance

Type of Insurance

TERM LIFE INSURANCE PERMANENT LIFE INSURANCE ENDOWMENT

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Term Life Insurance


Characteristics of Term Life Insurance Product
Coverage for a specified period of time The policy benefits are payable only if, the insured dies during the specified period, and the policy is in force when the insured dies.

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Term Life Insurance


Plans of Term Life Insurance Coverage
Level Term Life Insurance Decreasing Term Life Insurance Mortgage Redemption Insurance Credit Life Insurance Family Income Insurance Increasing Term Life Insurance

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Term Life Insurance


Renewable Term Life Insurance

Renewal Provision
Allows policyowner to renew the policy at the end of the term of coverage, without providing evidence of insurability

Yearly Renewable Term (YRT) Insurance


(1)
One-Year Term Life Insurance Policy Life Insurance Policy

(2)

Term Insurance Rider

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Term Life Insurance


Convertible Term Life Insurance

Conversion Privilege
Term Life Insurance Policy Permanent Life Insurance Policy

No evidence of insurability required


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Term Life Insurance


Type of Conversion

Attained Age Conversion

Original Age Conversion

Age of insured when policy was purchased

Age of insured when policy was converted

Age of insured when policy was purchased

Age of insured when policy was converted

Renewal premium is based on this age

Renewal premium is based on this age


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Introduction to Life Insurance

Next Chapter
Life Insurance Industry Meeting Needs of individuals and business Introduction to Risk & Insurance Underwriting Pricing Life Insurance Term Life Insurance Permanent Life Insurance Group Life & Annuities Supplementary Benefits Policy Beneficiaries Life Insurance Policy Provisions Policy Proceeds ( Claims, Dividends etc.)

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Introduction to Life Insurance

Permanent Life Insurance


Two Primary Distinct Characteristics
Permanent life insurance products offer lifetime coverage Permanent life insurance products provide insurance coverage and contain a saving element i.e. It builds a cash value.

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Permanent Life Insurance


Traditional Whole Life Insurance

Policy Purchased at Age 45


$150,000

Death Benefit

$100,000 $75,000 45 50 60 70 80 90 100 or death

Insureds Age

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Traditional Whole Life Insurance


Classification of Whole Life Policies

ContinuousPremium Policies
Premiums payable until the insureds death, cash value at the end of 3rd year
Date of policy purchase Insureds death

Limited Payment Policies


Premiums payable until stated period expires, cash value at the end of 1st year
Date of policy purchase End of specified period
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Traditional Whole Life Insurance


Classification of Whole Life Policies (Cont.)
Single Premium Policy

Single premium payment

Results in large cash value immediately available


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Introduction to Life Insurance

Traditional Whole Life Insurance


Other type of Whole Life Policies : Modified Whole Life Insurance - Modified Premium or Modified Coverage Joint Whole Life Insurance as first-to-die life insurance Last Survivor Life Insurance as second-to-die life insurance Family Policies coverage on the insureds spouse and children Monthly Debit Ordinary Policy Monthly premium & small face amount Pre-Need Funeral Insurance Funeral homes as policy beneficiary

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Permanent Life Insurance


A Newer Generation of Permanent Products
Universal Life Insurance

Flexible Premiums
LARGER SMALLER

Flexible Face Amounts


MORE

Unbundled Pricing Factors


1. Mortality Charges 2. Interest 3. Expenses
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$100,000 Life Insurance Policy

LESS

Introduction to Life Insurance

Universal Life Insurance


Unbundled Pricing Factors

Mortality Charges
Stated maximum amount May be less if mortality experience is favorable

Interest
May be higher if economic conditions warrant Stated minimum interest rate

Expenses
Each expense charge is listed in policy

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Universal Life Insurance


Flexible Face Amount

Option A Plan
Death benefit

Life Policy
Policy face amount

Option B Plan
Death benefit

Life Policy
Policy face amount Cash Value
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Universal Life Insurance


Flexible Premiums - Policyowner determines how much to pay

INITIAL AND RENEWAL PREMIUMS

Minimum amount Policyowner


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Universal Life Insurance


How a universal life policy operates

Pre miu ms

s tere In

ly nth Mo

es arg Ch

CASH VALUE

Oth loa er ch ns, arg with es, dra wa ls

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Introduction to Life Insurance

Universal Life Insurance


Regulation of Universal Life Policies A certain percentage of the policys face amount

Section 7702 Corridor Surrender Charges Periodic Reports

<
CASH VALUE

If policy includes surrender charges, regulators may require use of two separate terms to describe (1) cash value and (2) cash surrender value Insurers send each policyowner an annual, semiannual, or quarterly report giving the policys current values and benefits
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Introduction to Life Insurance

Permanent Life Insurance


Other Advanced whole Life Products
Adjustable Life Insurance Indeterminate Premium Life Insurance - A maximum guaranteed premium rate and a lower premium rate Interest-Sensitive Whole Life Insurance - Apart from flexible premium cash value can also be greater than the guaranteed Variable Life Insurance - Separate Investment Account Variable Universal Life Insurance - Combination of variable and universal life insurance

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Introduction to Life Insurance

Endowment Life Insurance


Endowment insurance provides a specified benefit amount whether the insured lives to the end of the term of coverage or dies during that term. The maturity date is reached either
at the end of the stated term, or when the insured reaches a specified age.

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Introduction to Life Insurance

Next Chapter
Life Insurance Industry Meeting Needs of individuals and business Introduction to Risk & Insurance Underwriting Pricing Life Insurance Term Life Insurance Permanent Life Insurance Group Life & Annuities Supplementary Benefits Policy Beneficiaries Life Insurance Policy Provisions Policy Proceeds ( Claims, Dividends etc.)

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Introduction to Life Insurance

Group Life Insurance


Group Insurance Contract

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Group Life Insurance


Type of Group Insurance Plan

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Introduction to Life Insurance

Group Life Insurance


Group Insurance Underwriting
Group Insurance differs significantly from individual insurance in the area of underwriting. Group Insurance underwriting generally focuses on the characteristics of the group and does not usually require individuals to provide the evidence of insurability. Objective is similar to determine whether the group presents an average risk. Group underwriter also seeks to prevent antiselection and to ensure that the administrative costs are as low as possible.

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Introduction to Life Insurance

Group Insurance Underwriting


Group Underwriting Considerations
Reason for the groups existence : The group must have been formed for a reason other than to obtain insurance. The eligible groups are

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Introduction to Life Insurance

Group Insurance Underwriting


Group Underwriting Considerations
Reason for the groups existence : The eligible groups (Cont.)

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Introduction to Life Insurance

Group Insurance Underwriting


Group Underwriting Considerations
Size of the group

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Introduction to Life Insurance

Group Insurance Underwriting


Group Underwriting Considerations
Flow of new members into the group

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Introduction to Life Insurance

Group Insurance Underwriting


Group Underwriting Considerations
Stability of the Group

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Introduction to Life Insurance

Group Insurance Underwriting


Group Underwriting Considerations
Activities of the Group

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Group Life Insurance


Eligibility Requirements

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Introduction to Life Insurance

Group Insurance Premium


The insurer
establishes group premium rates on a case-by-case basis determines the cost of providing coverage determines the cost of plan administration recalculates a groups rate every year

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Introduction to Life Insurance

Group Insurance Premium


Premium Rates

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Group Life Insurance


Termination Provision

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Introduction to Life Insurance

Annuity
Definition
The term Annuity means a contract under which one party - the insurer promises to make a series of periodic payments in exchange for a premium or a series of premiums. Does not cover life insurance

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Classification of Annuities
How Annuities are purchased

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Introduction to Life Insurance

Classification of Annuities
When benefit payments begin

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Introduction to Life Insurance

Classification of Annuities
When benefit payments end

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Introduction to Life Insurance

Classification of Annuities
How Annuity values are guaranteed or variable

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Introduction to Life Insurance

Annuity
Annuity Contract Provisions

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Introduction to Life Insurance

Next Chapter
Life Insurance Industry Meeting Needs of individuals and business Introduction to Risk & Insurance Underwriting Pricing Life Insurance Term Life Insurance Permanent Life Insurance Group Life & Annuities Supplementary Benefits Policy Beneficiaries Life Insurance Policy Provisions Policy Proceeds ( Claims, Dividends etc.)

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Introduction to Life Insurance

Supplementary Disability Benefits


Waiver of premium for disability benefit

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Introduction to Life Insurance

Supplementary Disability Benefits


Waiver of premium for PAYOR benefit

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Introduction to Life Insurance

Supplementary Disability Benefits


Disability Income Benefit

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Introduction to Life Insurance

Accident Benefits
Accidental Death Benefit

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Introduction to Life Insurance

Accident Benefits
Dismember Benefit

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Introduction to Life Insurance

Accelerated Death Benefits


Terminal Illness Benefit
A partial death benefit payment made to a policyowner if the insured has a terminal illness and 12 months or less to live

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Introduction to Life Insurance

Accelerated Death Benefits


Dread Disease Benefit
A partial death benefit payment made to a policyowner if the insured suffers from one of several specified diseases such as : Life-threatening Cancer Aids Coronary bypass surgery etc.

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Introduction to Life Insurance

Accelerated Death Benefits


Long Term Care Benefit
A monthly benefit paid to a policyowner if the insured requires constant care for a medical condition and is unable to perform several activities of daily living

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Introduction to Life Insurance

Other Benefits
Benefits for additional Insureds

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Introduction to Life Insurance

Next Chapter
Life Insurance Industry Meeting Needs of individuals and business Introduction to Risk & Insurance Underwriting Pricing Life Insurance Term Life Insurance Permanent Life Insurance Group Life & Annuities Supplementary Benefits Policy Beneficiaries Life Insurance Policy Provisions Policy Proceeds ( Claims, Dividends etc.)

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Introduction to Life Insurance

Life Insurance Policy Beneficiaries


Who can be a beneficiary

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Introduction to Life Insurance

Life Insurance Policy Beneficiaries


Types of Beneficiaries
Primary Beneficiary He/She is the party designated to receive the policy proceeds following the death of the insured. If more than one primary beneficiary, the policyowners indicates how the same is to be distributed. If no instructions from policyowner, the proceeds are divided evenly among the primary beneficiaries. In order to receive policy proceeds, the primary beneficiary must survive the insured.

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Introduction to Life Insurance

Life Insurance Policy Beneficiaries


Types of Beneficiaries
Contingent Beneficiary He/she will receive the policy proceeds if all primary beneficiaries should die before the insured. The policy owner can name any number of contingent beneficiaries and may decide how the proceeds are to be divided among the contingent beneficiaries.

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Introduction to Life Insurance

Life Insurance Policy Beneficiaries


Types of Beneficiaries
No Surviving Beneficiary If no beneficiary has been named or none of the named beneficiaries is living when the insured dies, then the policy proceeds are paid to the policy owner, if the policy owner is living. If the policy owner is deceased, then the proceeds are paid to the policy owners estate.

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Introduction to Life Insurance

Life Insurance Policy Beneficiaries


General rule for common disaster
If the insured and the beneficiary die at the same time or under circumstances that make it impossible to determine which of them died first, then policy proceeds are payable as if the insured survived the beneficiary. Example : Mohan and his wife, Radha died in an airplane crash and the evidence did not show which of them died first. Mohan owned an insurance policy in which Radha was the primary beneficiary and Mohans mother was the contingent beneficiary, Radha also owned an insurance policy in which Mohan was the primary beneficiary and Radhas father was the contingent beneficiary. Although Radhas father survived her, Mohans mother died several years before the crash.

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Life Insurance Policy Beneficiaries


Analysis of the case study
Mohans Policy : The insured, Mohan, is deemed to have survived the primary beneficiary, Radha. Thus, the policy proceeds are payable to the contingent beneficiary, if she survived the insured. Because Mohans mother predeceased him, the policy proceeds are payable to Mohans estate. Radhas Policy : The insured, Radha, is deemed to have survived the primary beneficiary, Mohan. Thus, the policy proceeds are payable to the contingent beneficiary, if he survived the insured. Because Radhas father survived her, the policy proceeds are payable to him.

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Introduction to Life Insurance

Life Insurance Policy Beneficiaries


Right of Revocation
Revocable Beneficiary A beneficiary designation is said to be revocable if the policy owner has the unrestricted right to change the beneficiary during the life of the insured. Irrevocable Beneficiary If the policy owner has the right to change the beneficiary only after obtaining the beneficiarys consent, then the designation is said to be irrevocable.

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Next Chapter
Life Insurance Industry Meeting Needs of individuals and business Introduction to Risk & Insurance Underwriting Pricing Life Insurance Term Life Insurance Permanent Life Insurance Group Life & Annuities Supplementary Benefits Policy Beneficiaries Life Insurance Policy Provisions Policy Proceeds ( Claims, Dividends etc.)

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Life Insurance Policy Provisions


Standard Policy Provisions
Free-look Provisions : Allows policy owner to examine the policy

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Life Insurance Policy Provisions


Standard Policy Provisions
Entire Contract Provisions This provision defines the documents that constitute the contract between the insurance company and the owner of the insurance policy. This provision prevents oral statements from affecting the terms of the policy and prevents controversies from developing regarding the terms of the contractual agreement.

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Life Insurance Policy Provisions


Standard Policy Provisions
Incontestability Provisions : usually 2 years for material misrepresentation

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Life Insurance Policy Provisions


Standard Policy Provisions
Grace Period Provision - Specifies the length of time within which a renewal premium may be paid without penalty, usually 30 days

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Life Insurance Policy Provisions


Standard Policy Provisions
Policy Loans : Grants a policy owner the right to borrow money from the insurer

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Life Insurance Policy Provisions


Standard Policy Provisions
Policy Withdrawals : In universal life insurance policies, permits the policy owner to withdraw funds

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Life Insurance Policy Provisions


Standard Policy Provisions
Re-instatement Provisions : Describes conditions that the policy owner must meet to reinstate a lapsed policy

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Introduction to Life Insurance

Life Insurance Policy Provisions


Standard Policy Provisions
Mis-statement of age or sex provision : Describes how the insurer will adjust the policy benefit if the insurers age or sex is incorrectly stated

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Life Insurance Policy Provisions


Non-forfeiture Benefits :
Available to a policy owner whose policy lapses but still contains a cash value

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Introduction to Life Insurance

Life Insurance Policy Provisions


Non-forfeiture Benefits
Cash Surrender Value

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Introduction to Life Insurance

Life Insurance Policy Provisions


Non-forfeiture Benefits
Reduced Paid-up Insurance

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Introduction to Life Insurance

Life Insurance Policy Provisions


Non-forfeiture Benefits
Extended Term Insurance

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Life Insurance Policy Provisions


Non-forfeiture Benefits
Automatic Non-forfeiture Benefit : Become effective automatically when the insured has not paid a renewal premium by the end of the grace period and has not elected another non-forfeiture option

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Life Insurance Policy Provisions


Life Insurance Policy Exclusions
Suicide Exclusion Clause

War Exclusion Clause Aviation Exclusion Clause

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Introduction to Life Insurance

Next Chapter
Life Insurance Industry Meeting Needs of individuals and business Introduction to Risk & Insurance Underwriting Pricing Life Insurance Term Life Insurance Permanent Life Insurance Group Life & Annuities Supplementary Benefits Policy Beneficiaries Life Insurance Policy Provisions Policy Proceeds ( Claims, Dividends etc.)

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Introduction to Life Insurance

Life Insurance Policy Proceeds


Policy Dividend Options
Methods of receiving policy dividends

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Introduction to Life Insurance

Life Insurance Policy Proceeds


Policy Dividend Options
Cash Dividend

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Life Insurance Policy Proceeds


Policy Dividend Options
Premium Reduction

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Life Insurance Policy Proceeds


Policy Dividend Options
Accumulation at Interest

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Introduction to Life Insurance

Life Insurance Policy Proceeds


Policy Dividend Options
Paid up Additional Insurance

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Life Insurance Policy Proceeds


Policy Dividend Options
Additional Term Insurance : also called the fifth dividend option

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Introduction to Life Insurance

Life Insurance Policy Proceeds


Processing Life Insurance Claims
Claimant must provide two documents

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Life Insurance Policy Proceeds


Claim Examination Process

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Life Insurance Policy Proceeds


Claim Examination Process
Status of Policy The policy must be in force when the insured died. For example, a term life insurance policy may have reached the end of its term and expired. The claim examiner must verify that the policy did not terminate for any other reason before the insureds death.

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Life Insurance Policy Proceeds


Claim Examination Process
Identification of the Insured : The claim examiner confirms that the person who died was the person insured by the policy

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Introduction to Life Insurance

Life Insurance Policy Proceeds


Claim Examination Process
Verification of the loss In order to verify that the insured has died, the claim examiner must examine the proof of loss document provided to him. In most cases, the death certificate or other proof of loss document submitted by the claimant provides all of the information the claim examiner needs to verify

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Life Insurance Policy Proceeds


Claim Examination Process
Verification of Policy Coverage The insurance policy is reviewed to determine what type of coverage it provides. The policy exclusions must be considered e.g. Suicide exclusion.

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Introduction to Life Insurance

Life Insurance Policy Proceeds


Claim Examination Process
Identifying the proper payee
Primary Beneficiary named ? Living ?

Approval to pay claim

Pay Primary Beneficiary

Proceeds payable to Policy owner if living; Otherwise to Policy owners Estate

Contingent Beneficiary named ? Living ?


Second Contingent Beneficiary named ?

Pay Contingent Beneficiary

Living ?
Other Contingent Beneficiary named ?

Pay Second Contingent Beneficiary

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Life Insurance Policy Proceeds


Claim Examination Process
Determining the amount of death benefits

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Life Insurance Policy Proceeds


Payment of Policy Proceeds

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Thank You for your participation

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