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Class 14 Insurance and Risk Management

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Incontestable Clause ... Suicide and incontestable clause may have expired ... Misstatement of Age or Sex Clause ... – PowerPoint PPT presentation

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Title: Class 14 Insurance and Risk Management


1
Class 14Insurance and RiskManagement
  • George D. Krempley
  • Bus. Fin. 640
  • Autumn Quarter 2006

2
Todays Agenda
  • Review Types of Life Insurance
  • Life Insurance Contractual Provisions
  • Dividend Options
  • Non-forfeiture Options
  • Settlement Options
  • Use of a Trust
  • Additional Life Insurance Benefits

3
Term Insurance
  • Term Insurance
  • Yearly renewable term
  • 5-,10-,15-, or 20-year term
  • Term to Age 65
  • Decreasing term
  • Reentry term

4
Whole Life Insurance
  • Ordinary Life
  • Limited Payment Life

5
Endowment Insurance
  • Traditional form of life insurance
  • Pays face amount
  • To the beneficiary, if insured dies before the
    end of the endowment period
  • To the policyowner, if the insured survives to
    the end of the policy period.
  • The policy matures. It endows, that is, it
    pays out the face amount.
  • No longer meets tax definition of life insurance

6
Variations of Whole Life
  • Variable Life
  • Universal Life
  • Variable Universal Life
  • Current Assumption Whole Life
  • Indeterminate Premium Whole Life

7
Other Types of Life Insurance
  • Modified Life Insurance
  • Preferred Risks
  • Second-to-Die Life Insurance

8
Characteristics of Universal Life
  • Unbundling of component parts
  • Two forms of universal life
  • Considerable flexibility see p. 379
  • Cash withdrawals permitted
  • Favorable income-tax treatment - Same favorable
    treatment as traditional whole life policies

9
EXHIBIT 17.2 Universal Life Insurance Death
Benefits
10
Tax Treatment Ordinary Life Insurance
  • Death benefits are not taxed (if paid to a named
    beneficiary, not estate)
  • Income tax not paid on increases in cash value
    while the policy is in force
  • Upon surrender, income tax is paid on
  • Cash surrender value - (sum of all premiums
  • sum of all policyholder dividends)

11
EXHIBIT 17.4 Comparison of Major Life Insurance
Contracts
12
EXHIBIT 17.1 Illustrative Examples of Term Life
Insurance Premiums, 250,000
13
EXHIBIT 17.3 100,000 Universal Life Policy,
Level Death Benefit, Male Age 25, Nonsmoker, 5.5
Percent Assumed Interest
14
Overview Life Insurance Contractual Provisions
  • Ownership Clause
  • Entire Contract Clause
  • Incontestable Clause
  • Suicide Clause
  • Grace Period
  • Reinstatement Clause

15
Overview Life Insurance Contractual Provisions
(cont.)
  • Misstatement of Age Clause
  • Beneficiary Designation
  • Change of Plan Provision
  • Exclusions and Restrictions
  • Assignment Clause
  • Policy Loan Provision
  • Automatic Premium Loan

16
Ownership Clause
  • Possible owners
  • Insured
  • Beneficiary
  • Third party

17
Owners Rights
  • Change the beneficiary (unless irrevocable)
  • Surrender the policy
  • Receive dividends
  • Elect settlement options

18
Ownership Change
  • File appropriate form with company
  • Policy may need to be endorsed
  • Key point
  • Generally, owner free to exercise rights
  • Without beneficiarys consent

19
Entire Contract Clause
  • Life insurance contract and attached application
  • Constitute the entire contract between the
    parties

20
Entire Contract Clause (cont.)
  • Statements made on application are
  • Representations
  • Not warranties
  • Claim cannot be denied unless
  • Statement made is a material representation and,
  • Statement is part of the application

21
Two-fold Purpose Entire Contract Clause
  • Prevents the Insurer from amending policy without
    consent of owner
  • Protects the beneficiary

22
Incontestable Clause
  • Insurer has 2 years to contest the policy on the
    basis of
  • Material misrepresentation
  • Concealment
  • Fraud

23
Incontestable Clause
  • Exception Limited set of outrageous fraud
    situations clearly violating public interest
  • Purchase with intent to murder insured
  • A person other than applicant takes medical exam
  • Insurable interest does not exist at policy
    inception

24
Suicide Clause
  • If insured commits suicide within two years of
    policy issuance date,
  • Face amount will not be paid
  • Instead, refund of premium will be made
  • Purpose Reduce adverse selection

25
Suicide Clause Legal Framework
  • Legal presumption against finding of suicide
  • Death normally considered an unintentional act
  • Insurer has burden of proof to prove insured
    committed suicide

26
Grace Period
  • 31-day period in which overdue premium can be
    paid without lapse of policy.
  • Insurance is in-force during grace period
  • Universal life and other flexible premium
    policies provide
  • Longer grace periods
  • E. g., 61 days

27
Reinstatement Clause
  • Provision allowing policy owner to reinstate a
    lapsed policy
  • Requirements
  • Evidence of insurability
  • Payment of past-due premiums
  • Re-payment or reinstatement of policy loans
  • Reinstatement must occur within a certain period,
    such as three years or five years
  • Policy must not have been surrendered for its
    cash value.

28
Reinstated Policy Vs. New Policy Advantages
  • Lower premiums
  • No additional acquisition expenses
  • Higher cash values and dividends
  • Suicide and incontestable clause may have expired
  • Reinstated policy may contain more favorable
    policy conditions (e. g, lower interest rate on
    loans)

29
Reinstated Policy Disadvantages
  • Substantial cash outlay required if policy lapsed
    for several years
  • New life products could have lower premiums
    because of
  • Lower mortality rates
  • Lower expense assumptions

30
Misstatement of Age or Sex Clause
  • Any amount payable under policy (Death benefit,
    cash value, etc.)
  • Reflects the amount that premiums would have
    purchased if the correct age and sex had been
    used.

31
Misstatement of Age Example
  • Male age 35 applies for 20,000 of ordinary life
  • Misstates age as 34.
  • Actual premium rate charged, age 34, per 1000 of
    coverage 19.
  • Premium rate that should have been charged, age
    35, per 1000 of coverage 20.
  • If insured dies and misstatement of age is
    discovered, death benefit payment reduced as
    follows
  • 19/20 x 20,000 19,000

32
Beneficiary Designation
  • Primary and contingent
  • Revocable and irrevocable
  • Specific and class

33
Primary Vs. Contingent Beneficiary
  • Primary First beneficiary entitled to receive
    policy proceeds upon insureds death
  • Contingent Entitled to receive proceeds if
    primary beneficiary dies before the insured

34
Key Issue Primary Vs. Contingent Beneficiary
  • Many families name children as contingent
    beneficiaries
  • Minor children lack legal capacity to receive
    policy proceeds directly

35
Primary Vs. Contingent Issue (cont)
  • Many insurers will require a guardian to be named
  • If court appoints guardian, payment may be
    delayed and legal expenses incurred.

36
Primary Vs. Contingent Issue (cont)
  • Two possible solutions
  • Name guardian in will who can legally receive
    death proceeds on childrens behalf.
  • Pay policy proceeds to a trustee, who has
    discretion and authority to use funds for
    childrens welfare

37
Revocable Vs. Irrevocable Beneficiary
  • Revocable Policyowner reserves right to change
    beneficiary without beneficiarys consent
  • Irrevocable Beneficiary cannot be changed
    without beneficiarys consent
  • Most policies provide that if irrevocable
    beneficiary dies before insured,
  • All rights to policy revert to owner, who then
    can name a new beneficiary

38
Specific Vs. Class Beneficiary
  • Specific Beneficiary specifically named and
    identified
  • Class Member of a class is designated as
    beneficiary.
  • Most Insurers restrict class designations because
    of
  • Problems with identifying members of the class
  • Class designation requires great care

39
Example My Children Vs. Children of Insured
  • My children means all children of insured share
    equally in policy proceeds, including
  • Legitimate
  • Illegitimate
  • Adopted
  • Children of Insured
  • Includes insureds children by any marriage
  • Excludes spouses children by a former marriage

40
Change of Plan Provision
  • Purpose Provide flexibility to policyowner to
    respond to changing needs for insurance
  • Allows exchange of present policy for different
    contract

41
Change of Plan Provision Rules
  • Change to higher-premium policy
  • Policyowner pays difference in policy reserve of
    new policy versus original contract
  • No evidence of insurability required

42
Change of Plan Provision Rules
  • Change to lower-premium policy
  • Insurer refunds difference in cash values
  • Evidence of insurability is required
  • Reduced cash value increases insurers net amount
    at risk
  • Lower premium policy provides higher pure
    insurance protection

43
EXHIBIT 16.3 Relationship Between the Net Amount
at Risk and Legal Reserve
44
Exclusions and Restrictions
  • Suicide clause
  • First two years only (most contracts)
  • One year (Appendix c, p702)
  • War clause
  • Excludes payment if insured dies as a direct
    result of war
  • Purpose To reduce adverse selection
  • Not contained in all policies

45
Exclusions and Restrictions (cont.)
  • Aviation exclusion variations
  • Exclude aviation deaths other than as fare-paying
    passenger on regularly schedule airline
  • Exclude military aviation or cover at additional
    premium only
  • Exclude private pilot not meeting certain flight
    standards, or charge higher premium

46
Exclusions and Restrictions (cont.)
  • Hazardous activities may be discovered in initial
    underwriting
  • Auto racing
  • Scuba diving
  • Hang-gliding
  • Travel or residence in a dangerous country
  • Underwriter may exclude or cover only with
    payment of extra premium

47
Payment of Premium
  • Payment modes Annual, semi-annual, quarterly or
    monthly
  • Carrying charge is relatively expensive
  • Example p.399
  • Annual premium 1,000
  • Semiannual premium 520
  • Apparent charge 4 40/1000
  • Effective carrying charge
  • 16.7 40/(1000-520) x 2

48
Assignment Clause
  • Life Insurance policy is freely assignable
  • Two types of assignment
  • Absolute assignment
  • Collateral assignment

49
Absolute Assignment
  • All ownership rights are transferred to a new
    owner
  • Church
  • Charity
  • Educational Institution
  • Insured
  • Beneficiary
  • New owner receives all ownership rights in the
    policy

50
Collateral Assignment
  • Policyowner assigns policy as collateral for a
    loan
  • Assignment form typically used
  • American Bankers Association assignment form
  • Collateral assignment confers limited rights in
    the policy
  • Assignee entitled to receive death proceeds only
    to extent of loan
  • Balance of proceeds are paid to beneficiary

51
Purpose/Workings Assignment Clause
  • Purpose To protect insurer from paying policy
    proceeds twice
  • If Insurer is not notified of assignment,
  • Proceeds are paid to named beneficiary
  • Insurer is relieved of any further obligation
  • Even if a valid assignment is in existence

52
Purpose/Workings Assignment Clause
  • If Insurer is notified of assignment,
  • A new contract exists between insurer and
    assignee
  • Insurer recognizes assignees rights as superior
    to beneficiarys rights
  • Implications?

53
Policy Loan Provision
  • Allows policyowner to borrow the cash value
  • Advantages
  • Low annual percentage rate
  • No paperwork, no credit check
  • Flexibility in repaying, no fixed repayment
    schedule
  • Disadvantages
  • Heavy borrowing may cause policy to lapse
  • Amount of protection is reduced

54
Automatic Premium Loan
  • Allows overdue premiums to be paid by borrowing
    from the cash value at the end of the grace
    period.
  • Purposeto prevent the policy from lapsing
  • Main disadvantages
  • If overused, cash values may become exhausted,
    leading to policy lapse
  • Amount of protection is reduced

55
Participating Policies
  • Participating policy definition
  • Policy which pays dividends
  • Participating policy
  • Gives policyowner right to share in the divisible
    surplus of insurer
  • Can be issued by both a stock insurer and a
    mutual insurer

56
Sources of Surplus for Dividends
  • Higher interest earnings than assumed
  • Lower mortality than expected
  • Lower operating expenses than expected
  • Relationship to design of Universal Life?

57
Dividend Options
  • Cash
  • Reduction of premiums
  • Accumulate at interest
  • Paid-up additions
  • Term insurance

58
Dividend Options (cont.)
  • Cash
  • Dividend payable after policy in force for a
    stated period
  • Policyowner receives a check usually on
    anniversary date
  • Reduction of premiums
  • Dividend used to reduce the next premium coming
    due.

59
Dividend Options (cont.)
  • Accumulate at interest
  • Company guarantees minimum rate on dividend
    accumulations
  • But, may pay a higher rate depending on market
    conditions.
  • Paid-up additions
  • Dividend used as a single premium to buy
    additional amounts of paid-up insurance.

60
Dividend Options (cont.)
  • Term insurance (Fifth Dividend)
  • Dividend used to purchase term insurance.
  • Two options
  • One-year term
  • Yearly renewal term (limited availability)

61
Other Dividend Uses
  • Convert policy to a paid-up contract
  • Policy becomes paid-up
  • when reserve value of basic contract
  • plus reserve value of paid up additions
  • equals reserve value of net single premium
    paid-up policy
  • at insureds attained age

62
Other Divided Uses (cont.)
  • Mature policy as an endowment
  • Policy will mature
  • When the reserve of basic contract
  • Plus reserve of paid-up additions
  • Equal the face amount of the policy

63
Non-forfeiture Options
  • Cash Value
  • Reduced Paid-up Insurance
  • Extended Term Insurance

64
Non-forfeiture Option
  • Surrender of policy for its cash value
  • Little or no cash value during early years
  • Payment of cash value can be delayed for six
    months if policy is surrendered (seldom used).

65
Reduced Paid-Up Insurance
  • Cash value used to buy a reduced paid-up policy
  • Appropriate option when person has limited
    income, but still has some life insurance needs

66
Extended Term Insurance
  • Cash value used to extend full face amount of
    insurance
  • into the future as term insurance
  • for a certain number of years and days.

67
Settlement Options
  • Cashmost proceeds are paid as cash
  • Interest Option
  • Fixed Period Option
  • Fixed Amount Option
  • Life Income Options

68
Settlement Options Advantages
  • Periodic income to the family
  • Guaranteed principal and interest
  • Can be useful in life insurance planning
  • Long-term guarantees
  • No additional cost

69
Settlement Option Disadvantages
  • Higher yields elsewhere
  • Settlement agreement may be inflexible and
    restrictive.
  • Life income options not attractive at younger
    ages
  • Insurance windfall can create problems for the
    beneficiary.

70
Interest Settlement Option
  • Interest paid to the beneficiary
  • Minimum interest rate guaranteed
  • Beneficiary can make withdrawals
  • Advantages
  • flexibility, may allow change to another option
  • Main disadvantage higher returns elsewhere.

71
Fixed Period Settlement Option
  • Pays monthly, quarterly, semiannual, or annual
    payments
  • Death of beneficiary
  • Remaining payments go to a contingent beneficiary
  • To the estate of primary beneficiary if the
    contingent beneficiary dies
  • Useswhen income needed for definite period of
    time
  • Social Security black-out period
  • readjustment period
  • family dependency period
  • Limitationsinflexible partial withdrawals not
    allowed

72
Fixed Amount Settlement Option
  • Specified amount paid to beneficiary each time
    period
  • Advantages
  • Considerable flexibility on withdrawals
  • May allow change to another option or
  • Increase and decrease in fixed amount

73
Life Income Settlement Options
  • Life income only
  • Life income with a period certain
  • Life income with refund option
  • Joint-and-survivor life income option

74
Use of a Trust
  • Alternative to Settlement Option
  • Desirable when
  • Amount of insurance is substantial
  • Judgment in amount and timing of pay-outs is
    required
  • Example situations
  • Minor children
  • Mentally handicapped adult
  • Disadvantages
  • Must pay trustees fee
  • Returns not guaranteed

75
EXHIBIT 18.1 Nonforfeiture Options (Dollar
Amount for Each 1000 of Ordinary Life Insurance
Issued at Age 21)
76
EXHIBIT 18.2 Fixed-Period Option (Minimum
Monthly Income Payments per 1000 Proceeds, 3
Percent Interest)
77
EXHIBIT 18.3 Life Income Options (Minimum
Monthly Income Payments per 1000 Proceeds)
78
EXHIBIT 18.4 Joint-and-Survivor Life Income
Option (Minimum Monthly Income Payments per 1000
Proceeds)
79
Additional Life Insurance Benefits
  • Waiver-of-Premium
  • Guaranteed Purchase Option
  • Double Indemnity Rider
  • Cost-of-Living Rider
  • Accelerated Death Benefits Rider

80
EXHIBIT 17.3 (continued) 100,000 Universal Life
Policy, Level Death Benefit, Male Age 25,
Nonsmoker, 5.5 Percent Assumed Interest
81
EXHIBIT 27.1 Commissioners 1980 Standard
Ordinary Mortality Table, Male Lives
82
EXHIBIT 27.1 (continued) Commissioners 1980
Standard Ordinary Mortality Table, Male Lives
83
EXHIBIT 27.2 Present Value of 1 at 5 Percent
Compound Interest
84
EXHIBIT 27.3 Figuring the NSP for a Five-Year
Term Insurance Policy
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