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DISABILITY INSURANCE
CREDITRE CORPORATION
330 Grapevine Highway
Hurst, TX 76054
Phone: (817) 788-8121
Fax: (817) 788-8123
This study guide was written to accompany the textbook, Credit Life and Disability
Insurance. The intent of this guide is to reinforce and simplify the concepts presented in
the textbook. All page number references apply to the textbook.
The order of the subject matter in this study guide differs from that of the textbook. This
ordering is designed to introduce and lead the reader through the many facets of the
credit insurance industry. Familiarity with the terms and formulas explained in earlier
lessons is a prerequisite for understanding subsequent lessons. A reader who is new to
the subject matter of credit insurance should follow the order of this study guide.
Each lesson contains objectives, key words, an outline of the suggested reading
material and review questions. A suggested course of study for any lesson is:
Read the material in the textbook, noting key words and important topics
indicated by the objectives.
Re-read the objectives. Make sure you can perform these objectives.
Helpful Hints:
Always make sure you can solve any examples given in the text and in the
outline. You will be asked to perform these skills in the review questions.
Keep a calculator handy when you are reading sections that involve mathematical
problems.
Special Note:
Page
OBJECTIVES
You will have mastered this lesson when you are able to:
Page 1
KEY WORDS
account
borrower
collateral
consumer credit insurance
Consumer Credit Insurance Association
credit disability insurance
credit life insurance
creditor
debt
debtor
democratization of credit
evidence of insurance
financial institution
gross minus refunded premiums
gross written premiums
lender
lending institution
Morris Plan Banks
Morris Plan Insurance Society
net written premiums
premium refunds
premium producer
single premium
Uniform Small Loan Act of 1916
written premiums
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OUTLINE
A. INTRODUCTION
Credit Life Insurance: Insurance that pays off a loan obligation if the insured
borrower or co-borrower dies.
The average policy size is under $20,000, and the term of insurance is short,
generally under sixty-one months.
The premium charged is a single premium paid at the inception of the policy.
The premium is included in the amount advanced and is financed along with
the principal of the loan.
The first beneficiary of the policy proceeds is the lender, who uses the
proceeds to extinguish the loan obligation. Any additional proceeds are paid
to the second beneficiary or the estate of the insured.
B. TERMINOLOGY
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Borrower or Debtor: The consumer entering into the debt obligation.
Loan or Debt: The obligation to repay money entered into by the borrower or debtor in
exchange for cash or consumer goods.
Evidence of Insurance: A form stating the conditions and coverage of the insurance. If
the borrower is insured under a group policy, he receives a certificate of insurance. If
he is insured under an individual policy, he receives an individual policy. The generic
term policy is often used to refer to both forms.
Premium: The amount paid by the borrower for the insurance, also called the gross
premium.
Single Premium: The total cost of the insurance paid at the time the policy or
certificate is issued (usually financed along with the principal of the loan).
Premium Refunds: The portion of the original single premium representing the unused
insurance which is returned to a borrower who terminates the insurance before
maturity.
Gross Written Premiums: The total premiums collected by the lender on all new
policies issued.
Written Premiums (or Net Written Premiums): The total gross written premiums less
the premium refunds paid on terminated policies. Also called gross minus refunded
(G-R) premiums.
Before 1910, bankers would only lend to those individuals who had deposits in the
bank or could provide unimpeachable collateral.
The lending practices of the day led Arthur J. Morris to develop an idea for the
democratization of credit; i.e., a bank should be willing to lend money if the
borrower could show good character and the earning power to repay the debt.
Morris formed the first bank holding company to aid in establishing other banks that
would adhere to his lending ideology.
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Morris franchised these types of banks nationwide, calling them Morris Plan
Banks.
The Morris Plan Bank concept spread. At its peak, 170 were operating.
Morris realized that the death or disability of the borrower cut off the
borrower's earning power, the collateral of the loan.
This situation led Morris to develop the concept of credit insurance. In 1917,
Morris established The Morris Plan Insurance Society, a credit insurance
company with the motto, "No man's debt should live after him."
Before 1960, the industry was generally divided between insurers writing
under group policy forms and those writing under individual policy forms. As
group statutes became more permissive, credit insurers wrote a
traditional group policy in order to benefit from the simpler administration
procedures and special deductions under the 1959 Tax Act.
The first credit disability insurance policies paid off the loan if the insured met
the conditions for being totally and permanently disabled.
Credit disability insurance has grown rapidly in the last twenty years.
Market Segments
In the 1950s, there were heated debates on the interpretation of state laws
and regulations based on the provisions of the Uniform Small Loan Act of
1916. The debates centered on whether a charge could be made for credit
insurance sold in conjunction with small loans. They were resolved by the
development of the NAIC Model Regulations and by the amendment of state
banking and loan laws that specifically authorized the sale of credit insurance
with a contributory charge.
E. TRADE ASSOCIATIONS
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Consumer Credit Insurance Association (CCIA): The primary trade association of
credit insurers. Founded in 1951, it now has over 200 member companies and
concentrates on the credit insurance industry.
Other trade associations serve many types of insurers, with credit insurance as only
one aspect of their activities:
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REVIEW QUESTIONS
1. Insurance that pays off the loan obligation if an insured borrower or co-borrower
dies is called .
5. All of the following are common characteristics of current credit insurance policies
except:
(1) No underwriting conditions are imposed and very few exclusions are contained
in a policy.
(4) The rate of the policy varies with respect to the age of the borrower.
(5) The premium is usually financed along with the principal of the loan.
6. Which of the following contributed to the growth of the credit insurance industry?
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D. The founding of the Morris Plan Insurance Society.
7. Why did the development of the Morris Plan Bank trigger the founding of the Morris Plan
Insurance Society?
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LESSON TWO: CREDIT LIFE INSURANCE
(REFER TO PP. 1-20)
OBJECTIVES
You will have mastered this material when you are able to:
2. List the loan conditions affecting credit life insurance for closed-end
loans.
6. State the common eligibility requirements and exclusions for credit life
insurance.
8. Given the type of loan, state the credit life insurance product(s)
commonly offered.
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KEY WORDS
B. INDEBTEDNESS
Initial net indebtedness: The total amount advanced, which normally includes the
principal of the loan plus the insurance premium.
Initial gross indebtedness: Initial net indebtedness plus the scheduled interest
charges.
Net indebtedness: The amount due under a debt obligation at any time. This
normally includes the outstanding principal and insurance premium amounts, plus
any accrued interest since the last payment.
Gross indebtedness: The sum of the remaining scheduled payments due under a
debt obligation. This includes the net indebtedness plus the unearned interest
charges.
C. CLOSED-END LOANS
Installment Loans
Conditions: A loan with both the amount and term fixed; the principal is repaid in
equal monthly payments. The monthly payment is the initial gross indebtedness
divided by the term of the loan. Each payment provides for payment of interest
charges (based on net indebtedness at the beginning of that month). The
outstanding balance at any time is the net indebtedness.
Level Loans
Conditions: A single payment loan in which the payment is due from the
borrower at maturity. Since the interest accrues as time elapses, the net
indebtedness increases during the term of the loan. The gross indebtedness
remains level during the term of the loan.
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Insurance: Level term insurance for the amount of initial gross indebtedness.
Balloon Loans
D. OPEN-END LOANS
Insurance: Insurance to meet the outstanding balance; i.e., net payoff coverage.
Effective Date and Termination Date are set by the corresponding dates of the loan.
The principal, initial net indebtedness, and initial gross indebtedness of the loan
affect the death benefit, which in turn affects the type of coverage and premium
charged.
Number of borrowers affects coverage; either single life or joint life coverage will be
offered.
The rate of interest and whether it is fixed or variable affect the type of coverage,
the amount of benefits and the premium charged.
Individual Policy: The contractual relationship is between the borrower and the
insurance company. The borrower receives an individual policy as evidence of
insurance.
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Group Policy: The contractual relationship is between the lender and the insurance
company. The borrower is enrolled in the group and receives a certificate of
insurance.
Group Maximum Limits: Laws and regulations in some states restrict the amount
of insurance which can be provided by group insurance. However, insurance can be
provided on loans when the initial indebtedness exceeds such limits by:
Offering the insurance with a death benefit equal to the maximum allowed or the
remaining indebtedness, whichever is less, i.e., a level-decreasing insurance
policy
Gross Coverage: Amount of insurance covers the gross indebtedness of the loan.
Uniform decreasing term life insurance is the resulting plan.
Net Payoff Coverage: Amount of insurance covers the net indebtedness of the
loan but limited to the scheduled net indebtedness plus an amount sufficient to
cover a specified number of delinquent payments (usually two).
Criticism: Amount of insurance may not be sufficient to pay loan balance if the
borrower has been delinquent in payments.
H. PREMIUM MODE
Single Premium: A premium to pay for the full coverage provided and charged to
the insured at the inception of the loan.
Premium rates are expressed per $100 of initial gross indebtedness, and per year
of coverage.
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Monthly Outstanding Balance (MOB): A premium collected monthly.
J. COVERAGE PERIOD
Generally, the coverage period is the same as the term of the loan.
Truncated Life Coverage: Usually net payoff coverage for the full outstanding net
indebtedness, but death must occur during the term of insurance coverage. The insurance
term is less than the term of the loan.
Eligibility Requirements
The borrower may be required to sign a good health statement. An application with health
questions may be required for larger amounts.
Exclusions
If suicide occurs within a specified period after issue (six months to two years), no benefit
is paid; but the estate receives a refund of the unused insurance premium.
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REVIEW QUESTIONS
1. Cash loans, installment sales contracts, and credit card borrowing are all types of
2. The total amount advanced (including the insurance premium) plus the scheduled
interest charges over the loan term equals the
3. Under an individual policy, the contractual relationship is between the and the
4. Under a group policy, the contractual relationship is between the and the
6. State the difference between critical period coverage and truncated life coverage.
Explain the reason for each coverage.
7. Decide whether the following statement is true or false. Justify your answer.
Single premiums are usually charged in conjunction with credit card borrowing.
8. Which of the following statements are true regarding the advantages of offering
group policies versus individual policies?
C. Special federal income tax deductions for group business were provided by
the 1959 Tax Act.
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D. Individual policies have maximum limits set by the various states.
E. Individual policies are often sold if the insurer desires to ask health questions.
9. Which of the following are common eligibility requirements and exclusions for credit
life insurance?
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LESSON THREE: CREDIT DISABILITY INSURANCE
(REFER TO PP. 21-34)
OBJECTIVES
You will have mastered this material when you are able to:
a. date of disability
b. elimination period
c. retroactive or non-retroactive benefits
d. monthly benefit
e. date disability ceases
3. Determine whether benefits are payable in a situation when the six and six exclusion
is in effect.
4. Describe the difference(s) between critical period disability coverage and truncated
disability coverage.
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KEY WORDS
actively-at-work
anti-selection
any occupation disability
critical period disability coverage
dismemberment benefit
elimination period
his (or own) occupation disability
lump sum coverage
monthly benefit gross coverage
non-retroactive benefits
preexisting condition
presumptive test of disability
retroactive benefits
six and six exclusion
total and permanent disability
truncated disability coverage
waiting period
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OUTLINE
Definition of Disability
If the insurer can determine that the disability is total and permanent, then
the benefit is paid. This method is used in the credit union market.
All disability policies provide gross coverage. The monthly benefit is equal to the
monthly loan payment, which includes interest charges.
Elimination Period: The period of disability before any benefits are payable,
also called the waiting period.
Example 1
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Benefits are payable since the length of disability exceeds the
elimination period.
Example 2
Benefits are not payable since the length of disability does not exceed
the elimination period.
Retroactive Benefits: Benefits are payable from the first day of the
elimination period, once the elimination period is completed.
Example 1
14R means that benefits are payable from the first day of disability.
Therefore, benefits for 16 days are payable.
=16x350
30
_ $186.67
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Example 2
= 53
Since the plan of insurance is 14E, benefits are payable from the
15th day of disablement.
53 - 14 = 39 days
=39x100
30
= $130.00
Exclusions
Preexisting Conditions
Definition: An impairment for which the insured has been treated prior to
the effective date of insurance.
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Six and Six Exclusion
Determine if benefits are payable when a six and six exclusion is in effect:
Example 1
The preexisting condition was treated within six months before the
effective date, but the disability occurred over six months after the
effective date. Benefits are payable.
Example 2
The preexisting condition was last treated seven months prior to the
effective date. Benefits are payable provided the elimination period
conditions are met.
Other Exclusions
Eligibility Requirements
Only the primary borrower is eligible for coverage in most cases. Joint
insurance is rarely offered in the U.S. but is available in Canada.
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The borrower must also be actively-at-work; i.e., working thirty or more hours
per week on the effective date of the insurance.
The monthly payment defines the monthly disability benefit. The maximum
benefit at any time equals the sum of the remaining payments.
When offered, the benefit is a lump sum equal to the outstanding balance of
the loan. However, the only coverage offered requires total and permanent
disability.
Open-End Loans
This policy usually has a 14- or 30-day elimination period and may have
either retroactive or non-retroactive benefits.
The benefit is the minimum monthly payment due, generally the amount
needed to repay the balance of the loan on the date of disability within 24
months.
The benefit is the outstanding balance of the loan on the date of disability,
usually with a 90-day elimination period.
D. COVERAGE PERIOD
Customarily, credit disability policies provide coverage and benefits for the full
term of the loan.
Definition: Coverage offered for the full term of the loan, but with the benefit
limited to a specified number of monthly payments, or the remaining
payments if less.
This coverage is usually offered on loans over sixty months to decrease the
borrower's total dollar outlay while offering essential protection.
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Truncated Disability Coverage
Definition: Coverage offered during a portion of the term of the loan. Benefits
are paid only if the disability occurs during the term of coverage. Monthly benefit
payments continue only until the end of the term of insurance.
For example, on a ten-year loan, truncated coverage may be offered for the first
five years. A disability must occur during the first 60 months. In addition, all
benefits cease at the end of the 60 month coverage period.
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REVIEW QUESTIONS
1. If the borrower is working thirty or more hours per week on the effective date of
insurance, he/she is considered
2. (Circle One) Increasing the elimination period will raise/lower/not affect the
premium.
John Smith is insured by a credit disability insurance policy. Payment is due on the
first day of each month. Benefits: 30R. Monthly loan payment: $300.00
7. If John is disabled from July 30 through August 31, what benefits are paid?
8. If John is disabled from July 25 through August 8, what benefits are paid?
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Use the information given below to answer questions 9-11. State only whether
benefits are payable.
12. All of the following are common exclusions for credit disability insurance EXCEPT:
13. Variations of the six and six exclusion exist. Read the information below and
answer the following:
What is the earliest date that disability from the preexisting condition can occur so
that benefits are payable? Explain.
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LESSON FOUR: DIRECT WRITERS, CAPTIVES, AND PRODUCERS
(REFER TO PP. 35-43, 49-61)
OBJECTIVES
You will have mastered this material when you are able to:
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KEY WORDS
acceptance corporation
assume (the risk)
assuming reinsurer
captive insurance company
cede
ceding insurer
controlled foreign corporation
direct-writing captives
direct writer
domestic insurer
domicile
exotic reinsurance company
extraterritorial regulations
finance and insurance specialist
line-of-credit
mutual life insurance company
non-controlled foreign corporation
penetration rate
reinsurance
reinsurer
retention
retrocede
retrocessionaire
retrospective compensation
stock life insurance company
Page 30
OUTLINE
A. DIRECT WRITERS
The direct writer must meet the obligations guaranteed by the policy, regardless
of any reinsurance arrangements.
Direct-Writing Captives
A direct writer is incorporated in one state, its state of domicile. In this state, it
is considered a domestic insurer.
Once the direct writer is incorporated, it can apply for licenses in other states.
The direct writer is considered a foreign insurer in these states.
Reinsurance
Definition: The transfer of risk from one insurance company (the ceding
company) to another insurance company (the assuming company). The direct
writer cedes the risk to the reinsurer who assumes the risk. If the reinsurer
does not want to retain all of the risk it assumes, it will retrocede a portion of
the risk to a second reinsurer, the retrocessionaire.
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B. CAPTIVE INSURANCE COMPANY (CAPTIVES)
Within the United States, a captive may be formed and licensed in only one
state; the requirements vary from state to state. Arizona is the logical choice.
A captive can also be formed outside of the United States in Bermuda, the
Cayman Islands, the Turks and Caicos or other sites; these are called offshore
captives.
Definition: A reinsurance company with more than one class of stock. It may
be onshore or offshore.
Advantages of an Exotic
The volume may qualify the captive for lower administrative fees from the
direct writer.
Disadvantages of an Exotic
Serious problems arise when one class has bad loss experience.
Page 32
C. PRODUCERS OF CREDIT INSURANCE
Credit insurance is offered to the borrower at the place where the loan is
extended. Therefore, the primary producers are lending institutions including the
following:
Banks
Credit Unions
Finance Companies
Acceptance Corporations
Retail Outlets
Penetration Rates
Example
100
250
= .40
= 40%
Page 34
REVIEW QUESTIONS
4. A direct writer formed in Arizona and licensed in all other states is considered
a/an insurer in Arizona and a/an
insurer in other states.
6. All of the following statements can correctly be made about an exotic reinsurance
company:
B. The combined volume of the producers may qualify for lower administrative
fees by the direct writer.
Life Disability
10. Which of the following correctly describes the relationship between a captive
reinsurer and the direct writer?
A. A captive reinsurer takes over the majority of the direct writer's administrative
functions.
D. A captive reinsurer does not have to be licensed in the state where the policy
is sold.
(1) D only
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LESSON FIVE: HOME OFFICE OPERATIONS 1
(REFER TO PP.87-125,130)
OBJECTIVES
You will have mastered this material when you are able to:
4. List the actions an examiner must take to adjudicate a death claim; a disability claim.
Page 37
KEY WORDS
assignment of commissions
case reserve
claimant
commission caps
compensating balances
contestable period
contingent commission
Continuance of Disability Form
experience refund
first and final
front commission
general agent
good health statement
guaranteed issue limit
non-resident agent
override commission
policyholder dividends
report and remittance
resident agent
retroactive commission
return commission
service fees
Page 38
OUTLINE
Sales Staff
Widely licensed insurers may utilize independent general agents who will
provide local sales and service.
Adjusting commissions
Cancelling business
Filing for rate increases
Reviewing policy forms and limits
Sales Administration
The initial setup work for a new account. This includes supplying the
account with reporting procedures, forms and rate calculation materials.
Page 39
B. COMPENSATION TO HOME OFFICE SALES STAFF, GENERAL AGENTS, AND
PRODUCERS
Service Fee: Payment for the actual cost of offering the products. Some
state and federal regulations do not allow the payment of commissions to
financial institutions, but permit payment of service fees.
Policyholder Dividends
Page 40
For group credit business, the producer is the group policyholder. The
allocation by policyholder generally follows the formula for experience
refunds. However, expense is allocated to the producer for actual expenses
incurred for processing the producers' business rather than a set charge.
Limitations on Compensation
Compensating Balances
C. AGENT LICENSING
State laws and regulations require that an agent must be licensed in his state of
residency. In this state, he is a resident agent. If licensed in other states, he is a
non-resident agent.
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D. PREMIUM BOOKING
Business issued
Refunds made
Remittance for the gross premiums collected minus the refunded premiums,
less any deducted compensation, is submitted to the insurer along with
supporting documentation (consisting of a copy of the group certificate or
individual policies).
Billing Method
E. CLAIMS ADMINISTRATION
Timely processing
Processing Requirements
The date of death is between the effective date and expiration date of
the insurance and a refund has not occurred.
The age on the death certificate is consistent with the age on the
insurance policy.
Disability Claims
Closed files are those for which the final payment has been made because
of termination of disability, expiration of coverage, or denial.
Pay
Payment may be first and final; i.e., a claim involving one payment.
Payment may continue for several years in which case the claimant
must complete a Continuance of Disability form every 30-90 days.
Deny
Investigate
Form letters, phone calls and inspection companies may be used for
inquiry.
Internally, the department measures and tracks time and quality of service.
Audits are also performed by the corporate internal audit staff. These audits
concentrate on timeliness, accounting and conformance with corporate
policy.
F. INVESTMENT DEPARTMENT
Investment departments attempt to match the terms of invested funds with the
terms of the underlying liabilities. Since credit insurance is short-term in nature,
a large portion of invested assets are short to medium term investments, such
as:
Certificates of deposit
Short-term bonds
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Checking accounts
Savings accounts
Other Responsibilities
Compare the amount of letters of credit posted to the required balance (of
offshore captives with letters of credit in lieu of a custodial trust)
Page 45
REVIEW QUESTIONS
2. The type of producer compensation that is contingent upon the profitability of the
business is called
3. When handling a disability claim, an examiner has four options. List them.
8. State the reasoning for the following statement, "Disability claims are more difficult to
process than death claims."
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LESSON SIX: HOME OFFICE OPERATIONS II
(REFER TO PP. 131-157)
OBJECTIVES
You will have mastered this material when you are able to:
2. Given the type of clause within a policy form, describe its contents and purposes.
3. List the major difference between group and individual policy forms.
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KEY WORDS
claim clauses
coverage clause
deemer provision
eligibility clause
Flesch Scoring Method
grace period
incontestability
insurable interest
insuring clause
misstatement of age clause
refinanced loan
variable reference basis
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OUTLINE
Provisions
Insuring Clause: The clause that describes the benefits paid under the
various life and disability plans. The group certificate provided to the insured
may contain all possible options, and the desired benefits are selected by
marking the appropriate benefit box.
Eligibility Clause: The specific requirements that the insureds must meet,
such as a maximum age limitation and an actively-at-work test.
Coverage Clause
This clause specifies the date when insurance begins and ends.
The purpose of the clause is to measure the effective date from the first
date of the loan.
The premium rates are defined for the plans of insurance, usually by
reference to a schedule or the group application.
Reports
Grace Period: The lender is permitted a 30 or 31 day grace period for the
remittance of premium to the insurer.
Entire Contract
The basic idea of this clause is to state that the written contract contains
all of the terms of the agreement.
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Misstatement of Age
Case One: The borrower misstates his age so that he is eligible for
insurance, but his true age exceeds the eligibility requirement.
Case Two: The borrower states his true age, however, his true age
exceeds the eligibility requirement.
The insurer must recognize the situation and rescind the certificate.
The time to rescind the certificate is limited in some states to 60 or
90 days after the effective date.
Claim Clause: Several clauses define the process of claim filing and the
beneficiaries under the policy.
Definitions Clause
This clause will define a variety of terms found in the contract, such as:
B. INDIVIDUAL POLICY
The contractual relationship is between the insured borrower and the insurer. The
individual policy is used for several reasons:
Underwriting of the policy may be desired by the insurer; i.e., health questions
may be required, and insurers often use an individual policy instead of a group
policy (some states do not permit health questions on group policies).
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The insurer generally issues individual policies.
C. POLICY FILING
The development of a policy form is a long and tedious process. Time for final
approval can range from one to eighteen months. The form must meet the credit
insurance regulations of each state where approval is desired. The general process
is:
An initial review is made for compliance with the state regulations where the
policy is to be filed. A master policy filing manual is referenced.
Filing requirements:
Readable forms are required in many states; the readability is judged by the
Flesch scoring method.
Filing fee
Some states have a deemer provision in their laws and regulations which
provide that a filing is deemed approved unless the department objects
within a specified period of time, usually thirty days.
Trends of Policy Filing
Many states require that a form be submitted and approved by the insurer's
domiciliary state before submission to other states.
3. List the possible reasoning for writing an individual policy instead of a group policy.
4. Read the following information and answer the questions that follow.
A 48-month credit life policy with a suicide provision of two years was accepted by
the insurer.
A. If the insured committed suicide during the third year of the policy term, would
the death benefit be paid? Why or why not?
B. If the insured committed suicide during the second year of the term, would the
death benefit be paid. Why or why not?
5. Circle the correct response. If an insured misstates his age on a policy and is actually
above the maximum age limit, death benefits are (payable/not payable) after the
contestable period.
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