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26 Cards in this Set
- Front
- Back
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What is subrogation
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Gives insurer the right to pursue others for a claim you make.
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Four definitions of insurance - aleatory, adhesion, waiver provisions, Unilateral
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Unilateral - only one party bound by commitment
Adhesion - a 'take it or leave it' contract. Waiver provisions: Only the president, VP, secretary may alter contract. Aleatory: Outcome affected by chance where payoff is unequal and large |
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Parts of the Insurance Contract
DDICE |
Declarations - factual statements that ID the specific people & property insured
Definitions - explanation of key policy terms. Insuring Agreement - basic promise of Ins Co. Conditions - detailed description of duties & rights of both parties. Exclusions |
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Defenses against Unintentional Torts (infringement of rights)
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1) Assumption of risk - skiing
2) Contributory - jaywalking 3) Comparative (apportions blame) 4) Last clear chance |
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Sections on a Home Owners Insurance Policy
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Abode (Dwelling & attached structures)
Buildings Contents - personal property 'Ditional (indemnity - i.e. loss of use) Enemies (liability) First Aid (Medical payments to others) |
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Basic Perils Covered
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Wind
Hail Aircraft Riot Vandalism Explosion Smoke Fire Lightning Theft |
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Broad Form Incl Basic + RAF
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Rupture of a system
Artificially generated electricity Falling object |
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Exclusion
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Earthquake
Flood Intentional Loss Neglect Ordinance Earth movment, War, Power failure, nuclear hazard |
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Dividend Options
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Cash:
Reduction of premiums: Accumulation with interest: (taxable interest) Paid up Additions: 1 year term (aka 5th dividend option - div used to buy 1yr term = to CV) |
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Non-forfeiture Options
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- Cash Option
- Usage - Reduced amount of paid-up - Paid up term (aka 'extended term') policy stays in force as term for as long as CV pays term premium |
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Home Owners Insurance
(Coverages) |
Abode (dwelling & attached structures
Buildings (detached buildings) Contents - Boats & trailers ltd to $1K. Excl property of renters. 'Dittional (Loss of use) Enemies (personal liability) First aid (medical payments to others) |
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Basic Perils Covered
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Wind
Hail Aircraft Riot Vandalism Explosion Smoke Fire Lightening Theft |
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Broad Form Coverage
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WHARVES / FLT
+ Rupture of a system Artificially generated electricity Falling objects / Freezing of plumbing |
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8 General Exclusions
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1) Ordinance of law
2) Earthquake 3) Water damage (flood) 4) Power failure 5) Neglect 6) War 7) Nuclear hazard 8) Intentional loss also sinkhole is a covered peril |
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Policy Types and Coverage
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HO-1 - Basic
HO-2 - Broad HO-3 - Open (B = 10%, C = 50%, D = 30%) HO-5 (3/15) - Open HO-8 - Older home - Basic HO-4 - (renter's) - C = broad, D = 30% of C HO-6 - Condo owner - C - Open, D - Broad + $5K of loss assessment |
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Medicare Part A: Hospital Insurance
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Eligibility: >65 & entitled to SocSec or disabled & receiving benefits >2yrs.
Benefits: A) Hospital stays for 60 days (1st deductible), add'l 30 days (2nd deductible), add'l 60 days (3rd deductible). Inpatient hospital care ltd to 150 days. B) SNF for ≤100days. C) Unltd post-hospital home health services D) Hospice E) 3 pints of blood |
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Medicare Part B: Medical Insurance - What's Included?
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Voluntary program - premiums payable. Medicare pays 80% of approved charges (with no out of pocket limit).
Benefits: A) Doctors services (house calls, office visits & in hospital) B) Diagnostic tests, radiology/pathology, OT, drugs that CANNOT be self-administered. C) Outpatient services D) Unltd home health services E) Preventative care (colorectal & mammograms) & annual physical |
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Medicare Part B: Medical Insurance - What's Excluded?
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1) Routine dental care and dentures
2) Optometry needs 3) Most immunizations (although 1 free flu and pnemonia shot) 4) Prescription drugs` |
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Medicare Part D: Prescription Drugs?
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Need to be part of a private insurance program. Must have Part A/B. Entitles patient to 50% drug discount
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Medicare Supplement Policies
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Ten medicare supplement policies available (A - J).
Generally incl deductibles & co-insurance. Further down the list incl add'l benefits. Retirees may only be sold 1 medigap policy at a time. |
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Health Savings Accounts (HSA's)
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Deductible for AGI on front of 1040. Contributions by individual or employer. Tax deductible up to $3050-S/$6150-MFJ. Must be covered under a High-deductible health plan. Deductible from plan (min) $1200 single/$2400 family.
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Medical Savings Account (MSA)
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Either individual OR employer may contribute but NOT both. Suitable for self-employed or small employers (<50). Must have High-deductible Health Plan. Deductible range = $2-$3K for single & $4.1-$6.15K for family.
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Conditions Applicable to both HSA's and MSA's
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Distributions can be for health-care needs not covered by HDHP & are tax free. No OTC drugs. Funds can be used to pay for retiree health insurance, prescription drugs, COBRA & LTC. Can be carried forward. Can do one-time IRA to HSA/MSA rollover. Can be used for dental, optical,
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Accelerated Benefits Rider (ABR) on a Life Insurance Policy
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Pays a portion of the DB if insured deemed to be terminally ill (<2yrs) or chronically ill (unable to perform ≥ 2 ADL's & will qualify for LTC expenses only). May typically make available 50% of DB payable tax-free now & the other 50% at death.
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Viatical Settlements
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Sale by a terminally ill (2yrs to live) insured to a company specializing in these transactions. Amounts received tax free to insured. Viatication company receives full DB, taxable only on amount received above basis (basis incl's premiums paid + initial purchase amount).
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Life Settlements
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Sale by non-terminally ill person. Proceeds received are taxable as follows;
a) Up to basis (tax-free) b) Ordinary income on difference between basis & cash-value (represents growth in cash-value) c) LTCG above ≥ CV or basis to proceeds received. |