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199 Cards in this Set
- Front
- Back
CSO
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Commissioner Standard Ordinary Table
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ERISA
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Employee Retirement Income Act of 1974
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FEGLI
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Federal Employees Group Life Insurance
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MIB
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Medical Information Bureau
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OASDI
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Old Age and Survivors Disability Insurance Benefits
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PAR
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Participating
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SGLI
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Services Group Life Insurance
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TSA
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Tax Sheltered Annuity
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VGLI
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Veteran's Group Life Insurance
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absolute assignment
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assignment by the policyowner of all control and rights to a third party
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accident
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an event that is unforeseen and unintended
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accident insurance
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a form of health insurance against loss by bodily injury
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accidental means
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the unexpected or unintended cause of an accidental bodily injury
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additional insured
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a person, firm, or corporation other than the named insured on a policy is protected against loss by the terms of the policy
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adjustable life
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a form of life insurance that allows changes on the policy face amount, the amount of premium, period of protection, and the length of the premium payment period
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adjustable premium
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usually used in connection with guaranteed renewable health policies in which the premium may be changed by classes of insured parties
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adjuster
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an individual who represents the insurance company and acts for the company in working on agreements regarding the amount of a loss and the liability of the company in a claim
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admitted company
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an insurance company authorized and licensed to do business in a given state and has been issued a "certificate of authority" by the insurance department
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adverse selection
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selection against the company; the tendency of more poor risks to buy and maintain insurance than good risks
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adverse underwriting decision
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any decision involving individually underwriting insurance coverage resulting in termination of existing insurance, declination of an application, or writing the coverage only at higher rates
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age limits
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the ages below or above which the insurance company will not issue a given policy or renew a policy in force. generally found in health contracts
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agency
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when one person acts on behalf of another person, an agency is created with the first person being the agent and the second person being the principal. The principal generally can be held responsible for acts of its agents
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agent
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the individual appointed by an insurance company to solicit, negotiate, effect, or countersign insurance contracts on its behalf
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agent's appointment
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official authorization from an insurance company granting an agent the authority to act as its agent
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aggregate limit
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the maximum dollar amount that a contract will pay over the lifetime of the contract or for a single occurrence
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alien insurance company
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an insurance company formed under laws of a country other than the united states
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all risk
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insurance against loss or damage to property arising from any fortuitous cause, except such as may be specifically excluded
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annuitant
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the person who is covered by an annuity and who will normally receive the benefits of the annuity
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annuity
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(1) an amount of money payable yearly, or by extension, at other regular intervals; (2) an agreement by an insurer to make periodic payments that continue during the survival of the annuitant(s) or for a specified period
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annuity (period) certain
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an annuity that pays for a fixed number of years. If it pays for life after the certain period, it is called an "annuity certain and for life thereafter"
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annuity payout option
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a method of liquidating and distributing an annuity's principal and interest so that it lasts for the lifetime of the annuitant
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annuity period
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the period of time, usually at retirement, during which the annuitant begins to receive annuity payments or benefits from the insurer
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apparent authority
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authority of an agent that is created when the agent overstaps actual authority, and when inaction by the insurer does nothing to counter the public impression that such authority exists
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assignment
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a transfer of rights in a policy to other than the policyowner (absolute or collateral)
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attained age
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the age an insured has reached on a given date. Normally the age used to determine the premium charge for a life or health risk
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automatic premium loan
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a provision in a life policy authorizing the insurance company to use the loan value to pay any premium not paid by the end of the grace period
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avoidance of risk
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taking steps to remove a hazard, engage in an alternative activity, or otherwise end a specific exposure
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back dating
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calculation of insurance premiums based on an age less than the current age of the proposed insured. Typically, insurers will allow backdating for up to 6 months from the date of application
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beneficiary
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a person who may become eligible to receive or is receiving benefits under an insurance policy, other than as a participant. Insurers normally accept three designations: primary, contingent, and tertiary
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binder
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in lines other than life and (usually) health, a binder is an acknowledgment that insurance applied for is in force whether or not premium settlement has yet been made or the policy issued. In life and health insurance, binders are not issued, but if premium settlement is made with the application, what is often erroneously referred to as a binder or "binding receipt" is issued. This is a conditional binding receipt
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boycott
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an unfair trade practice that occurs when someone in the insurance business refuses to have business dealings with another until he or she complies with certain conditions or concessions
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broker
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one who represents an insured in the solicitation, negotiation or procurement of contracts of insurance, and who may render services incidental to those functions. by law the broker may also be an agent of the insurer for certain purposes such as delivery of the policy or collection of the premium. in north carolina a broker must post a $15,000 Surety Bond with the NCDOI
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business insurance
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life or health insurance written to cover business situations such as key man, sole proprietor, partnership, corporations, etc.
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cancelable
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a contract of insurance that may be terminated by the insurance company or insured at any time
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cancellation
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termination of contract of insurance in force by voluntary act of the insurance company or insured
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capital stock insurance company
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an insurance company having, in addition to surplus and reserve funds, a capital fund paid in by stockholders
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capital sum
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maximum amount payable in one sum in event of accidental dismemberment
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carrier
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an insurance company that "carries" and/or issues the insurance
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cash value life insurance
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a policy that generates a saving's element
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cash surrender value
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the amount of cash that is due the insured that surrenders cash value life insurance. such surrender with termination of insurance benefits is often called "cashing out"
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cease and desist order
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an order of the state Insurance Commissioner or of a court requiring that a company or person stop engaging in a particular act or practice, usually involving insurance trade practices
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claim
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the demand for benefits as provided by the policy
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clause
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a term used to identify a particular part of a policy or endorsement
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coinsurance
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in health insurance, a provision that the insured and insurance company will share covered losses in agreed proportion. In health insurance, the preferred term is "percentage participation"
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collateral assignment
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assignment of a life insurance policy as security for a loan, the creditor receive the proceeds or values to the extent of his interest
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combination policy (plan)
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contract of life insurance that includes whole and term life insurance
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commission
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portion of premium retained by the agent or broker as compensation for sales, service, and distribution of insurance policies by him
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commissioner
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the title of the head of the department of insurance in most sales
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commissioner standard ordinary table (CSO)
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actuarial chart used in calculating the number of persons that will be alive at a given year from a set population
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concealment
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the withholding of facts by an applicant for insurance that affects an insurance risk or loss
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conditional receipt
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"temporary" contract of life and health insurance. it provides that if premium (consideration) accompanies the application, the coverage shall be in force from the date of application (whether the policy has yet been issued or not) provided the insurance company would have issued the coverage on the basis of facts as revealed by the application and other usual sources of underwriting information
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consideration
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exchange of value on which a contract is based. in life and health insurance, the consideration is usually the premium and the statements in the application
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consumer report
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a report ordered on an insured or applicant under which information about the person's credit, characer, reputation, personal characteristics or life-style is obtained, primarily through institutional sources. contract with investigative consumer report
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contingent beneficiary
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person or persons named to receive benefits if the primary beneficiary is not alive
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contributory
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a general term used to designate any plan of insurance (usually group or franchise) in which the insured pays at least part of the premium
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conversion
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change of one policy form to another, usually without evidence of insurability
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convertible
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a policy that may be changed to another form by contractual provision and without evidence of insurability
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death benefit
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the amount payable upon the death of a named insured in a life or health insurance policy. the death benefit is payable for natural death as well as accidental death if such coverage was included in the contract
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dismemberment
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loss or loss of use of specified members of the body resulting from accidental bodily injury
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dividend
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return of part of the premium paid for a participating policy
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dividend option
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any one of several ways to take policy dividends other than in cash, as provided in the policy
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domestic insurance company (insurer)
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an insurance company formed under the laws of the state where the insurance is written
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effective date
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the date on which an insurance policy goes into effect, and from which protection is furnished
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embezzlement
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fraudulent use of money or property that has been entrusted to one's care
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endorsement
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a form attached to the policy bearing the language necessary to change the terms of the policy to fit special circumstances
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endowment insurance
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a form of life insurance where the face amount is payable to the insured at the end of the contract period or to a beneficiary if the insured dies first
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employee retirement income act of 1974 (ERISA)
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law that established rules and regulations to govern private pension plans, including vesting requirements, funding mechanisms, and general plan design
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excess interest
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interest credited in excess of the minimum guaranteed by the life insurance policy contract
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exclusions
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causes, conditions or property listed in the policy which are not covered and for which no benefits are payable
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expiration
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the date upon which a policy will cease to cover, unless previously cancelled
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express authority
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authority of an agent that is specifically granted by the insurer in the agency contract or agreement
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face
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the first page of a policy
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face amount
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in a life insurance policy, the death benefit stated on the first page of the policy
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facility of payment
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a provision permitting the insurance company to pay a portion of the proceeds of a policy to any relative or person who has possession of the policy and appears entitled to such payment
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fair credit reporting act
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public law 91-508 requires that an applicant be advised that a consumer report may be requested. If insurance is declined because of information contained in that report, the insurer must provide the name and address of the reporting agency
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federal employees group life insurance (FEGLI)
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life insurance plan for federal government employees. benefits are administered by a life insurance company and reinsured by other private life insurers. benefits are based on the participant's salary
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fiduciary
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a person who occupies a position of special trust and confidence (for example, in handling or supervising the affairs or funds of another)
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fixed-amount installments
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a settlement option under which fixed, periodic benefits payments are made until the principal and interest are exhausted
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fixed-period installments
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a settlement option under which the proceeds are guaranteed to be paid in equal installments for a specified period of time
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flexible premium annuity
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an annuity that allows the contract holder to vary the amount of the premium payment, or stop payments and resume payments at will. A flexible premium annuity is used to fund IRA and Keogh retirement plans because it allows the amount of premium to change as wages change
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flexible premium polichy
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a life insurance policy under which the policyowner may vary the amount of timing of premium payments
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foreign insurer
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an insurer formed under the laws of another state other than the state in which the property is written
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franchise
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in life and health insurance, this is a plan for covering groups of persons with individual policies uniform in provisions (although they may differ in benefits). Usually used for groups too small to qualify for true group or in association-group cases. In life insurance, the term wholesale is sometimes used instead of franchise
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fraternal
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an insurance company organized under a special section of the state insurance code, characterized by a lodge or social system, and issuing insurance only to members
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free look
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a period of time (usually 10, 20 or 30 days) during which a policyowner may examine a newly issued individual policy of life or health insurance, and surrender it in exchange for a full refund of premium if not satisfied for any reason
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general account
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an investment portfolio used by the insurer for investment of premium income. This portfolio generally consists of safe, conservative, guaranteed investments, such as real estate and mortgages
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grace period
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a period of time (31 days) after premium due date during which a policy remains in force without penalty, even though the premium due has not been paid
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graded premium
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a life insurance policy, for which the initial premium is low, then increases in steps over a period of time after which it becomes a level premium
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guaranteed insurability
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an option in life or health insurance contracts that permits the insured to buy additional prescribed amounts of insurance at pre-scribed future time intervals without evidence of insurability
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health insurance
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insurance against loss by sickness or bodily injury. the generic form for those forms of insurance that provide lump sum or periodic payments in the event of loss occasioned by bodily injury, sickness or disease, and medical expense
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implied authority
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authority of an agent that the public may reasonably believe the agent to have. If the authority to collect and remit premiums is not expressly granted in the agency contract, but the agent does so on a regular basis and the insurer accepts, then the agent has exercised implied authority
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indemnity contracts
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the contract "promises" to pay an amount for losses covered under the policy. all insurance contracts could be considered as such, but to be precise, property contracts follow the definition of indemnity very strictly
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in-force
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insurance on which the premiums are being paid or have been fully paid. In life insurance, usually refers to insurance by face amount. In health, usually refers to premium volume being paid to insurance company or insurance companies in aggregate
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installment refund annuity
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promises to continue the periodic payments after the death of the annuitant, until the combined benefits paid to the annuitant and his beneficiary have equaled the purchase price of the annuity
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installment settlement
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payment of the proceeds of a life insurance policy (or of the cash value) in installments in contrast to lump sum
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insurability
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acceptability of an applicant for insurance to the insurance company
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insurable interest
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any interest in a subject of insurance or any legal relation to it in such a nature that a a certain happening might cause monetary loss to the insured
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insurance commissioner
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common title for the head of a state department of insurance
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insuring clause
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this is the clause in a policy that specifies, in brief, the contract's intent
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interest sensitive provision
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provisions in variable and flexible premium policies that guarantee certain interest earnings plus an additional interest percentage should the current interest rate rise above a specified percentage
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irrevocable beneficiary
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beneficiary that cannot be changed without his or her permission
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investigative consumer report
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a report ordered on an insured or applicant under which information about the person's character. reputation, or lifestyle is obtained through personal interviews with the person's neighbors, friends, associates, or acquaintances. Contrast with Consumer Report
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joint life policy
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pays the insurance when the first of two or more covered persons die
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joint and survivor life annuity
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income is payable through the joint lifetimes of two or more annuitants and continues throughout the lifetime of the last survivor
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juvenile policies
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in life insurance, policies modified to meet the needs of young children
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lapse
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termination of a policy because of failure to pay the premium. In life insurance, the term is sometimes confined to non-payment before the policy has developed any non-forfeiture value, being called termination if premium failure is after non-forfeiture values develop or surrender if cash value is withdrawn
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level premium insurance
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(life insurance) the premium which remains at the same level (amount) throughout the life of the insured
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life annuity
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a contract that provides a stated income for life, payable annually or more frequently
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life with period certain
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annuity option which provides a lifetime income to the annuitant plus an extra guarantee of income for a specified period of time such as 5 or 10 years. The period certain provides income to the annuitant or the annuitant's survivor
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limited pay life policy
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a whole life contract with premium limited until the expiration of a stated (limited) period
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limited policy
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one that pays only for specified contingencies other than those excluded
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loading
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the amount added to the pure insurance cost to cover the cost of the operations of an inurer, the possibility that losses will be greater than statistically expected, and fluctuating interest rates on the insurer's investments. The "pure" insurance cost is that portion of the premium estimated to be necessary for losses
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master policy
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policy contract issued to the employer (or other entity) under a group insurance plan
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maturity
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date at which the face amount of a life insurance policy comes due either by reason of death or endowment
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medical examination
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examination by a physician on behalf of an application for insurance or in substantiation of a claim
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medical information bureau (MIB)
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an organization serving as a a clearinghouse of medical information on impaired risks reported to it by insurance companies that are members of the service and reported to them as a source of underwriting information on applicants
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misrepresentation
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use of written or oral statements of the insured or insurance company misrepresenting the risk, terms, coverage, benefits, privileges or estimated future dividends of any policy
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mortality
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in life insurance, this means the frequency of death in a population. Males generally exhibit a higher frequency of death at any given age
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mutual insurance company (insurer)
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an incorporated insurance company without incorporated capital whose governing body is elected by the policyowners. The policyowners are the shareholders and they share in the success and sometimes the failure of the company
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net cost
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premiums paid minus cash value and any policy dividends paid as of the date the calculation is being made. In the life business, it is common to draw up net cost comparisons at the end of ten and twenty years
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non-admitted insurance company (insurer)
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an insurance company not licensed to do business in a given state
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non-contributory
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any plan or program of insurance (usually group) for which the employer pays the entire premium
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non-forfeiture values
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those values in a life (and rarely health) insurance policy that the policyowner does not forfeit even if he ceases to pay premiums: cash value, loan value, paid-up value, extended value
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non-occupational
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a health insurance policy that covers off-the-job accident and sickness
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non-participating
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insurance that does not pay policy dividends
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non-qualified plan
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retirement plan that is not qualified for special tax considerations by the IRS. The plan may discriminate as to participation and is not filled with the IRS
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non-resident agent
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an agent licensed in a state in which he is not a resident
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old age and survivors disability insurance benefits (OASDI)
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name of the Social Security program. Federal government program that provides death, retirement, disability and survivor's benefits to insured workers and surviving family. Program also provides benefits under the Medicare and Medicaid programs
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optionally renewable
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contract of health insurance in which the insurer reserves the unrestricted right to terminate the coverage at any anniversary or, in some cases, at any premium due date, but does not have the right to terminate coverage between such dates
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ordinary life
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(1) all life insurance policies not classifiable as Industrial or Group, and (2) a continuous premium, whole life policy (also sometimes called Straight Life)
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other insurance
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existence of another contract covering the same interest and perils
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over-insurance
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condition in which (1) more insurance is in force on the insured or the risk of more than the potential loss or (2) so much is in force as to constitute a moral or morale hazard (such as so much disability insurance being in force that it becomes profitable to become disabled.)
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paid-up
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life insurance on which all premiums have been paid but that has not yet matured by death or endowment, such as a Limited Payment policy on which the premium-paying period has been completed or the insurance paid for by using the cash value under the paid-up Non-forfeiture option
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paid-up adds
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abbreviation for paid-up additions. additional single premium life insurance paid for by policy dividends and added to the face amount
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parol evidence rule
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this rule states that no changes in a written contract are allowed unless they are executed in writing and with the consent of both parties - the insurer and the insured
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partial disability
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a condition in which, as a result of injury or sickness, the insured cannot perform all of the duties of his occupation but can perform some. Exact definitions vary from policy to policy
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participating (par)
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insurance that pays policy dividends
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payor benefit
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rider or provision, usually in juvenile polices, under which premiums are waived if the Payor (usually parent) of the premium becomes disabled or dies while the child is still a minor
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permanent life insurance
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a term loosely applied to life insurance policy forms other than Group or Term, usually cash value life insurance including Endowment as well as Whole Life
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physical hazard
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material, structural, or operational features of the risk itself, apart from the morale or moral hazards of the persons owning or managing it
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policy dividend
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return of the overcharge in a participating premium. It represents the difference between the premium charged and actual experience
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policy loan
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loan made by the insurance company to the policyowner with the cash value of the policy as security or collateral. This is one of the usual non-forfeiture options
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policyowner
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this is the person who has the right to exercise the rights and privileges in the policy contract. Such person may or may not be the insured, depending on policy ownership and assignment, if any
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policy proceeds
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amount actually paid on a life insurance policy at death or when the insured receives payment at surrender or maturity. It includes any dividends left on deposit and the value of any additional insurance purchased with dividends; It excludes any loans not repaid, plus unpaid interest on those loans
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pre-existing condition
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condition of health or physical condition (and sometimes moral condition) that existed before the policy was issued
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preferred risk
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an insurance classification indicating a risk that is superior to the average risk on which the rate has been calculated and thus eligible for a reduced rate
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premium notice
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notice from the insurance company to the policyowner that a premium is (or will be) due on a given date
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primary beneficiary
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beneficiary named first to receive proceeds or benefits, if living when proceeds from benefits are due
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principal sum
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amount payable in one sum in the event of accidental death
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proof of loss
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formal statement made by the insured to the insurance company regarding a loss. The purpose of proof of loss is to place before the company sufficient information concerning the loss to enable it to determine its liability under the policy or bond
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qualified plan
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retirement plan that qualifies for special tax advantages due to filing with and approval by the IRS. Qualified plans must meet certain IRS requirements to be classified as qualified
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reciprocal insurance
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insurance resulting from an interchange among persons known as subscribers of the reciprocal agreements of indemnity, the exchange being made through an attorney-in-fact common to all such persons, and the group of such subscribers being a reciprocal insurance company
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reduced paid-up insurance
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a form of insurance available as a non-forfeiture option that provides the cash value of the policy may be used as the single premium for paid-up insurance in whatever amount it will provide (which will be a lesser or reduced amount than the policy face amount in most cases)
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refund life annuity
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an annuity paying installments as long as the insured lives and paying installments after death to the beneficiary until the amount paid equals the principle sum of insurance
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reinstatement
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putting a lapsed policy back in force. provision is usually made for a method of reinstating the policy to its original amount
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renewable term
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term life insurance that may, upon expiration of the term for which issued, be renewed for another term without evidence of insurability
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renewal
|
continuation in full force and effect of something that is about to expire. With an insurance policy, it is made by the issuance of a new policy, renewal receipt, or certificate to take effect upon the expiration of the old policy
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retention of risk
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act of assuming all or part of a risk instead of purchasing insurance or otherwise transferring the risk
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retirement income endowment policy
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endowment policy used to accumulate savings for retirement income. Policies usually mature at retirement age
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return of premium
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a rider or provision that agrees to pay in addition to the face amount, a supplemental amount equal to the total of premiums paid to date of death
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rider
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an amendment attached to a policy that modifies the conditions of the policy by expanding or decreasing its benefits or excluding certain conditions from coverage
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risk
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(1) a chance of loss. (2) a person or thing insured (impaired or substandard risk: an applicant whose physical condition or moral habits do not meet the standard on which the rate is based)
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risk management
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management of the pure risks to which a company might be subject. it involves analyzing all exposures to the possibility of loss and determining how to handle these exposures through such practices as avoiding the risk or retaining the risk
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risk retention group
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a mutual insurance organization formed to insure people in the same business, occupation, or profession, such as pharmacists, dentists, or engineers. Often the insurance is needed to address commercial concerns
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services group life insurance (SGLI)
|
provides group life insurance for uniformed members of the US military. Private insurers on a peacetime mortality rate underwrite this coverage, with any additional cost for wartime coverage picked up by the federal government
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stated amount
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agreement by the insurance company to pay a specified amount of money to or on behalf of the insured upon the occurrence of a defined loss (in contrast to a reimbursement benefit)
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stock insurance company (insurer)
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incorporated insurance company with capital divided into shares and owned by the shareholders
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surety bond
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bond in which the surety agrees to answer the obliged for the non-performance of the principal (also known as the obligor)
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surplus line
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coverage procured in an unlicensed insurance company because of its unavailability in the licensed market
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surrender
|
withdrawing the cash value of a policy and surrendering the policy form to the insurer (usually a requirement when the cash value is withdrawn)
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tax sheltered annuity (TSA)
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qualified annuity for employees of certain non-profit organizations as described in the Internal Revenue Code, such as school system employees, church employees, etc.
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temporary agent
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person who is licensed to act as an agent for a brief period of time (usually 180 days) without taking a written examination
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temporary license
|
commonly granted to allow someone to continue the business of an agent who has died, become disabled, or entered active military service
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tertiary beneficiary
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a beneficiary designated as third in line to receive proceeds or benefits, if the primary and secondary beneficiaries do not survive to draw them
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time limit on certain defenses
|
A Uniform Provision specifying that after a given number of years (usually two or three) no statements (except fraudulent misstatements) made in the application shall be used to deny a claim or void the policy,and that no claim shall be denied or reduced on the group that a disease or physical condition not excluded at time of issue existed prior to effective date
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transfer or risk
|
shifting all or part of a risk to another party. Insurance is the most common method of risk transfer, but other devices, such as hold harmless agreements, also transfer risk
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twisting
|
inducing or seeking to induce a policyowner by misrepresentation to terminate an existing policy to take a new policy
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underwriter
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(1) A person trained in evaluating risks and determining the rates and coverage’s that will be used for them. (2) An agent, especially a life insurance agent, who might qualify as a "field underwriter."
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underwriting
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The process of evaluating a risk for the purpose of issuing insurance coverage on it.
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unearned premium
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That portion of an advance premium that has not yet been used for coverage written. Thus in the case of an annual premium, at the end of the first month of the premium period, 11 months of the premium would still be "unearned, etc."
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uniform simultaneous death act
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State law which states that if the insured and (primary) beneficiary die in the same accident and it cannot be determined which died first, it will be assumed that the beneficiary died first and all proceeds will then pass to the insured's contingent beneficiary.
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universal life
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is a combination flexible premium, adjustable life insurance policy. The premium payer may select the amount of premium he or she can pay. The policy benefits are those that the premium will purchase. Or, the premium payer may change the amount of insurance and pay premium accordingly.
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variable annuity
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An annuity contract in which the amount of the periodic benefit varies, usually in relation to security market values, a cost-of-living index, or some other variable factor in contrast to a fixed or guaranteed return annuity.
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variable life insurance
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A form whose face value varies depending upon the value of the dollar or securities or other equity products at the time payment is due.
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variable universal life
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is a combination of the features of Variable Life Insurance and Universal Life Insurance under the same contract. Benefits are variable based on the value of equity investments. Premiums and benefits are adjustable at the option of the policyowner.
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veteran's group life insurance (VGLI)
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Group insurance available to veterans who were covered under SGLI (Servicemen's Group Life Insurance) if converted within 120 days of separation from the service.
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war clause
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Usually inserted into life policies during periods of war or impending war, and on the lives of young men of draft age. Clauses vary in type and may exclude death resulting from war or go so far as to exclude death while in the military service.
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warranty
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A statement made on an application for insurance that is warranted to be true in all respects. If untrue in any respect, even though the person giving the warranty may not have known the untruth, the contract may be voided whether or not the untruth or inexactness is material to the risk. Statements on life and health insurance applications are, in the absence of fraud, not warranties but representations.
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whole life
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A life insurance policy that runs for the whole life, that is, until death (except that it will pay the face amount at the ultimate age on the mortality table being used because, as far as the table goes, that age is 100 for the surviving insured). Premiums for a Whole Life policy may be paid for the whole life or for a limited period during which the higher premium charged pays up the policy.
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