1. Lecture Thirteen： Life Insurance Contractual Provisions, and buying Life Insurance

2. Learning Objective
Explain the incontestable clause, suicide clause, and grace period provision
Identify the dividend options that are found in participating policies
Explain the non-forfeiture options that are found in cash-value policies
Describe the various settlement options for the payment of life insurance proceeds
describe the rules to follow when purchasing life insurance

3. Main Contents Life insurance contractual provisions Dividend options
Nonforfeiture options
Settlement options
Additional life insurance
Determining the cost of life insurance
Rate of return on saving component
Shopping for life insurance

4. Case
Scott, age 36, and Michelle, age 34, are married and have two small children. Michelle is the owner and beneficiary of a $500,000 life insurance policy on Scott’s life. Three years after the policy was purchased, Scott committed suicide because of chronic depression and the bankruptcy of his business. Because Scott deliberately caused his own death, Michelle was concerned that the insurer might deny payment of the claim. Michelle's life insurance agent, however, assured her that the claim would be paid in full.

5. Questions
Do you think Michelle could receive Scott’s life insurance payment
In the preceding case, Michelle’s financial security was affected by a contractual provision in a life insurance policy dealing with suicide. ?

6. Life Insurance Contractual Provision
Life insurance contracts contain dozens of contractual provisions that affect the insured and beneficiary and payment of the death proceeds.
Some contractual provisions are mandatory and must be included in every life insurance policy. Other provisions are optional.

7. Life insurance contractual provisions
Life insurance policy contain numerous contractual provisions as follows:
Ownership Clause
Entire-contract Clause
Incontestable Clause
Suicide Clause
Grace Period
Reinstatement Clause
Misstatement of Age or Sex Clause

8. Life insurance contractual provisions
Beneficiary Designation
Change-of-Plan Provision
Exclusive and Restrictions
Payment of Premiums
Assignment Clause
Policy Loan Provision
Automatic Premium Loan

9. Life insurance contractual provisions
Ownership Clause (保单所有人条款）
The of a life insurance policy can be the beneficiary, a trust, or anther party.
In most cases, the applicant, insured, and owner are the same person
The policyowner possesses many rights as the following:

10. Life insurance contractual provisions
Naming and changing the beneficiary
Surrendering the policy for its cash value
Borrowing the cash
Receiving dividends,
Electing settlement options
Designate a new owner and inform the insurer. The policy will be endorsed.

11. Life insurance contractual provisions
Entire-contract Clause （完整合同条款）
The life insurance policy and attached application constitute the entire contract between the parties.
All statements in the application are considered to be representations rather than warranties
No officers of the insurer can change the policy forms unless the policyonwer consents to the change.

12. Life insurance contractual provisions
Incontestable Clause（不可抗辩条款）
The insurer has two years in which to discover any irregularities in the contract.
The insurer cannot contest the policy after it has been in force two years during the insured’s lifetime, the death claim must be paid even if it is a material misrepresentation, concealment, or fraud when the policy was first issued. The following cases are exceptional:
The beneficiary murdering the insured
someone else take a medical examination
An insurable interest does not exist at the inception of the policy

13. Life insurance contractual provisions
Incontestable Clause（不可抗辩条款）
The following cases are exceptional:
The beneficiary murdering the insured
someone else take a medical examination
An insurable interest does not exist at the inception of the policy

14. Life insurance contractual provisions
Suicide Clause(自杀条款）]
If the insured commits suicide within two years after the policy is issued, the face amount of insurance will not be paid; there is only a refund of the premiums paid.
If the insured commits suicide after two years since the policy is issued, the policy proceeds are paid

15. Life insurance contractual provisions
Grace Period（宽限期条款）
A period during which the policyowner has a period of days to pay an overdue premium.
The insurance remains in force during the grace period. If the insured dies within the grace period, the overdue premiums is deducted from the policy proceeds.

16. Life insurance contractual provisions
Reinstatement Clause(复效条款）
A policy may lapse if the premium has not been paid by the end of the grace period, or if an automatic premium loan provision is not in effect. The reinstatement provision permits the owner to reinstate a lapsed policy.

17. Life insurance contractual provisions
Reinstatement Clause(复效条款）
The following requirements must be fulfilled:
Evidence of insurability is required
All overdue premiums plus interest be paid
Any policy loan must be repaid or reinstated.
Not have been surrendered for it cash value
Must be reinstated within a certain period ( 3-5years in US, within 2 years in China)

18. Life insurance contractual provisions
Misstatement of Age or Sex Clause(年龄或性别误报条款）
If the insured’s age or sex is misstated, the amount payable is the amount that the premiums paid would have purchased at the correct age and sex.

19. Life insurance contractual provisions
Beneficiary Designation （制定受益人）
the party named in the policy to receive the policy proceeds.
The principal types of beneficiary designations are as follows:
Primary and contingent beneficiary
Revocable and irrevocable beneficiary
Specific and class beneficiary

20. Life insurance contractual provisions
Change-of-Plan Provision(改变保障计划条款）
Life insurance policies may contain a change-of-plan provision that allows policy-owners to exchange their present policies for different contracts. The purpose of this provision is to provide flexibility to the policy-owner.

21. Life insurance contractual provisions
Exclusive and Restrictions （除外或限制责任）
A life insurance policy contains very few exclusions and restrictions，such as suicide within first two years, war death, aviation death, etc.

22. Life insurance contractual provisions
Payment of Premiums (保费支付)
Life insurance premiums can be paid annually, semiannually, quarterly, or monthly.
If the premium is paid other than annually, the policyowner must pay a carrying charge(分期付款的利息 ) due to the true interest rate

23. Life insurance contractual provisions
Assignment Clause(转让条款) A life insurance policy is freely assignable to another party. There are two types of assignments:
An absolute assignment（绝对转让）
a collateral assignment （担保物的转让）

24. Life insurance contractual provisions
Policy Loan Provision（保单贷款条款）
Cash-value life insurance contains a policy loan provision that allows the policy-owner to borrow the cash value. The interest rate is stated in the policy.

25. Life insurance contractual provisions
Automatic Premium Loan（自动保费贷款）
The automatic premium loan provision can be added to most cash-value policies. Under it, an overdue premium is automatically borrowed from the cash value after the grace period expires, provided the policy has a loan value sufficient to pay the premium.
Interest is charged on the premium loan at the stated contractual rate.

26. Dividend Options
Life insurance policies frequently contain dividend options. If the policy pays dividends, it is known as a participating policy（利益）分享保险单).
Policy dividends are generally derived from three sources:
the difference between expected and actual mortality experience;
excess interest earnings on the assets required to maintain legal reserves;
the difference between expected and actual operating expenses.

27. Dividend Options
There are several ways in which dividends can be taken:
Reduction of premiums
Accumulate at interest
Paid-up additions
Term insurance (fifth dividend option)
Other uses of dividends

28. Dividend Options Paid-up additions (额外购买缴清保单）
Under the paid-up additions option, the dividend is used to purchase a small amount of paid-up whole life insurance.

29. Dividend Options Term insurance (fifth dividend option)
Some insurers offer a fifth dividend option by which the dividend is used to purchase term insurance.
Two forms of this option are typically used.
to purchase one-year term insurance
to use the dividend to purchase yearly renewable term insurance.

30. How to select the best dividend Option? ?
There is no one best dividend option. The best dividend option is the one that is best for you in terms of your financial circumstances, needs, and objective.
If your income is limited or if premium payments are financially burdensome, the dividend can be paid in cash or used to reduce the next premium.
If you are substandard in health or uninsurable, then the paid-up additions option is appropriate.
If income-tax considerations are important, you should not use the interest option because the interest i5 taxable. Instead, the paid-up additions option would be more appreciate.

31. How to select the best dividend Option
Why
because the dividend becomes the legal reserve under the paid-up addition, and interest accumulations on the legal reserve are not axed as current income to the policy-owner.
If your objective is to have a paid-up policy at retirement, then the paid-up additions option is desirable, if you need additional life insurance, the fifth dividend option can be used if it is available, in short, no single dividend option is best for all insured. Each insured must choose an option suited to his or her situation.

32. Non-forfeiture Options (不丧失或不没收选择权）
Most cash-value policies have the provision that the insurers pay the cash surrendered value or a non- forfeiture value.
There are three non-forfeiture options or cash surrender options:
Cash value
Reduced paid-up insurance（减额缴清保险）
Extended term insurance

33. Settlement Options (人寿险赔贷款选择）
Settlement options, or optional methods of settlement, refer to the various ways that the policy proceeds can be paid other than in a lump sum. The most common settlement options are as follows:
interest option
fixed period option
fixed amount option
life income option

34. Settlement Options (人寿险赔贷款选择）
interest option
Under it, the policy proceeds are retained by the insurer, and interest is periodically paid to the beneficiary. The beneficiary can be given withdrawal rights, by which part or all of the proceeds can be withdrawn.

35. Settlement Options (人寿险赔贷款选择）
fixed period option
Under it, the policy proceeds are paid to a beneficiary over some fixed period of time.
Payment can be made monthly, yearly, etc.
Both the principal and interest are systematically liquidated under this option.

36. Settlement Options (人寿险赔贷款选择）
fixed amount option
Under the fixed-amount (installment-amount) option, a fixed amount is periodically paid to the beneficiary. The fixed-amount option provides considerable flexibility.

37. Settlement Options (人寿险赔贷款选择）
Life income options
Death benefits can also be paid to the beneficiary under a life income option. The cash surrender value can also be disbursed under a life income option. The major life income options are as follows:
Life Income (installment payments to the beneficiary while he or she is alive)
Life Income with Period Certain
Life Income with Refund
Joint-and-Survivor Income

38. How to Buy Life Insurance

39. Buying Life Insurance
Jennifer, age 30, is divorced and has a son, age 2. she wears $55,000 as sales representative for a national oil company. Jennifer wants to update her life insurance program. Recently, a life insurance agent present her with several proposals. Although Jennifer is a careful shopper, she does not know how to evaluate the plans offer to her.
Could you Tell Jennifer How to buy life insurance? ? ?

40. Buying Life Insurance Determining the cost of life insurance
Rate of return on saving component
Shopping for life insurance

41. Buying Life Insurance Determining the cost of life insurance
The cost of life insurance is a complex subject. In general, cost can be viewed as the difference between what you pay for a life insurance policy and what you get back.

42. Buying Life Insurance Two widely used cost methods are:
When determining the cost of life insurance, four major factors must be considered:
Annual premium
Cash values
Dividends
Time value of money
Two widely used cost methods are:
The traditional net cost method
Interest-adjusted cost method

43. Buying Life Insurance The traditional net cost method
Under this method, the annual premiums for some time period are added together. Total expected dividends to be received during the same period and the cash value at the end of the period are then subtracted from the total premiums to determine the net cost of life insurance. Examples
This method has some defects. Examples

44. Buying Life Insurance Interest-adjusted cost method
Under this method, the time value of money is taken into consideration by applying an interest factor to each elements of cost.
There are two principal types of interest-adjusted cost indexes:
The surrender cost index
The net payment cost index Examples

45. Buying Life Insurance Rate of return on saving component
Another important consideration is the rate of return earned on the saving component of a traditional whole life insurance policy
Liton yield
Yearly rate-of-return method
Examples

46. Buying Life Insurance Shopping for life insurance
A good life insurance program involves seven steps, as illustrated in the following Exhibit.

47. Shopping for life insurance
Determine whether you need life insurance
Estimate the amount of life insurance you need
Decide on the best type of life insurance for you
Decide whether you want a policy that pays dividends
Shop around for a low-cost policy
Consider the financial strength of the insurer
Deal with a competent agent

48. Summary
Life insurance contracts contain dozens of contractual provisions that affect the insured and beneficiary and payment of the death proceeds. The most popular provisions are: the ownership clause, the entire-contract clause, the incontestable clause, the suicide clause, the grace period.
A dividend represents a refund of part of the gross premium. Dividends are paid in several ways, such as cash, reduction of premium, accumulate at interest, paid-up-additions, term insurance.

49. Summary
There are three non-forfeiture or cash surrender options: cash value, reduced paid-up insurance, extended term insurance.
There are enormous cost variation among similar life insurance policies.
Life insurance experts typically recommend several rules to follow when shopping for life insurance: determine whether you need life insurance, estimate the amount of life insurance, decide on the best type of insurance for you, decide whether you want a policy that pays dividends, shop around for a low-cost policy, consider your financial strength, deal with a competent agent

50. Review Questions
I. Briefly explain the ownership clause and entire-contract clause in a life insurance contract.
2. Describe the incontestable clause and explain why it appears in a life insurance policy.
3. Explain the requirements for reinstating a lapsed life insurance policy.
4. If the insured's age is misstated, can the company refuse to pay the policy proceeds? Explain.
5. Describe the various beneficiary designations in tire insurance.
6. Can a life insurance policy be assigned to another party? Explain.
7. Are dividends to policy-owners guaranteed? Explain.
8. Explain the non-forfeiture or cash surrender options that are found in cash-value life insurance.

51. Review Questions
9. Identify the various settlement options for the payment of life insurance proceeds.
10.Explain the definition of total disability that is found in a typical waiver-of-premium provision..
11. Describe the traditional net cost method for determining the cost of life insurance.
12. Describe the rules that should be followed when shopping for life insurance
13. Should cost be the only factor to consider when a life insurance policy is purchased? Explain.

52. Case application
A participating ordinary life policy in the amount of $10,000 is issued to an individual, age 35. The following cost data are given:
Annual premium $230
Total dividends for 20 years $1613
Cash value at end of 20 years $3620
Accumulated value of the annual
premiums at 5 percent for 20 years $7985
Accumulated value of the dividends
at $ percent for 20 years $2352
Amount to which $1 deposited
annually at the beginning of each
year will accumulate in 20 years
at 5 percent $34.719
a. Based on this information, compute the annual net cost for each $1000 of life insurance at the end of 20 years using the traditional net cost method.
b. Compute the annual surrender cost index for each $1000 of life insurance at the end of 20 years.
c. Compute the annual net payment cost index for each $1000 of life insurance at the end of 20 years.

53. Search For Information
Search for information on Provisions of life insurance policies of a life insurance policy in Chinese market.
How about Dividend options of life insurance?

54. Preview
Text: individual health and disability-income insurance (P );
Assignments /Questions