Free Life Policy Provisions Options and Riders Study Guide
California Life, Accident & Health exam — Life Policy Provisions Options and Riders.
The national guide covers standard life provisions, nonforfeiture and settlement options, beneficiaries, and riders. California has several rules that differ from most states and from the national model:
- a 60-day grace period
- a lapse-notice designee
- a free look of 10 to 30 days, rising to 30 days at age 60
- a nonforfeiture benefit after one year
Free look (CIC 10127.9, 10127.10)
| Buyer | Free look | Refund |
|---|---|---|
| Under 60 | Stated on the cover; at least 10 and no more than 30 days | Fixed policy: all premiums and fees, within 30 days. Variable policy: account value plus fees |
| 60 or older on the purchase date | 30 days | Fixed policy: all premiums and fees. Variable annuities for seniors stay in fixed-income or money-market funds during the free look unless the owner directs otherwise |
- The free look starts at delivery. Delivery is by registered or certified mail, personal delivery or first-class mail with a signed receipt, or other approved means. If the insurer uses other means, it bears the burden of proving delivery (CIC 10113.6).
- Group life policies and certificates offered to people 65 or older carry a 30-day examination period (CIC 786).
Grace period and lapse notices (CIC 10113.71, 10113.72)
- Individual life policies have a grace period of at least 60 days, and it doesn't run concurrently with any period of paid coverage.
- If the insured dies during the grace period, the overdue premium is deducted from the death benefit.
- A notice of pending lapse is mailed at least 30 days before termination.
- Before issue, the applicant may name a designee to receive lapse notices. The insurer reminds the owner of this right every year.
Incontestability and nonforfeiture
- A policy is incontestable after two years in force during the insured's lifetime, except for nonpayment (CIC 10113.5).
- A reinstated policy can be contested on the reinstatement statements for the same period.
- Nonforfeiture: a paid-up nonforfeiture benefit is required after premiums have been paid for one full year (CIC 10160).
Accelerated death benefits (CIC 10295 and following)
- An accelerated death benefit may not be marketed as health, accident, or long-term care insurance.
- It must offer a lump-sum option on a qualifying event.
- Agents must be able to explain how it differs from LTC insurance.
- Selling a rider that requires personal care services triggers LTC training requirements (CIC 10234.93).
Settlement and beneficiary rules
- A policy paying in installments may include a spendthrift clause, which keeps the beneficiary from assigning installments before they're due (CIC 10132).
- Insurable interest:
- A person may insure their own life and name anyone as beneficiary.
- Relatives have an insurable interest through love and affection; creditors and others through economic interest.
- For life insurance, the interest must exist when the contract is made (CIC 10110, 10110.1).
- STOLI is prohibited.
Illustrations and cost comparisons
- An illustration must be labeled "life insurance illustration" (CIC 10509.955).
- A cost comparison that ignores the time value of money must be paired with one that recognizes it (CIC 10509.970).
Replacement (CIC 10509 and following)
- Each application includes statements by the applicant and the agent on whether a replacement is involved.
- The Notice Regarding Replacement is given no later than the application, signed by both, and left with the applicant along with all printed materials used.
- The replacing insurer notifies the existing insurer within 3 working days. The existing insurer has 20 days to try to conserve the policy.
- Penalties: at least $1,000 for an agent's first violation, and $5,000 to $50,000 for knowing or repeat violations.
- A pattern of "no replacement" answers on applications that turn out to be replacements creates a presumption that the agent knew.
- Group and credit life are exempt.
Group life (CIC 10200 and following)
- Group life may be issued at rates below individual rates.
- It may exclude losses from war, military service, or aviation (CIC 10206.5).
- Conversion: apply within 31 days after coverage ends, without evidence of insurability, at attained-age rates, up to the group amount. Death during the 31 days pays the convertible amount (CIC 10209).
Common exam traps
- California's life grace period is 60 days. Lapse notices go out 30 days before termination, and a designee may receive them.
- The free look is 10 to 30 days, or 30 days at 60 or older. The senior age here is 60, not 65.
- Nonforfeiture benefits start after one year of premiums.
- The replacing insurer notifies the existing insurer within 3 working days.
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Practice questions are study aids generated for exam preparation and are not actual exam questions. Content is provided for educational purposes and is not legal advice. Verify current statutes, rules, and exam specifications with the Insurance Department and the exam administrator before relying on it.