Free Life Policy Provisions Options and Riders Study Guide
Idaho Life, Accident & Health exam — Life Policy Provisions Options and Riders.
The national guide covers the standard life policy provisions, nonforfeiture, dividend and settlement options, and riders. Idaho's required life provisions are in Idaho Code chapter 41-19, group life rules in chapter 41-20, and replacement rules in IDAPA 18.03.04. These notes give the Idaho numbers. Two are frequent traps: Idaho's life free look is 20 days, and reinstatement interest can run up to 8%.
National concepts in brief
- Nonforfeiture options: cash surrender, reduced paid-up and extended term.
- Dividend options: cash, reduce premium, accumulate at interest, paid-up additions.
- Settlement options: interest only, fixed period, fixed amount, and life income.
- Riders: waiver of premium, accidental death, guaranteed insurability, and accelerated benefits.
Required individual life provisions
| Provision | Idaho rule |
|---|---|
| Grace period | 30 days, or one month of at least 30 days. The policy stays in force. The insurer may charge interest of up to 6% a year for the days of grace, and may deduct an overdue premium from a death claim (Idaho Code 41-1904) |
| Incontestability | After two years in force during the insured's lifetime, the policy can be contested only for nonpayment of premium. Disability and accidental death benefits may be left out of the clause (Idaho Code 41-1905). Idaho's statute has no fraud exception |
| Entire contract | The policy plus the attached application. Statements are representations, not warranties, absent fraud (Idaho Code 41-1906) |
| Misstatement of age | The benefit is what the premium would have bought at the correct age (Idaho Code 41-1907) |
| Dividends | Participating policies apportion surplus yearly, starting no later than the end of the third policy year (Idaho Code 41-1908) |
| Policy loans | Must be available once three full years of premiums are paid and there is a cash value. The interest rate is a fixed maximum of 8%, or an adjustable rate tied to a published index (Idaho Code 41-1909) |
| Reinstatement | Within three years of default. Requires a written application, evidence of insurability, and back premiums with interest of up to 8% (Idaho Code 41-1911) |
| Payment of claims | Any settlement period stated in the policy may not exceed two months after proof (Idaho Code 41-1913) |
Related rules:
- A reinstated policy can be contested over the reinstatement application only for the same period as after original issue (Idaho Code 41-1929).
- Incontestability doesn't stop the insurer from enforcing exclusions (Idaho Code 41-1916).
Free look and claim payment
- Free look: 20 days from delivery for life policies under the nonforfeiture law and for every annuity (Idaho Code 41-1935). A policy returned to the insurer or the agent is void from the beginning, and the premium is refunded.
- Interest on death claims: a death claim not paid within 30 days of satisfactory proof of death earns interest, generally from the date of death (Idaho Code 41-1337).
- Lapse notice:
- The insurer must mail notice by first-class mail at least 14 days before a lapse.
- The applicant must be offered the chance to name one additional person to receive the notice (Idaho Code 41-1830).
Ownership, consent and creditors
- Insurable interest must exist when the contract is made. For people who are not close relatives, it is a lawful and substantial economic interest in the insured's life continuing (Idaho Code 41-1804).
- Consent: generally the insured's written consent is required. Exceptions: a spouse insuring the other spouse, a person with an insurable interest insuring a minor, and family policies (Idaho Code 41-1808).
- Minors: a minor 15 or older may buy insurance on their own life and can't later void the contract because of age (Idaho Code 41-1807).
- Assignment: a policy may be assigned. The insurer may deal with the assignee until it receives written notice otherwise (Idaho Code 41-1826).
- Payment discharges the insurer unless it first received written notice of a competing claim (Idaho Code 41-1828).
- Creditor protection:
- A beneficiary takes the proceeds free of the insured's creditors, except premiums paid to defraud creditors (Idaho Code 41-1833).
- Group life proceeds are also protected (Idaho Code 41-1835).
- Change of ownership: the insurer must confirm the change, or explain why it can't, within 30 days (Idaho Code 41-1961).
Group life
Required provisions:
- Grace period: 31 days (Idaho Code 41-2011).
- Incontestability: a member's statements can't be used after two years, and only if they are in a signed writing (Idaho Code 41-2012).
- Certificates: each member gets one showing the coverage, the beneficiary and conversion rights (Idaho Code 41-2017).
Conversion:
- On leaving the group, apply within 31 days for any form the insurer customarily issues except term (Idaho Code 41-2018).
- If the group policy ends, only members insured five years may convert, and the amount may be capped at $2,000 (Idaho Code 41-2019).
- If the member dies during the conversion period, the convertible amount is paid as a group claim (Idaho Code 41-2020).
- If notice of the conversion right is late, the period extends to 15 days after notice, but never more than 60 days past the original deadline (Idaho Code 41-2021).
Assignment: members may assign ownership rights, including conversion (Idaho Code 41-2025).
Replacement (IDAPA 18.03.04)
What counts as a replacement: a new purchase where existing coverage is:
- lapsed or surrendered;
- converted to reduced paid-up or extended term;
- reduced in benefits;
- reissued with less cash value;
- borrowed against for more than 25% of its loan value.
Who must do what:
- Applicant: signs a statement with every application saying whether the purchase replaces coverage.
- Producer: presents the replacement notice no later than when the application is taken. It is signed by both and left with the applicant, along with copies of the sales material used.
- Replacing insurer: notifies existing insurers within 5 working days, and gives an unconditional refund right for 20 days from delivery.
- Existing insurer (conservation): if it tries to keep the business, it sends a policy summary or ledger within 20 days.
Records: kept at least three years, or until the next domiciliary exam, whichever is later.
Exempt: credit life, group coverage, and conversions with the same insurer.
Common exam traps
- The Idaho life and annuity free look is 20 days, not 10.
- Reinstatement interest is capped at 8%; grace-period interest at 6%.
- Policy loans become available after three full years of premiums.
- Group conversion: 31 days, any form except term. If the plan ends, 5 years of coverage and a $2,000 cap.
- Borrowing more than 25% of the loan value can make a sale a replacement.
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