Free Life Policy Provisions Options and Riders Study Guide
West Virginia Life, Accident & Health exam — Life Policy Provisions Options and Riders.
The national Life Policy Provisions guide covers the standard provisions, nonforfeiture and dividend options, settlement options and riders. This guide covers the West Virginia rules:
- the required provisions in Article 13 of Chapter 33
- the 10-day free look
- permitted exclusions, including suicide
- death claim interest and creditor protection
- application and delivery rules
- replacement (CSR 114-8)
- disclosure and advertising
Free look and delivery (33-6-11b; 33-6-5a)
- Life and accident and sickness policies issued in West Virginia print on the first page a right to return the policy within 10 days of receipt for a premium refund, for any reason.
- Hand delivery: the insured signs and dates a delivery receipt, and the 10 days start on the delivery date.
- Delivery by mail with a certificate of mailing: the policy is presumed received 20 days after mailing.
- A replacement gets a 30-day right to return (CSR 114-8).
Applications (33-6-5a to 33-6-7)
- The application is signed by the proposed insured and the agent. A licensed, appointed agent completes it in the proposed insured's presence. Electronic and mass-marketed applications are exempt.
- Any change made after signing is disclosed in writing and signed by the proposed insured. Failing to do so doesn't void the coverage.
- An application can be used as evidence only if a true copy was attached to the policy (33-6-6).
- Statements are representations, not warranties. A misstatement bars recovery only if it was fraudulent, material, or would have changed the insurer's good-faith decision (33-6-7).
Required provisions (Article 13)
| Provision | West Virginia rule |
|---|---|
| Grace period (33-13-3) | 31 days for each premium after the first. Coverage continues, and an unpaid premium may be deducted from a claim. |
| Incontestability (33-13-4) | Incontestable after two years in force during the insured's lifetime, except for nonpayment of premium. Disability and accidental death benefits may be excepted. There is no fraud exception. |
| Entire contract (33-13-5) | The policy, plus the application if a copy is attached, is the entire contract. |
| Misstatement of age (33-13-6) | The amount payable is what the premium would have bought at the correct age. |
| Dividends (33-13-7) | Participating policies apportion surplus yearly starting by the end of the third policy year. The owner has at least 30 days after a dividend is due to choose another option. |
| Policy loans (33-13-8, 8a) | Once there is cash value, the insurer must lend up to the loan value. The loan rate is a fixed maximum of 8% or an adjustable rate tied to a published bond index. The insurer may defer a loan, except one to pay premiums, for six months. An automatic premium loan may be included at the owner's election. |
| Reinstatement (33-13-12) | Within three years of default, with evidence of insurability and back premiums plus interest. A reinstated policy is contestable for the same period as a new one (33-13-26). |
| Settlement (33-13-14) | Paid on proof of death. Any settlement period stated in the policy can't exceed two months. |
- An incontestable clause bars only challenges to the policy's validity. It doesn't override provisions that exclude or restrict coverage (33-13-16).
Permitted exclusions (33-13-25)
A life policy may exclude or restrict coverage only for:
- war or military service
- aviation
- specified hazardous occupations
- death outside the continental U.S. and Canada
- suicide within two years of issue
When a restriction applies, the insurer must still pay at least the policy reserve.
Death claims and creditors
- Interest runs from the date of death for a West Virginia resident, at the insurer's rate on proceeds left on deposit (33-13-14a).
- Proceeds payable to a beneficiary other than the insured or the insured's estate are protected from the insured's creditors, except premiums paid to defraud creditors. Proceeds payable to the estate lose that protection (33-6-27).
- Group life proceeds generally can't be seized to pay a person's debts (33-6-28).
- An owner who can change the beneficiary may make a collateral assignment without the beneficiary's consent. The beneficiary's rights then come after the assignee's (33-6-20).
- Simultaneous death: if there is no proof otherwise, proceeds are paid as if the insured outlived the beneficiary (33-6-24).
Replacement (CSR 114-8)
- Replacement includes lapsing, surrendering or converting an existing policy to reduced paid-up or extended term, cutting its benefits, or using it in a financed purchase.
- The producer and applicant sign a statement about existing coverage. If there is replacement, the producer reads the notice no later than when the application is taken. Both sign, and copies of all sales material are left with the applicant.
- The replacing insurer notifies the existing insurer within five business days. The existing insurer offers the owner policy information within five business days of a request.
- 30-day return right with a full refund.
- When the insurers are the same or affiliated, the new policy credits time already served under the old policy's incontestable and suicide periods.
- Exempt: credit life, certain group coverage, structured settlements and nonconvertible term expiring within five years.
- Records are kept five years.
- Telling an applicant to deny a replacement is a violation. A pattern of "unintended" replacements is evidence of intent.
Disclosure and advertising (CSR 114-11, 114-11A)
- The Buyer's Guide is given before the first premium is accepted. With a 10-day unconditional refund right, it may come with the policy.
- The policy summary is titled "Statement of Policy Cost and Benefit Information." Policy data covers 20 years, and the insurer may charge up to $10 for it.
- Before a sales presentation, the producer says they are acting as a life insurance producer and names the insurer. Titles like "financial planner" may not be used to suggest an advisory business that doesn't exist.
- Ads can't use "vanish" or "vanishing premium."
- Ads saying "non-medical" must state that issue may depend on health answers, unless issue is guaranteed.
- Ads can't present a policy as an investment or savings plan in a misleading way.
- Insurers keep each ad on file for five years.
Insurable interest and consent (33-6-2 to 33-6-5)
- Anyone may insure their own life for any beneficiary.
- Insurable interest in another must exist when the contract is made. It may be love and affection for close relatives, or a lawful economic interest. Buy-sell partners and certain charities also qualify.
- The insured must apply for or consent to a policy, except a spouse insuring the other spouse, or someone with an insurable interest insuring a minor.
- A minor at least 15 may buy life or accident and sickness insurance on their own life.
Common exam traps
- West Virginia's free look is 10 days for life and A&S policies. A replacement gets 30 days.
- Grace is 31 days.
- Incontestability is two years with no fraud exception.
- The suicide exclusion is limited to two years, and the insurer pays at least the reserve.
- The loan rate cap is 8% fixed, and loans may be deferred 6 months.
- Settlement can be delayed no more than two months after proof.
- Death claim interest runs from the date of death.
Practice Life Policy Provisions Options and Riders questions All Life, Accident & Health topics
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.