Understanding Life
Insurance
Article Courtesy of the
Texas Dept of Insurance
(January 2008)
www.tdi
Life Insurance Basics
When you buy a life
insurance policy, you specify whom you want
to receive the policy’s death benefits when
you die. The people you specify are called
“beneficiaries.” It’s important to
understand that the primary purpose of life
insurance is to help your beneficiaries
maintain their standard of living after you
die. Life insurance isn’t an investment. A
life insurance policy is generally
guaranteed to pay death benefits when the
policyholder dies. With an investment,
however, there’s a risk to the payoff – an
investor might earn money, but he or she
also might lose some or all of it.
While some types of life
insurance include a savings component that
can provide some retirement income, Texas
law prohibits marketing life insurance as an
investment or retirement income source. If
an agent or company tries to sell you a life
insurance policy as a good investment, be
careful. Complicating matters somewhat,
many life insurance companies also sell a
legitimate investment product called
“annuities” that are similar in principle to
life insurance. People often purchase these
investments to provide for retirement
because they can provide a steady stream of
income over a long period of time.
Insurance companies use a
process called “underwriting” to determine
which policy applicants to accept and what
premium rates to charge. The company will
consider certain “risk factors,” including
your age, gender, medical condition, and
whether you smoke. Younger applicants who
are in good health and who don’t smoke will
generally be charged lower premiums. The
insurer expects that these policyholders
will live longer and thus be able to make
more premium payments. Older applicants who
have health problems or those who smoke can
expect to pay significantly more because
their risk of early death is statistically
higher. Some companies may determine that,
based on its review of an applicant’s risk
factors, the applicant is too great a risk
and may decline to issue coverage
altogether.
If a company declines to
cover you or charges you more for coverage
because of your health status or other
factors, keep shopping. Different companies
have different underwriting guidelines. If
you are accepted for coverage at a higher
rate, ask whether your premium can be
lowered later. Some companies will lower
your premium if you maintain good health for
a specified period of time, give evidence
that your health has improved, or change to
a less-hazardous occupation.
Who Needs Life Insurance?
When purchasing life
insurance, be sure to consider your
individual circumstances and the standard of
living you want to leave for your
dependents. If you don’t have anyone
depending on you for financial support, you
may not need life insurance, or you may need
only enough to cover funeral expenses or
other financial obligations. The following
guidelines can help you decide if life
insurance is right for you:
-
Families,
including single-parent households,
generally need life insurance because
children depend on their parents’
incomes. Typically, the younger a
child, the greater the family’s need for
life insurance. It’s a good idea to
consider insuring both parents, even if
only one is a primary wage earner. This
can help ensure that the surviving
parent can pay for any increases in the
cost of child care if the parent
primarily responsible for child care
dies.
-
Single adults
typically don’t need life
insurance, unless they are single
parents or support someone such as an
elderly parent.
-
Working couples
without children or dependent parents
typically don’t need life insurance,
particularly if the survivor would earn
enough to meet expenses and pay debts
without exhausting savings. However,
life insurance may be a good idea if
only one spouse is employed because the
nonworking spouse could maintain his or
her standard of living should the
working spouse die. Young couples who
plan to start a family may want to
consider purchasing life insurance since
life insurance can cost significantly
less when purchased at a younger age.
-
Older people
whose children are grown and independent
are less likely to need life
insurance. A well-planned savings
program can decrease a family’s need for
life insurance as wage earners near
retirement age.
Although life insurance is
sometimes used to pay for prepaid funeral
arrangements, it is often not the best
funding source. Make sure you fully review
your needs and all of your options to pay
for funeral expenses.
You may purchase a life
insurance policy on your own life or on the
life of anyone who gives their consent for
you to do so and agrees to undergo the
insurer’s underwriting process. The person
who purchases the policy is known as the
“policyholder” and is the person responsible
for making the premium payments to keep the
coverage in force.
Most often, life insurance
is purchased by policyholders to insure
their own lives and provide a death benefit
to a spouse, dependent child, or other
family member. However, in some cases you
may wish to buy a life insurance policy on
someone else and name yourself as the
beneficiary. For instance, if you are
divorced and your former spouse provides
child-support payments, you might want to
purchase a life insurance policy on your
ex-spouse to guarantee continued support
payments if he or she dies.
You may name any individual,
organization, or trust as the beneficiary of
the policy’s death benefit, or you may
choose to name multiple individuals as
“shared beneficiaries” and stipulate how the
benefit will be divided among them. You may
also choose to name “secondary
beneficiaries” who will only receive the
benefit if the primary beneficiary is no
longer living.
In some cases, a creditor
may have an interest in the life of a loan
recipient. The creditor may purchase a life
insurance policy to cover the balance of the
loan in case the recipient dies before
repayment. Businesses also sometimes
purchase policies on the lives of certain
key employees who are vital to company
operations.
This publication generally
discusses life insurance from the
perspective of an individual purchasing a
policy on his or her own life to benefit a
single named beneficiary. Unless otherwise
noted, however, the same rules apply to
policies purchased by third parties and
policies with multiple beneficiaries.
The Main Types of Life
Insurance
Life insurance can generally
be classified as either “term life,” “cash
value life,” or a combination of the two.
Term life coverage is typically less
expensive and less complex. These policies
pay only once – with a specified death
benefit when the insured dies – and only if
the person dies during the specified term
that the coverage is in force. Cash value
life policies typically provide a variety of
features and benefits in addition to the
death benefit, and they typically cost
more. The key feature of all cash value
life insurance is a savings component that
accumulates over time and may be withdrawn,
invested, or borrowed against during the
policyholder’s lifetime, depending on the
policy terms.
In addition to a basic life
insurance policy form, your agent or company
will likely offer a choice of “riders” that
can be added to a policy to extend, limit,
or modify the coverage. Riders that
increase coverage typically increase the
premium.
Term Life Insurance
Term life policies take
their name because coverage only lasts for a
specific period of time – such as one, five,
15, or 20 years – or until the insured
reaches a certain age. The cost of term
life generally increases as you get older.
For people under age 40, term life generally
provides the largest death benefit per
premium dollar of any type of life
insurance.
Term life policies typically
don’t include a savings component. If you
die during the term, the insurance company
pays the amount of the death benefit
specified by the policy. If you don’t die
during the term, the policy lapses, no
benefit is paid, and you must either renew
or purchase another type of coverage if you
wish to keep life insurance.
Term life can be a good
choice for young families with children.
You may only need coverage until the
children are old enough and financially able
to provide for themselves.
Common features of most term
life policies include:
-
Convertibility.
You can exchange the policy for
permanent life insurance of equal value
without taking a medical exam or any
further underwriting. For example, you
could transfer a $100,000 convertible
term policy into a $100,000 cash value
policy without having to answer
questions about your health or medical
history. However, your premium will
probably increase because cash value
coverage typically costs more than term
life. Convertibility can be an
important feature if your health
declines and you become unable to
qualify for a permanent policy through a
separate application. Converting to a
cash value policy can also allow you to
begin using your policy to build
savings. Insurers typically only allow
policyholders to convert term life
policies before age 65.
-
Renewability.
You can extend the policy for additional
terms, regardless of your health and
without having to pass a medical exam.
This can be another advantage of term
life coverage as you age or if you
become ill. Even if you no longer meet
an insurer’s underwriting criteria, the
company still must renew. Terms can
renew at 20, 10, or five years, or even
annually. Premiums generally increase
at each renewal term. Annually
renewable premiums can be extremely high
for policyholders past middle age. If
you’re paying high annually renewable
premiums, you may want to convert to
some other type of coverage.
Term life insurance
typically comes in one of three common
policy variations:
-
Level term
coverage pays a death benefit
that remains constant over the term.
For example, a 20-year level term policy
with a $100,000 death benefit will
always pay that amount, whether the
insured dies in the fifth or 15th year.
Depending on the policy, your premium
for level term coverage will either
remain constant or increase at a
scheduled rate.
-
Decreasing term
coverage pays a death benefit
that decreases over the term at a
scheduled rate. For example, a 20-year
decreasing term policy may begin with a
$100,000 death benefit that decreases by
$5,000 per year. If you die in the 11th
year, the policy pays $50,000.
Decreasing term coverage can be a good
option to provide for children in the
event of a parent’s early death since
the need for coverage typically
decreases as they near adulthood. A
disadvantage of decreasing term coverage
is that its convertibility value also
decreases each year. Premiums typically
remain constant over the term.
-
Increasing term
coverage pays a death benefit
that increases over the term at a
scheduled rate, which is often pegged to
inflation. For example, a 20-year
increasing term policy may begin with a
$100,000 death benefit that increases by
5 percent of the face value per year.
If you die in the 12th year, the policy
would pay about $155,000. Premiums
typically increase each year for
increasing term policies relative to the
benefit increase.
Cash Value Life Insurance
Cash value life policies
provide both a death benefit and a way to
accumulate funds over time. However, the
primary purpose of cash value coverage is to
provide permanent life insurance protection,
not to serve as a retirement or savings
plan.
Initial premiums for cash
value insurance are typically higher than
for term life insurance because you’re also
purchasing the savings feature. However,
cash value premiums generally increase at a
slower rate. If you buy a cash value policy
at a young age and continue the policy into
middle age, your premium will likely be
lower than they would for a term life policy
with a comparable death benefit.
A portion of each cash value
premium is placed into an account that
accumulates over time. This is the policy’s
“cash value.” The amount may grow at a
fixed interest rate, be tied to indexed
interest rates, or increase according to the
performance of stocks, bonds, or other
securities in which the account is invested,
depending on the policy type.
A policy may allow you to
withdraw from the cash value, use it as
collateral for a loan, or use it to make
future premium payments, depending on the
terms. Withdrawing all of the cash value
cancels the policy and ends coverage,
however.
When you die, beneficiaries
may receive only the policy’s stated death
benefit or the benefit plus any remaining
cash value, depending on the policy terms.
Premiums will be higher for the second
option.
It typically takes at least three to five
years for a policy to build significant cash
value. Moreover, if you withdraw some or
all of the money before a specified time
period, you will likely incur a substantial
“surrender charge,” which can be as high as
10 percent or more. You may also be liable
for income taxes on the money. If you
purchase a cash value policy, try to keep it
for at least 15 to 20 years. About half of
the people who purchase these policies cash
them in within five years, which is often a
financial mistake.
Cash value life insurance
can be a good option for people with
financial discipline.
The two most common
variations of cash value insurance are:
-
Whole life
insurance. Whole life
insurance remains in force for the
duration of the insured’s lifetime or
until the policy is cashed in, provided
that the premium is paid. You never
have to renew. Premiums either remain
constant or increase at a scheduled
rate. Part of each premium goes to pay
for the death benefit, part to pay the
insurer’s overhead costs and profit, and
part to increase the cash value. Some
whole life policies are “participating,”
meaning they may also pay a dividend
depending on the performance of the cash
value investment account. Typically you
will have the choice of receiving the
dividend in cash, adding it to your
policy’s cash value to purchase
additional death benefits, or using it
to pay future premiums.
Dividends are not guaranteed. Some
policies fail to pay dividends at the
insurer’s projected rate, while others
may exceed the projection. Your agent
may present you with a detailed chart
called an “illustration” that shows a
policy’s projected earnings. Ask for
the company’s history of dividends
projected versus dividends actually
paid. The agent shouldn’t object.
-
Flexible premium
universal life insurance. The
key feature to this type of policy is
flexibility. Within certain limits, a
flexible premium universal policy will
allow you to choose the amount of
coverage, the premium you pay, and the
cash value you build. As long as the
premiums continue to be paid and the
monthly deductions don’t deplete the
cash value, the policy will remain in
force until the “maturity date,” at
which point coverage ends and the cash
value is paid to the policyholder.
Some flexible premium policies pay a
guaranteed rate of return. Others are
“variable universal life” policies whose
value depends on the performance of
stocks, bonds, or other investments.
For this reason, agents and brokers who
sell variable life insurance in Texas
are required to maintain a federal
securities license in addition to the
standard state insurance license. The
precise rules and policy terms for
flexible premium policies can be
complex. It is a good idea to consult a
financial or estate planning adviser to
ensure you fully understand the policy
details before purchase.
A flexible premium policy will allow you
to adjust the amount you pay in premium,
the death benefit, or the cash value at
any time. Any adjustment you make will
impact one or both of the other areas:
Increasing your premium will build
either your cash value, death benefit,
or both.
Many flexible premium policies will even
provide the option of lowering your
premium payments below the amount needed
to pay the insurer’s overhead expenses.
The company will then deduct that amount
from your cash value. But be careful
with this option. If the cash value
reaches zero, you will have to resume
paying the full amount of the premium
out of pocket or the policy will lapse.
The contract will state that the insurer
is required to send you an annual report
of the state of your cash value and also
notify you if at any point you’re in
danger of losing your policy because of
insufficient cash value.
Most flexible premium policies contain a
provision for a “secondary guarantee,”
or a no-lapse premium benefit. A
“primary guarantee” is the payment of
the premium necessary to cover the
monthly deduction. If the primary
guarantee isn’t satisfied, a secondary
guarantee may keep the policy from
lapsing. The secondary guarantee
provides a benefit whereby payment of a
premium that would not be large enough
to pay for the monthly deduction
satisfies the no-lapse condition and
keeps the policy in force.
Comparing the Major Types
of Life Insurance
|
|
TERM LIFE |
WHOLE LIFE |
UNIVERSAL
LIFE |
|
PREMIUM |
Lower initially.
Increases with each renewal. |
Higher initially
than term. Normally doesn´t
increase. |
Flexible premiums. |
|
PROTECTS FOR |
A specified period. |
Entire life if you
keep the policy. |
A flexible time
period. |
|
POLICY
BENEFITS |
Death benefits only. |
Death benefits and
eventually a cash and loan value. |
Flexible death
benefits and eventually cash and
loan value. |
|
ADVANTAGE TO
BUYER |
Low outlay.
Initially buyer can purchase a
larger amount of coverage for a
lower premium. Buyer could consider
developing outside investment
program. |
Helps buyer with
financial discipline. Generally
fixed premium amount. Cash value
accumulation. Buyer can take loan
against policy. |
More flexibility.
Takes advantage of current interest
rates. Offers the possibility of
improved mortality rates (increased
life expectancy because of
advancements in medicine, which may
lower policy costs). |
|
DISADVANTAGES TO BUYER |
Premium increases
with age. No cash value. |
Costly if you
surrender early. Usually no cash
value for at least three to five
years. May not meet short-term
needs. |
Same as whole life
and buyer assumes greater risks due
to program flexibility. Low interest
rates can affect cash value and
premiums. |
|
OPTIONS |
May be renewable or
convertible to a whole life policy. |
May pay dividends.
May provide a reduced paid-up
policy. Partial cash surrenders
permitted. |
May pay dividends.
Minimum death benefit. Partial cash
surrenders permitted. |
Individual vs. Group
Policies
As you shop for life
insurance, you will find that policies are
sold in one of two ways: either as
“individual” or “group” coverage. Group
policies are most commonly offered through a
company’s employee benefits plan, although
other types of organizations may provide
them as well. Individual policies are those
purchased by individual consumers directly
from an agent or broker. If you purchase a
life insurance policy, the type you choose
will have implications for price, the amount
of coverage you receive, and level of
underwriting required.
Individual life
insures single or joint lives under a single
policy. Accordingly, this type of coverage
will afford you the most choice, as you’re
free to shop among multiple insurers for the
policy that best meets your needs. In
addition, many insurers are willing to offer
an individual policy that includes only the
features you need and none that you don’t.
Underwriting tends to be
strict for individual policies because the
insurer’s risk is concentrated on one
person. The company needs to be careful
that it doesn’t sell a disproportionate
number of policies to people who will die in
the near term. Younger people and those in
good health can often obtain the most
coverage for their premium dollar through an
individual life policy. People who are
older or who have high risk factors can
expect to pay more. A company may even
decline to issue coverage altogether for
certain applicants that are deemed a high
risk.
Group life
insures a group of people under a single
contract. Most of these policies are
offered by employers as part of an employee
benefits plan, although group policies may
also be offered as benefit of membership to
other types of organizations, such as
professional associations, trade unions,
churches, fraternal groups, and other
similar organizations.
State and federal laws place
restrictions on insurers’ underwriting
criteria for group policies. If you’re
unable to qualify for an individual policy
because of age or health reasons, group life
coverage may be a good option. Any
organization that sponsors a group life
policy must make it available to all members
regardless of age or health status. It is
against the law to require group members to
purchase a policy as a condition of
membership. Group life insurance may be
sold as term life, whole life, or universal
life coverage.
Modifying your Coverage
Policy “riders” and
“endorsements” are additional policy
benefits that you may be able to add to the
basic coverage, usually for an additional
premium. You can use riders or endorsements
to modify the coverage of an existing policy
to better suit your needs. Some of the most
common endorsements are:
-
Additional term
insurance essentially adds term life
coverage to a whole life or universal
life policy. For instance, if you need
$500,000 worth of total coverage, you
could purchase a $100,000 cash value
policy with a $400,000 additional term
insurance rider. As your financial
resources grow, you could convert some
or all of the term rider into the main
cash value policy, in the same manner
that most stand-alone term life policies
are convertible to cash value
insurance.
-
Guaranteed
insurability ensures that you
will be able to purchase additional
coverage from the insurer in the future,
regardless of your age or health
condition. These factors may still be
used to determine your premium rate.
Options to purchase additional coverage
must generally be exercised by certain
named dates or life events, such as
retirement or reaching age 65.
-
Accidental death
provides for an increased death benefit
– typically double the value – if the
insured dies as the result of an
accident. Certain restrictions may
apply.
-
Disability
waiver of premium suspends your
obligation to pay premiums if you become
disabled as defined by the rider. The
benefit lasts for the duration of the
disability. This rider is typically
only available to individuals under age
60.
-
Accelerated
death benefit option provides
for prepayment of some or all of the
death benefit while the insured is still
living if the person is diagnosed with a
terminal illness, specified disease, or
a long-term care illness. The rider is
typically purchased to help pay the
costs of end-stage care for the insured,
which can be expensive. To qualify as a
long-term care illness, the rider will
usually require a physician’s
determination that the insured is unable
to perform a specified number of defined
“activities of daily living,” such as
bathing, continence, dressing, eating,
toileting, or transferring.
-
Spousal rider
provides an amount of
additional term insurance coverage for
the spouse of the primary insured.
Essentially, this rider combines two
policies into one.
-
Children’s rider
provides additional term insurance for
the insured’s children. Age limitations
for this coverage typically extend from
at least 14 days old until age 21 or 25.
Special Case Life Insurance
Some policies provide only
certain narrowly defined types of coverage
or are sold in unique circumstances:
Credit life
refers to a type of policy purchased by
lenders to cover the balance of a loan in
the event the borrower dies before
repayment. A bank or lender may require you
to purchase a credit life policy as a
condition of a loan. “Credit accident and
health” coverage, technically health care
coverage and not life insurance, is
frequently also required in case the loan
recipient becomes sick or injured and unable
to repay the loan. The premium for these
coverages is usually automatically factored
into the loan’s payment schedule.
You should expect to be
required to undergo some level of
underwriting for credit life insurance.
Texas law contains several restrictions on
the circumstances under which purchasing
credit life and credit accident and health
insurance may be required by a lender,
however:
-
A lender may never
require credit life or credit accident
and health coverage as a condition of
any home loan. In this case you will
probably be required to purchase a
“mortgage guaranty policy” instead,
which is a type of coverage that
protects a lender from default under
more general circumstances.
-
Credit life and credit
accident and health coverage may never
be required for any loan of more than 10
years.
-
A lender may never
charge a loan recipient more than the
amount of the insurer’s premium for the
coverage or otherwise profit by
requiring the coverage.
-
The lender may never
require you to purchase the coverage
from any specific insurer.
-
If you already have a
life insurance policy, you may not need
credit life. You may instead agree to
an “assignment of benefits” to the
lender promising to repay the loan
balance using the death benefit of your
existing coverage.
Prepaid funeral
insurance is a special type of
policy to prearrange payment of funeral
services. An advantage of this insurance is
that it “locks in” the funeral cost at
current prices. However, funeral insurance
can be relatively expensive compared with
other types of life insurance. Often the
amount of premium individuals pay exceeds
the amount of the death benefit within a few
years. At the same time, many policies will
not pay the full amount of funeral expenses
if you die before paying a required amount.
A standard life insurance policy or a
well-planned savings program may be a better
way to pay funeral costs. You should shop
carefully before you buy funeral insurance
and make sure you understand a policy’s
details.
Home service life
refers to any type of insurance
that is sold door to door. Some companies
also market these policies as “industrial
life insurance.” Be careful with these
policies. Some home service life policies
can be a good deal, but many offer low death
benefits, accumulate cash value at a low
rate, and have high premiums.
Settlement Options
A policy’s death benefit is
typically paid in cash as a single lump
sum. However, there are other payout
options. A policy’s settlement may be
specified by the policyholder or chosen by
the beneficiary if no terms are designated.
Common settlement options include:
-
Interest option.
The amount of the death benefit remains
with the insurance company, and the
interest on the amount is paid to the
beneficiary on a regular basis.
Withdrawal of the principal is often
allowed under certain conditions.
-
Fixed period.
The death benefit is paid out at regular
intervals, with interest, over a period
of time specified in the policy.
-
Life refund.
The insurance company pays a set monthly
amount to the beneficiary for the
remainder his or her lifetime. Under
this option it’s possible for the
beneficiary to receive more than the
policy’s stated death benefit if he or
she lives for a long time. However, if
the beneficiary dies after a short time,
he or she might have received
substantially less. The amount of the
monthly payment is determined by the
face value of the policy and the
beneficiary’s age and health status.
-
Joint and
survivor. Periodic payments
are made for the duration of two
lifetimes, rather than one. Joint and
survivor settlement is a common option
when a policy beneficiary is married.
If the spouse who is the primary
beneficiary dies first, the surviving
spouse will still receive regular
payments. The amount of a joint and
survivor payment is determined by the
age and health factors of both spouses.
Know Your Rights
Prompt Payment of
Death Benefits
Insurance companies must
acknowledge your claim within 15 days and
either make payment within 45 days or
explain why the claim is delayed. For an
individual life policy, the company must
also pay interest on a death benefit from
the time the company receives the proper
proof of loss statement to the time the
company pays the death benefit.
Missing a Premium
Payment
Most policies have a 31-day
grace period after your premium’s due date
during which you can pay with no interest
charged. If the insured dies during this
period, the beneficiary receives the death
benefit minus the premium owed.
If Your Policy
Lapses
To reinstate a lapsed
policy, you may be required to pay some or
all the overdue premium, with interest, and
repay or reinstate any loans obtained using
the policy as collateral. Most companies
will reinstate a policy within a five-year
period, but may require you to answer
additional health questions or take another
medical exam.
Financial Implications of
Owning Life Insurance
Medicaid
The cash value of a life
insurance policy is generally considered to
be an asset when determining Medicaid
eligibility. Some or all of the proceeds
from a loan using the policy as collateral
might not be considered an asset under
certain circumstances, however. If you’re
on Medicaid, you may want to consult an
attorney or financial adviser to fully
understand any consequences of owning a life
insurance policy.
Taxes
The cash value of a life
insurance policy generally accumulates tax
deferred. Withdrawals from the cash value
are generally nontaxable until the
withdrawal amount exceeds the total amount
of premiums paid into the policy.
If a policy has a named
individual as the beneficiary, the law
generally considers the death benefit to be
reimbursement for the person’s loss, and not
income. For this reason, the death benefit
is typically exempt from the federal income
taxes and inheritance taxes that otherwise
apply to the insured’s estate. However, if
a policy does not have a named beneficiary,
or the beneficiary is deceased, the death
benefit is paid to the insured’s estate.
Heirs to the estate will then have to pay
full taxes on the money. If you are
considering purchasing life insurance as an
estate planning vehicle, you may wish to
consult an attorney or financial adviser to
fully understand the tax consequences.
Bankruptcy
The cash value and death
benefit of a life insurance policy are fully
exempt from creditors, all demands in any
bankruptcy proceeding, and from execution,
attachment, garnishment, or other legal
processes unless a statutory exemption, such
as fraud, is applicable.
Replacing Your
Policy with a New One
Price competition and the
development of new types of policies can
make it a good idea to review the price and
coverage of your policy periodically.
However, replacing an old insurance policy
with a new one is not always a good idea.
Consider the following:
-
New policies usually
take longer to build cash values and to
pay dividends.
-
The two-year contestable
period begins again under the new
policy. During this period, if you die
and the insurer discovers a material
misrepresentation on your policy
application, the death benefit will go
unpaid.
-
If changing to a new
policy means withdrawing early from a
cash value policy, you could pay
substantial surrender fees. Also, the
withdrawal counts as income for tax
purposes.
-
The new policy may not
provide the same benefits and coverages
as the old one, causing you to become
underinsured.
-
You will probably have
to answer additional health questions or
have another medical exam.
State law requires agents to
give life insurance policyholders a consumer
notice with advice regarding
discontinuing or changing an existing
policy. The notice urges consumers to
carefully consider whether a replacement is
in their best interest.
If you exchange a policy,
your agent will earn a commission on the
sale. Persuading a consumer to switch to a
new policy for the purpose of earning a
commission, without regard to the
implications for coverage, is a practice
called “churning” and is against the law.
If you believe an agent has improperly
encouraged you to sell a policy in order to
purchase a new one, you may file a complaint
with TDI.
Buying Life Insurance
Whey you apply to buy a life
insurance policy, the company will generally
evaluate your risk factors to determine
whether to accept you and what rates to
charge. At a minimum, you can expect to
fill out a health questionnaire as part of
the company’s underwriting process. If you
are applying for a policy with more than
$100,000 in coverage, you can also expect to
provide medical records and take a physical
exam.
It’s important that you
provide full and accurate information on
your application. All life insurance
policies have a two-year “contestable
period.” If the insured dies within this
period, the company may investigate the
cause of death and reverify the information
provided on the application. If the company
discovers the insured withheld any
information that might have impacted the
decision to issue coverage – even if the
information is unrelated to the actual cause
of death – the company can deny payment of
the death benefit. If payment is denied,
the company must refund the premiums paid
into the policy.
By law, the contestable
period may not exceed two years. If the
insured dies for any reason after this
period, the company must pay the death
benefit. Information the insured disclosed
truthfully can never be used as the basis to
deny payment. Never allow someone else –
including an agent – to fill in personal
information on your application, and don’t
allow anyone else to sign it on your behalf.
In addition, almost all life
insurance policies have a suicide clause.
This clause stipulates that the company will
not pay the death benefit and will return
premiums paid if the insured commits suicide
during the first two policy years.
How Much Life
Insurance is Right for You?
There is no precise formula
to determine the amount of life insurance a
person needs. Some consumer groups
recommend buying coverage in the amount of
five times your annual household income,
while some insurance industry organizations
recommend 10 times your income. To decide
the amount that’s right for you, consider
your family’s current and anticipated
financial obligations and the amount of time
your beneficiaries may have to meet these
obligations. It is also important to
consider the value of services provided by
nonwage earners. For example, a
stay-at-home parent’s duties of child care
and household management should be included.
Shopping Smart for Life
Insurance
-
Get quotes from
several companies. Each
insurance company uses its own
underwriting guidelines. One company
may sell you a policy at a substantially
lower premium than another. Life
insurance agents are “captive,” meaning
they can only issue policies for the
insurance company they work for.
Brokers, on the other hand, are
“noncaptive” independent contractors who
can sell policies of multiple insurers.
A broker may therefore be able to
provide you with price quotes from
several companies during a single
visit.
-
Compare “apples
to apples.” Be sure any
policies you compare offer similar
levels of coverage. The more features,
options, and added benefits a policy
includes, the more it will typically
cost. A policy that’s substantially
cheaper than another may have fewer
features or provide a substantially
lower death benefit. A more expensive
policy might actually prove to be a
better value when you calculate the
amount of the death benefit per premium
dollar charged. However, don’t just
decide on price; decide if the features
are worth it.
-
Buy the policy
that’s right for you. The more
a policy costs, the more an agent or
broker typically earns as a commission.
When shopping for life insurance, keep
in mind that the policy that’s best for
your agent or broker might not be the
best for your insurance needs.
-
Make sure your
company and agent are licensed.
It is illegal for an agent or company to
sell insurance in Texas without a state
license. The Life, Accident, Health,
and Hospital Insurance Service Guaranty
Association pays some or all of most
claims for Texas-licensed companies that
go bankrupt or become insolvent. If
your company is unlicensed and goes
bankrupt, your death benefit could go
unpaid.
-
Research your
company. An insurance
company’s financial strength and
customer service record can be good
indicators of the level of service you
can expect. You can learn a company’s
financial rating by calling TDI’s
Consumer Help Line. You can learn
information about the frequency of a
company’s customer complaints against a
company by calling the Consumer Help
Line or by using the “Insurer Search”
feature on the TDI website.
-
Shop for a
low-load policy. You may save
money, particularly on cash value life
insurance, if you buy a policy with low
commissions and administrative fees,
collectively known as “the load.”
Financial planners who are licensed
insurance counselors often sell these
policies. Generally, financial planners
charge clients a flat service fee as
opposed to earning commissions, meaning
they receive no benefit from a high
load. Since low load policies have
fewer initial fees, your risk of losing
money is also reduced if you cash out
early from a cash value policy.
-
Use your
“free-look” period. Most Texas
policies will provide you with a “free
look” or “right to examine” period of at
least 10 days, during which you may
cancel the policy for a full refund for
any reason. Use this time to read your
policy carefully to be sure the coverage
is right for you.
Here are some additional
tips to help you shop for life insurance:
-
Agents often use charts
called “illustrations” to show how a
policy’s cash value might grow. Confirm
that the chart shows a cash value that
is guaranteed by the insurance company,
and not a financial projection.
Projections are based on assumptions and
should never be relied upon as a promise
of policy performance because you might
earn much less. Ask your agent for a
history of a company’s projections
versus the actual growth of cash
values. The agent shouldn’t object.
-
Be careful if an agent
tells you that interest or dividends
earned on your policy will cause your
premiums to “vanish” during the life of
the policy. If interest rates or
dividends drop, you may have to pay
higher premiums or pay for a longer
period of time than you expected.
-
Some agents also sell
retirement investments and student
loans. The law prohibits agents from
offering discounts on an investment or
loan, or offering any type of gift, as
an inducement to buy life insurance. If
you believe an agent has made an
improper offer, call the TDI Consumer
Help Line.
-
Insurance companies
sometimes market life insurance policies
as retirement savings tools, estate
plans, election funds, or mortgage
protection. Not clearly identifying a
policy as life insurance is a
misrepresentation and a violation of the
law. If you believe an agent or company
has misrepresented a policy, call TDI’s
Consumer Help Line.
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A few simple guidelines
can help you avoid becoming a victim of
insurance fraud: Never pay cash for a
policy. Never sign a blank
application. Never buy insurance over
the phone or on the first visit. If you
think you need help choosing the right
policy for you, have a friend or family
member visit the agent with you. The
agent shouldn’t object.
Viatical and Life Settlements
In some instances, you may
need to access your policy’s death benefit
or otherwise convert it to cash before you
die. This can happen when a policyholder
outlives his or her retirement savings or
develops a serious medical condition that
requires extensive care. A life insurance
policy is considered personal property.
Therefore, it may be sold for cash in a
similar manner to other property, although
some special rules apply.
Life insurance policies can
be sold to authorized viatical/life
settlement providers for a percentage of the
policy’s death benefit.
A viatical settlement is the
sale of a life insurance policy by a
policyholder who has a catastrophic or
terminal illness or condition. In this
case, money is often needed to pay for
end-stage care. The policyholder must be
diagnosed as having a life expectancy of two
years or less. A life settlement, on the
other hand, is one in which a policyholder
who does not have a terminal illness sells a
policy. Under federal law, all earnings
from a viatical settlement are tax free.
Earnings from a life settlement are taxed at
the normal rate.
The settlement provider will
only pay a percentage of the policy’s face
value. For example, a viatical/life
settlement provider might pay $75,000 now
for a life insurance policy that will pay
$150,000 when the policyholder dies. There
are no laws requiring a certain minimum sale
amount, and settlements typically range from
between 25 percent to 75 percent of a
policy’s face value, depending on a number
of factors.
A policy’s sale price is
negotiable, and it’s a good idea to contact
multiple settlement providers as prices
offered may vary greatly. The following
factors primarily determine how much a
settlement provider will be willing to pay:
-
Life expectancy
of the insured. The longer the
insured is expected to live, the longer
the settlement provider may have to wait
before the policy pays. Therefore,
settlement providers will pay more for
policies where the insured has a shorter
life expectancy. For this reason,
policies sold in viatical settlements
typically receive much higher prices
than life settlements. In general, most
settlement providers won’t buy a policy
in a life settlement unless the insured
is age 65 or older.
-
Current interest
rates. As time goes on, the
amount of a policy’s death benefit
typically does not increase in line with
interest rates. Therefore, when
interest rates are high, other
investment options become a more
attractive alternative to viatical or
life settlements, and you can expect to
receive less for your policy. When
interest rates are low, however, your
policy will be worth more.
-
Policy premium
rates. Because the settlement
provider generally assumes all future
payment obligations, the lower your
premiums, the more a policy is worth.
-
Whether the
policy is contestable. The
sales price will be substantially less
if your policy is still in the
contestable period because the insurer
can deny payment of the death benefit
under certain circumstances. Most
settlement providers will not purchase
policies that are still in the
contestable period.
It’s important to note that
the income you earn from a viatical/life
settlement may affect your eligibility for
Medicaid or other government benefits. The
income may not be exempt from bankruptcy or
creditor proceedings. Before entering into
a viatical or life settlement, it’s a good
idea to consult an attorney or financial
advisor regarding any potential
consequences.
Viatical/life settlement
providers, provider representatives, and
brokers (agents who represent policyholders
to negotiate settlement transactions) must
register with TDI. For a list of registered
viatical/life settlement providers, provider
representatives, and brokers, call the TDI
Consumer Help Line or view “TDI Lists” on
our website. For questions and assistance
with viatical/life settlements, call TDI’s
Life, Annuity and Credit Section
512-322-3406
Alternatives to Consider
There are often other ways
of converting a policy to cash than through
a viatical or life settlement. It can be a
good idea to compare these other options
when deciding whether selling your policy is
the best financial decision for you:
-
If your policy has a
cash value, you can cash it in.
-
Many lending
institutions will give you a loan using
your policy as collateral.
-
A policy with an
accelerated benefits provision or rider
will prepay all or some of the death
benefit before the insured dies if he or
she is diagnosed with a terminal
illness, specified disease, or long-term
care illness
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