2) Where a conditional receipt was issued, may an insurer, as a condition of, or as a requirement for, the delivery of an issued individual life insurance policy, require an additional certification of good health?
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Several applications for individual life insurance were submitted for which a conditional receipt to a foreign authorized life insurer had been issued. As part of the submission, included were a full modal premium, a health history, and, where applicable, an Attending Physicians Statement and/or the results of a current insurance medical examination. When the life insurer sent the policies to the producer for delivery to the insureds, it indicated that as a condition precedent to such delivery, the producer must obtain a current certification from the insureds that there had been no change in their insurability.
The producer is aware of the requirements of N.Y. Comp. Codes R. & Regs. tit. 11, 52.53 and inquires if such requirements are applicable to individual life insurance and the ramifications of insureds making current certifications of insurability.
Except as otherwise stated herein an insurer must issue either a conditional receipt or interim insurance agreement if premium is paid prior to delivery of the policy and the insurer requires a determination of insurability as a condition precedent to the issuance of a policy. The following rules shall apply to conditional receipts and interim insurance agreements: (a) a conditional receipt which requires a determination of insurability as a condition precedent to coverage shall include an agreement: . . . (2) to provide that such insurability be determined as of a date no later than the date of completion of all parts of the application, including completion of the first medical examination if one is required by the company's underwriting rules, and the required premium has been paid. Completion of a second medical examination may be required as a condition precedent to coverage if initially required by the company's underwriting rules because of the amount of insurance applied for or the age of the proposed insured.
(e) Although the proposed insured dies, undergoes a change in health or otherwise becomes uninsurable according to the company's underwriting standards for the plan of insurance for which application was made after the date provided for in subdivision (a) of this section but before the application is approved or rejected, and before the expiration of any time limit specified in the receipt, a company may determine that the proposed insured is not insurable only as of the date specified in subdivision (a) of this section. Information relating to an event or physical condition which is the subject of a question in any part of the company's application cannot be considered for underwriting purposes if the event or accident occurred or sickness first manifested itself after completion of that part of the application.
While Regulation 62 by its terms only applies to health insurance, the Department has in Circular Letter 4 of 1963 (September 20, 1963), as amended by Circular Letter 3 of 1969 (May 16, 1969), established Guidelines for Examination of Individual Life Policies and Related Forms. Since New York Insurance Law 3201(a) (McKinney 2000 and 2005 Supplement) includes all documents providing insurance within the definition of "policy form", conditional receipts are subject to approval by the Insurance Department.
Can the beneficiary of a life insurance policy above the age of 14 years and six months, but below the age of 18 years, receive the proceeds of a life insurance policy that was owned by the minor beneficiary's deceased parent?
Yes. Pursuant to N.Y. Ins. Law 3207(a) (McKinney 2000) the minor above the age of 14 years and six months shall be deemed competent to be a beneficiary of a life insurance policy that was owned by the minor's deceased parent. The minor has an insurable interest in the deceased parent pursuant to N.Y. Ins. Law 3205(a)(1)(A) (McKinney Supp. 2004). We assume that all the facts below are accurate.
At the time of the parent's death the minor was the age of 17 years and six months. The insurer's position is that it would not pay the life insurance policy's proceeds to the minor beneficiary until the minor is the age of 18 years.
The inquirer requested that we also assume the following facts: (1) the parent's life insurance policy was in force at the time of the parent's death, (2) there is not a relevant will or trust, and (3) a guardian was not appointed by the Surrogate's Court.
(a) A minor above the age of fourteen years and six months shall be deemed competent to enter into a contract for, be the owner of, and exercise all rights relating to, a policy of life insurance upon the life of the minor or upon the life of any person in whom the minor has an insurable interest, but the beneficiary of such policy may be only the minor or the parent, spouse, brother, sister, child or grand-parent of the minor. (Emphasis added)
We construe the phrase "exercise all rights relating to" in Section 3207(a) as the basis for the minor beneficiary being deemed competent to receive the proceeds of the life insurance policy. Since the owner of the life insurance policy was the minor's deceased parent, the minor has an insurable interest in the parent pursuant to Section 3205(a)(1)(A). Accordingly, if the facts provided are accurate, and assuming the terms of the policy provide for it, the minor beneficiary may receive the proceeds of the life insurance policy. However, this opinion is limited to the specific facts provided and interpretation of the Insurance Law and Regulations promulgated thereunder. There may be other laws that may affect the proper disposition of the policy's proceeds.
You can generally exclude from income payments you receive from qualified long-term care insurance contracts as reimbursement of medical expenses received for personal injury or sickness under an accident and health insurance contract. Also, you can exclude from income certain payments received under a life insurance contract on the life of a terminally or chronically ill individual (accelerated death benefits). Refer to Publication 907, Tax Highlights for Persons with Disabilities.
Insurance Premiums Tax is a tax paid by all life insurance companies, all stock insurance companies, all mutual insurance companies, and all captive insurers doing business in Kentucky.
136.330 Tax on premium receipts life insurance company -- Exception.
136.340 Tax on amounts paid to stock insurance companies, other than life.
136.350 Tax on amounts to mutual companies, other than life and Lloyd's insurers.
136.360 Tax on amounts paid to stock insurance, to defray cost of administering fire prevention and insurance laws.
136.377 Filing of declaration of estimated tax by company -- Payment -- Penalty.
136.381 Reports and payments due notwithstanding dissolution or retirement.
136.390 Tax on insurance companies other than stock or mutual.
299.530 Annual report on reinsurance premiums -- Tax on premiums paid to unauthorized companies.
304.3-270 Retaliatory provision.
304.4-030 Tax as to unauthorized reinsurance.
304.11-050 Premium tax on unauthorized insurer.
304.49-220 Tax levied on premium receipts -- Rates -- Exclusivity of premium tax -- Distribution of revenue for administration of KRS 304.49-010 to 304.49-230.
Employees on a leave of absence without pay are billed monthly and must remit payment to the GIC to maintain GIC insurance coverage. An employee can cancel some or all of their GIC coverage while on a leave of absence. However, when the employee returns to work after a leave of absence he/she is subject to Annual Enrollment (basic life and health insurance) and Evidence of Insurability requirements (LTD and Optional Life). Employee on FMLA or military leave only, may enroll in GIC health insurance upon return from leave. The status change form (Form 1A) must be received at the GIC within 60 days of the return to work.
If you voluntarily canceled GIC health insurance coverage at the beginning of your FMLA or military leave of absence, you can re-enroll in GIC basic life and health insurance coverage upon your return from leave. Optional Life and Long Term Disability are subject to evidence of insurability unless you are returning from a military leave. The enrollment form must be received at the GIC within 60 days of the return to work. Forms received after 60 days are returned and you may re-apply during Annual Enrollment.
New state employees can enroll within 10 days of hire in Optional Life Insurance for a coverage amount of up to eight times your salary. If you don't apply as a new hire, you can apply at any time, but you must have basic life insurance and you are subject to evidence of insurability. If you select an amount of Optional Life Insurance that is a multiple of your salary of two to eight times, up to $1.5 million maximum, you will be enrolled in the Automatic Increase; your Optional Life Insurance coverage will increase automatically after an increase in your salary. If you elect to change from a fixed amount (where your coverage does not increase as your salary increases) to Automatic Increase, you will be subject to evidence of insurability.
State employees only - Employees actively at work who have the following qualifying family status changes during the year may enroll in or increase optional life insurance coverage without evidence of insurability in an amount not to exceed four times the salary: marriage, birth/adoption, divorce and death of a spouse. Proof of the qualifying event and the completed form must be received by the GIC within 31 days of the qualifying event. You must already have basic life insurance for this option. Forms received after 31 days are subject to evidence of insurability.
State employees who are enrolled in GIC's optional life insurance plan and retiring should review the amount of your optional life insurance coverage and its cost to determine whether you want to keep it or reduce your amount of coverage. If you do not change your optional life insurance coverage amount, you will be responsible for the new higher monthly premiums.
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