Someone has made a comment on another industry blog concerning life insurance that I though would best be addressed in this forum. The writer appears confused over the significance of the contestable period on a life insurance policy. Here's what she writes:
"I have noticed lately that there are a lot of
concerns about life insurance policies and the fact that you have to keep them
for at least a year or whatever the term says before you can actually bank on
the policy. So if you get a life insurance policy and you die in 2 weeks, then
you do not get the life insurance payoff because you died too fast (no matter
what the reason is). It is important to check out the life insurance company you
are going to be dealing with on this aspect".
The contestable period defines a measure of time during which a life or health insurance company can protect itself from material misstatements made in an insurance application. Consider that a nominal down payment could turn into a $1 million claim in a matter of days or hours and perhaps you will understand the need for the life insurance company to have all of the information at its disposal to properly evaluate the risk.
Let us assume. for example, that you applied for a life insurance policy and lied on the
application that you never smoked. If during the contestable period the insurance company
discovers that you in fact smoke like a chimney, they can rescind the policy, and refund your money. If, however, they
discovered this after the contestable period had expired, they could
not take the policy away from you.
Contestable periods are defined in the policy and are typically 1-2 years. Some policies have extended periods for fraud.
With respect to "banking on the policy", there is plenty of evidence that insurance companies pay claims during the contestable period. If you prepay your life insurance application or disability insurance application you will receive a conditional receipt. The receipt spells out the conditions for which a claim will be paid
during the underwriting period. Assume someone dies in a motor vehicle accident one month after a life insurance application and insurance physical have been submitted to the insurer. Should there be a claim during this time, the insurance company will typically continue underwriting the application as if the decedent were alive, collect all the underwriting requirements to determine if the decedent would have been insurable. If so. it pays the claim.
A contestable period is an important consideration in the event you are replacing one insurance contract with another. If you have had a policy with company A for 5 years, the contestable period is over. If you go to policy B to save a few bucks but in aspiring to be the next "Leland Van Lew" you neglect to disclose your "crocodile wrestling" and "volcano luging" avocations on the app, you may have some problems.
The classic scene from Universal Pictures' Along Came Polly features a passionate promotion of risk taking "Leland Van Lew" (portrayed by Bryan Brown) for insurance by "Sanford Lyle" (portrayed by Philip Seymour Hoffman) to a panel of "insurance underwriters".
What is notable is that "the insurance" was approved after FULL DISCLOSURE.
"I have noticed lately that there are a lot of concerns about life insurance policies and the fact that you have to keep them for at least a year or whatever the term says before you can actually bank on the policy. So if you get a life insurance policy and you die in 2 weeks, then you do not get the life insurance payoff because you died too fast (no matter what the reason is). It is important to check out the life insurance company you are going to be dealing with on this aspect.
Comments
The contestable period on a life insurance policy is designed to protect the insurance company and policyholders (in the case of a mutual company) or stockholders (in the event of a stock company) from material misrepresentation and frauds. The actuaries of the insurance company sets it prices in good faith relying on the truthful recording of answers by applicants and agents.
In "The MIsrepresentation Defense in Life and Disability Insurance Cases" by C. Edgar Sentell states
"These rules have typically been formulated in terms of whether the misrepresentation was “material.” In some states, the insurance company’s right to defend or rescind is further limited by an additional requirement that the matter misrepresented actually contributed to the loss, contingency, event or hazard for which the claim is made. In other words, in a limited number of states, the insurance company may not deny a claim or seek rescission unless a “causal relation” exists between the misrepresentation and the actual loss. Under such statutes or case law, when there is an applicant who falsely claims to be a nonsmoker, the insurance company can escape liability if the then insured dies of lung cancer due to smoking, but not if the insured later dies of AIDS. Finally, in some cases, the insurance company cannot avoid liability even when the policy has been procured through outright fraud".
In addressing the Professional Planner forum, attorney George Berger of the New York law firm Phillips Nizer stated:
"All that the N.Y. Insurance Law requires is that there be a material misrepresentation in the application. Even an innocent misrepresentation will do and the common position taken by the insured that I told the broker or agent the truth but he failed to write it down will not excuse the misrepresentation.
The test for what is material is stated in section 3105 the N.Y. Insurance Law and it says:
"No misrepresentation shall be deemed material unless knowledge by the insurer of the facts misrepresented would have led to a refusal by the insurer to make such contract."
More Comments
IF you are part of the majority that is truthful on your application you should be able to "bank on your policy", even if the indeterminable loss occurs within the contestable period.
When you apply for life insurance, you should carefully review the application BEFORE you sign the application. The application becomes part of the contract and is usually attached thereto, at the back. When you receive your annuity contract from your agent or the company, you should look over the application AGAIN and make sure that your application (that is now part of the contract) is completely truthful and accurately recorded.
Just remember if you screw up on your life insurance application you may never know the ramifications, but your family will!