Term
| What is an Attending Physician's Statement? |
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Definition
| Document reporting the care given by a physician who has treated a person. The U.S. accepts a death certificate and sometimes an APS upon death to file a claim. In Canada, they accept a death cert., APS, or hospital certificate. |
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Term
| What is the difference between a fraudulent claim and a mistaken claim? |
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Definition
| A fraudulent claim is when someone attempts to collect policy proceeds by providing false information to the insurer. A mistaken claim is when a claimant makes and honest mistake in presenting a claim - like he believes that the policy insured a certain person when in fact it was insuring someone else. |
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Term
| What is the Simultaneous Death Act? |
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Definition
| This is when the insured and beneficiary die in the same accident and the beneficiary is said to have died after the insured. Proceeds are paid to the beneficiaries heirs. |
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Term
| What is the Survivorship Clause? |
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Definition
| This states that the beneficiary must survive the insured by a specified period, usually 30-60 days, to be entitled to receive the policy proceeds. |
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Term
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Definition
| This is a procedure under which an insurance co. that cannot determine which claimant in entitled to receive policy proceeds may pay such proceeds to a court and ask the court to decide the proper recipient. |
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Term
| To calculate the Amount of the Benefit Payable, the following totals are reviewed: |
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Definition
| Face Amt. plus Accumulated policy proceeds minus Outstanding Policy Loan = Total Policy Benefit Payable |
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Term
| In regard to the Disappearance of an insured, what general rule is followed? |
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Definition
1. Be missing more than 7 years
2. A reasonable search took place
3. No communication with him since his
disappearance.
Premiums must have been kept up until the court has named a date of death. |
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Term
| What happens when the beneficiary is responsible for the death of the insured? |
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Definition
| The claim is denied. The policy still has to be paid to someone, most of the time the contingent beneficiary unless it is proven that the policy was purchased with the intention to profit from the insured's death. |
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