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Question

Difficulty: HardInitial Premium and Premium Receipts

On April 12, an agent collects an application and the initial premium for a $500,000 permanent life insurance policy from a 45-year-old client, immediately issuing a conditional insurability receipt. The insurer's underwriting guidelines require a routine medical examination for this face amount, which the client successfully completes on April 18. Tragically, the client is killed in a structural collapse on April 24. On April 26, the underwriter reviews the completed application and medical results, determining that the client fully qualified as a standard risk exactly as applied for. Based on these sequence of events, identify the legally accurate statements regarding the insurer's obligations and the policy's status. (Select all that apply)

  1. The insurer is legally obligated to pay the $500,000 death benefit to the designated beneficiary.Answer
  2. The effective date of the life insurance coverage was established as April 18.Answer
  3. C
    The coverage retroactively began on April 12, the date the initial premium was accepted and the receipt was issued.
  4. D
    The insurer will deny the claim because the policy was not physically delivered to the client while they were in continued good health.
  5. E
    The agent exceeded their implied authority by issuing a conditional receipt for a policy requiring a medical exam, rendering the contract voidable.

Answer

The legally accurate statements are that the insurer is obligated to pay the $500,000 death benefit, and the effective date of the coverage was established as April 18.
The statements confirming the insurer's liability and the April 18 effective date are correct because of how a conditional insurability receipt operates. When a medical exam is required, coverage is triggered retroactively to the date of that exam (April 18, the later date), strictly on the condition that the applicant is ultimately found to be insurable at the applied-for risk class. Because the underwriter approved the client as a standard risk, coverage was legally in force on the date of death (April 24), obligating the insurer to pay the claim despite the policy never being printed or delivered.

Step-by-Step Solution

1
Analyze the legal function of the specific receipt issued.
A conditional insurability receipt dictates that coverage becomes effective as of the application date OR the date of a required medical exam, whichever occurs later, provided the applicant is ultimately found insurable.
Establishing the legal rule is necessary to evaluate the timeline.
2
Apply the timeline to the conditional receipt rule.
The application date was April 12, but the medical exam was completed on April 18. Therefore, the potential effective date shifted to the later date: April 18.
Determines the earliest possible moment the insurer assumed the risk.
3
Evaluate if the insurability condition was satisfied before or after the applicant's death.
The underwriter determined on April 26 that the client was a standard risk based on the April 18 exam. Even though this decision occurred after the April 24 death, the condition of being insurable on the effective date (April 18) was legally met.
Confirms whether the conditional coverage converted into actual liability.
4
Determine final liability.
Because coverage was legally in force starting April 18, the death on April 24 is covered, compelling the insurer to pay the full death benefit.
Resolves the scenario based on established policy law.

Key Concept

Conditional Insurability Receipts and Effective Dates
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Topics

Initial Premium and Premium Receipts

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