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Zorluk: KolayInitial Premium and Premium Receipts

Marcus, a freelance graphic designer, completes a life insurance application and gives his producer a check for the initial premium. The producer provides a conditional receipt in return. No medical exam is required for this policy. Two days later, before the home office can process the application, Marcus dies in a sudden accident. The underwriting department later confirms he would have been approved as a standard risk on the application date. What action must the insurance company take?

  1. A
    Deny the claim because the insurance contract lacked consideration from the insurer at the time of death
  2. B
    Return the premium check to his estate without paying the death benefit
  3. Pay the full death benefit to his beneficiaryCevap
  4. D
    Pay the claim only if the producer had expressly bound the coverage in writing

Cevap

Pay the full death benefit to his beneficiary
When an initial premium is paid with the application and a conditional receipt is issued, coverage becomes effective on the date of the application (or the medical exam, whichever is later) as long as the applicant is found to be insurable as a standard risk. Since Marcus was insurable on the application date, the coverage was retroactively in force at the time of his death.

Adım Adım Çözüm

1
Identify the type of receipt issued.
A conditional receipt was issued.
This determines when the coverage technically begins.
2
Determine the conditions required for coverage to be effective under a conditional receipt.
The applicant must be found insurable as a standard risk as of the application date (or medical exam date, if required).
Conditional receipts grant retroactive coverage only if underwriting approves the risk.
3
Apply the facts of the scenario to the conditions.
No medical exam was required, and underwriting confirmed Marcus was a standard risk on the application date.
Because all conditions were met, the policy was effectively in force when he died.
4
Determine the insurer's obligation.
The insurer must pay the full death benefit.
Since the policy was in force retroactively, the death claim is valid.

Anahtar Kavram

Conditional Receipts and Effective Date of Coverage
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