Chapter 8 - Morbidity Risks Flashcards
(114 cards)
1
Q
Mortality
A
The number of deaths that occur at a given time, in a given group, or from a given cause.
2
Q
Morbidity
A
The prevalence of disease or disability within a population
3
Q
Mortality risk
A
The risk of a particular individual dying, at any given time, when compared to other individuals of the same age and sex.
4
Q
Morbidity Risk
A
The risk of a particular individual contracting a disease, or other disabling condition, at any given time, when compared to other individuals of the same age or sex. For example, individuals with a long history of back problems have a higher morbidity risk because they are more likely to be disabled due to back problems than other individuals of the same age, sex, and occupation, who have never had back problems.
5
Q
Disability Insurance
A
42% probability that a person who is 25 yrs old today will become disabled for at least 90 days before reaching age 65.
At age 55 there is a greater than 1/5 probability of suffering a disability.
For disabilities lasting 90 days are usually handled by their financial affairs.
Average length of disability at 25 is 2.5 yrs, at 55 it reaches 5 yrs.
Insurance usually converse as short as 12 months or can extended beyond age 65.
6
Q
Disability Insurance - Products - Base policy
A
When total disability occurs, a benefit is payable (i.e., the monthly benefit) after a definer period of time (i.e., the waiting period), for a defined length of time (i.e., the benefit period).
7
Q
Disability Insurance - Three types of renewability provisions
A
- Conditionally renewable (non-traditional)
- Guaranteed renewable (traditional)
- Non-cancelable (traditional)
8
Q
Disability Insurance - Conditionally Renewable
A
“Cancelable” - allow the insurance company the most flexibility in making changes to in force policies. This policy type does not provide for any premium or policy provision guarantees nor for the continuation of the policy (can be cancelled or premium increased).
Usually for those looking for cheap coverage or who do not qualify for tradition disability insurance.
9
Q
Disability Insurance - Guaranteed Renewable
A
Cannot be cancelled, have any changes made to its provisions or additional restrictions applied, provide the premium is paid to date. Though a lower premium can be charged initially it could be increased by class if the company is experiencing a poor claims history on that particular block of business. Underwriting is less restrictive than non-cancelable. Can include benefit limitations like conditionally renewable such as limited benefit period, longer elimination period, or reduced benefit amount. Some impairments can be completely excluded.
10
Q
Disability Insurance - Non-cancelable
A
Most strictly underwritten as it presents the greatest risk to the company. The company cannot:
1. Increase or add additional charges for the policy w/out agreement from policyholder
2. Change/add any provision or restrictions
3. Cancel the policy, regardless of changes (occupation or health).
Usually an age limit to 65.
Coverage can continue past age 65 as long as working full time.
11
Q
Disability Insurance - Non-cancelable after age 65
A
Changes include:
1. premiums are no longer guaranteed and are based on attained age on an annually renewable basis.
2. The waiting period remains unchanged but the benefit period is changed to either 12-24 months.
3. The definition of disability it “total”
4. Any benefit riders are terminated.
Max age could be 70 to 75 depending on company.
12
Q
Disability insurance policies define the conditions that must be met in order for a benefit to be payable. Three categories are
A
- Own occupation
- Regular occupation
- Any occupation
13
Q
Own occupation
A
Provides disability coverage for the individual who cannot perform their specific job function. The inability, due to injury or sickness, to perform the important duties of his/her current occupation. Although disabled from his occupation, He can work in another job while still receiving claim benefits.
Many no longer offer this coverage, and if they do, this is restricted to certain occupations.
Sometimes this is only for a limited period of time.
14
Q
Regular Occupation
A
Almost identical to own occupation except the insured is ineligible for disability benefits , if able to work in an occupation for which he/she has been educated, trained, or has experience with respect to the duties required under that specific job.
Regular occupation period would last for the first 2.,5.or 10 yrs of the benefit period - changing to any occupation after.
15
Q
Any Occupation
A
Based on the insured’s ability to work in any reasonable occupation. Adjudicator will determine the individual’s ability to work.
16
Q
Loss of income policies (Residual)
A
Some disability policies measure total disability in term of income loss. The amount paid is based on proportionate loss of income rate than the loss of ability to perform duties. If the insured is unable to return to gainful employment due to disability. the full benefit of the policy will be paid.
17
Q
Disability Insurance - Policy Structure
A
Benefit Payment
Waiting Period
Benefit Period
Contractual exclusion riders
18
Q
Policy Structure - Benefit Payment
A
Normally payable on a monthly basis for the duration of the disability and, upon recovery and continued premium payments, the policy remains in force.
19
Q
Policy Structure - Waiting Period
A
Also known as the elimination period, designates the period of time one must be disabled prior to benefits becoming payable. Usually around 30 days but can range from 0 days to 2 years.
20
Q
Policy Structure - Benefit Period
A
Refers to max period for which benefits will be paid during a disability. Usually around 2 years, 5 years, and up to age 65.
21
Q
Policy Structure - Contractual Exclusion Riders
A
Various exclusion riders provide that benefits will not be payable if a disability occurred secondary to:
- an act or accident of war, declared or undeclared, or due to any type of military conflict.
- committing or attempting to commit a felony, or engaging in an illegal occupation.
- normal pregnancy or childbirth
- transplant surgery where a part of the insured body is transplanted to another person during the first 6 months the policy is in force.
- Cosmetic surgery, during the first 6 months the policy is in force.
22
Q
Business DI Products
A
- Key Person Insurance
- Office Overhead Expense
- Disability Buy-Sell
23
Q
DI - Key Person Insurance
A
Designed to protect a business and replace lost profits in the event of the loss of a key employee (someone who is considered a valuable asset to the company and a necessity for its successful operation.
Regular or Own Occupation definitions of total disability are typically utilized.
Waiting periods are 30, 60, or 90 days
Benefit period is typically 12, 18, or 24 months.
24
Q
DI - Office Overhead Expense
A
Reimburse covered fixed business expenses during the disability of the insured owner. Benefit payable is based on the actual covered expenses incurred by the business during each month of disability.
Typical definition is Own or Regular Occupation
Waiting periods are 30, 60, or 90 days
Benefit period is typically 12, 15, 18, or 24 months.
25
DI - Office Overhead Expense - Covered expenses
1. Rent
2. Property tax
3. Utilities
4. Depreciation
5. Leased and rented equipment
6. Business liability insurance
7. Dues for professional association
8. Interest on debt
9. Accounting fees
10. Certain employee wages
11. Other fixed expenses customary in the operation of the business.
26
DI - Disability Buy-Sell
Designed to help fund a buy-sell agreement - which details the procedures to be followed if one of the partners or shareholders suffers from a long-term disability.
Total disability definition is usually Regular or Own Occupation
Waiting period of 12 or 24 months
Benefit period of 60 months
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DI - Disability Buy-Sell - Forms of benefit payment
1. lump sum that pays the benefit out all at once
2. months benefit payment
3. combination of a lump sum and a monthly benefit
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Underwriting DI
1. Medical
2. Avocation
3. Occupation
4. Financial
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Underwriting DI - Medical
More restrictive than life underwriting. There are many medical impairments that increase the change of disability without affecting mortality risk (i.e., back, vision, mental/nervous, arthritis, etc).
APS and specialist reports are of great importance.
30
Underwriting DI - Avocation
Increasing popularity of extreme sports means that the underwriter must be especially careful to request all of the relevant information in order to asses the disability risk accurately.
Due to the increased risk of a disabling injury these g/l are typically more conservative than those for other insurance products.
31
Underwriting DI - Occupation
Important factor in determining:
1. Whether the client is eligible for disability insurance
2. The type of product available
3. The amount of coverage
4. The rates to be charged.
32
Underwriting DI - Occupation - Example of Class system.
Class 5 represents the least occupational risk and Class 1 the greatest
Class 5 - High level of education and/or training. Includes most professional and white-collar executives (actuaries, engineers, lawyers, accountants)
Class 4 - White-collar office workers (sales managers, lab tech)
Class 3 - Non-hazardous occupations, not working full-time at a desk, spending time outside of an office environment to perform their duties (Plant managers, newspaper reports, insurance adjusters)
Class 2 - Skilled or semi-skilled light manual work for established business in non-hazardous industries (tradesman, mechanics, electricians, plumbers, chefs, nurses assistant).
Class 1 - Moderate to heavy physical work, unusual hazards, skilled or unskilled workers with light duties in stable companies and industries, (i.e, drywallers, caretakers, transport drivers, ambulance drivers, heavy equipment, and factor workers)
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Underwriting DI - Occupation - Class system, ways to get bumped up a class
Income level
Years of experience
Number of employees supervised.
34
Detailed insight into duties of an occupation are fundamental, information can include
1. Type of industry
2. Area of department where the individual works
3. Material handled
4. Processes engaged in
5. Amount of time travelling
6. Number of people supervised
7. % of time spend in each duty (with particular attention to physical duties)
8. Machines, vehicle and tools used.
35
Underwriting DI - Occupation - Unstable employment history requires full details on
```
Prior employment
Duties performed
Length of time spent at each job
Reasons for leaving
**those unhappy working may choice to claim though MSK or nervous/mental
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36
Underwriting DI - Financial
Insurable income is earned income that would cease during disability.
Insurers establish earned income limits that identify max benefits for various income levels. The goal is to replace about 75-80% of after tax income for lower income individuals, reducing the percentage to 35-50% for individuals in high tax brackets. The rising tax rate and probable rise in unearned income are only 2 of the many factors that influence a decreasing income replacement ratio as income rises.
37
Underwriting DI - Financial - Unearned income
Income that would continue if the insured became disabled. These include investments (stocks and bonds), trusts, dividends, interest, rentals, pensions, alimony, capital gain, and royalties.
Recognized as self-insurance.
This will be taken into account when determining an appropriate amount of disability coverage.
Most companies also include principal residence, assets for personal use, and total net worth of up to $5M before monthly benefit amount/benefit period reduction would be required.
38
Counter Offers - if it is determine that there is an increased morbidity risk for either medical or non-medical reason, a number of options are available including:
1. Premium rating (usually %)
2. Change of policy type (change from non-cancellable to cancelable or accident-only policy)
3. Benefit adjustment - increasing waiting period, decreasing benefit period, decreasing benefit amount, or deleting benefit riders
4. Exclusions - not paid on disabilities stemming from a specific medical condition or avocation.
39
In Canada - Contra proferentum
If the language in an exclusion rider can have more than 1 meaning or is unclear - this principle applied and the ambiguity will be resolved in favor of the insured.
In the US - the interpretation of insurance contracts is based on the principle of reasonable expectations.
40
Long Term Care
Provides payment for ongoing care of an individual who is unable to live independently, typically manifested by the inability to perform two or more activities of daily living, and/or the presence of cognitive impairment.
41
Products
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Base policy
Facility Care Benefit
Home Care Benefit
Policy Structure
Combination Plans
Contractual Exclusion Riders
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42
Long Term Care - Base Policy
Most LTC are guaranteed renewable - meaning that once the policy is in force, the insurance company cannot make any adjustments to the policy other than to the premium. If a change in premium is necessary, the change must occur for all policies issued within the same class, which is defined as a series, age or region.
43
LTC - Facility Care Benefit
Benefits are payable if the insured is confided in a LTC facility and receiving care based upon the loss of 2 or more ADLs/cognitive impairment.
The facility must be approved by the insurance company and be in the country.
44
LTC - Home Care Benefit
Benefits are payable if the insured is receiving home care based on the loss of 2 or more ADLs/cognitive impairment.
Home care is defined as a program of services provided in the insured's home by skilled caregivers. Some contracts allow for care by a family member.
45
LTC - Policy Structure
Benefit payment is based on a daily, weekly, or monthly fixed amount. In the event of claim, payments are made in 1 of 3 ways:
1. Indemnity method - set dollar amount, not based on the specific services received or the expenses incurred.
2. Expense incurred method - paid if the insured is eligible for benefit and if the claim is for eligible services. Coverage pays the lesser of the expense incurred or the dollar limit of the policy.
* * most common method**
3. Disability method - once the insured meets the benefit eligibility criteria, the full daily benefit is paid even if the insured is not receiving any LTC services.
- waiting periods are usually 0-180 days.
- benefit period usually range from 1 year to lifetime, w/ some offer a variety of choices in between.
46
LTC - Combination plans
Some combine facility and home care, and the claim is submitted for either type of care. Others will separate and provide different benefit amounts and benefit periods for the two types of care.
47
LTC - Contractual Exclusion Riders
Not paid if incurred as a result of the following:
1. participation in ware or hostile action of the armed forces of any country, whether such war is declare or undeclared, unless the insured is a victim of war or hostile action including terrorism.
2. While in the military/naval services
3. Self-inflicted injury or illness, while sane or insane
4. Committing or attempting to commit a felony or engage in illegal occupation.
5. Chronic alcoholism or chemical dependency unless dependency results from administration of drugs pursuant to tx by a physician.
6. Being legally intoxicated/under the influence of any narcotic unless such narcotic is taken under the advice of a physician
7. Nervous/mental disorders, without demonstrable organic cause (does not include Alzheimer's or senile dementia)
8. Any tx paid for by the government ( the plan can be second payer to government benefits)
48
LTC - Underwriting
1. Medical
2. Cognitive Status
3.Medical Requirements
4. Family hx
5. Avocation and Occupation
6. Financial
7 Counteroffers
49
LTC - Underwriting - Medical
Best predictors of LTC is functional status, which includes the ability to perform ADLs and IADLs.
Often there is use of cognitive screening as an assessment tool on older proposed insured's.
Other assessment of risk include - telephone (for those under age 65) or in-person assessments (over age 65) to evaluate medical, functional, and cognitive risk.
Complete physical could be required for those who have no seen a physician in over 2 years.
50
LTC - Underwriting - Medical - ADLs
1. Bathing
2. Continence
3. Dressing
4. Eating
5. Toileting
6. Transferring
51
LTC - Underwriting - Medical - ADLs - Bathing
The ability to wash - sponge, shower or tub, including task of getting into or out of the tub or shower or otherwise maintain adequate personal cleanliness, with or without the air of special
52
LTC - Underwriting - Medical - ADLs - Continence
The ability to voluntarily maintain control of bowel and bladder function, with or without the use of catheters or colostomy bags, incontinence pads or other artificial aids, and perform any other tasks associated with personal hygiene.
53
LTC - Underwriting - Medical - ADLs - Dressing
The ability to dress and undress, including putting on and taking off all items of clothing and any necessary braces, fasteners, artificial limbs, or surgical appliance usually worn.
54
LTC - Underwriting - Medical - ADLs - Eating
The ability to eat and drink, including feeding oneself by getting food into the body from a receptacle (such as plate or cup)
55
LTC - Underwriting - Medical - ADLs - Toileting
The ability to get to and from, and on and off, the toilet, and perform and maintain an adequate level of personal hygiene.
56
LTC - Underwriting - Medical - ADLs - Tranferring
The ability to move without assistance in or out of a bed, chair, or wheelchair, with or without the aid of equipement.
57
LTC - Underwriting - Medical - IADLs
```
Social survival skills that must be performed either for a household or an individual.
Telephone
Managing finances
Using transportation
Shopping
Laundry
Housework
Medication administration
Meal preparation
These can be a precursor to ADL loss.
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58
LTC - Underwriting - Medical - ADLs/IADLs coverage
A person who requires assistance or supervision for any one of the ADLs or 2 or more of the IADLS generally would not be considered eligible for coverage.
59
LTC - Underwriting - Medical - Conditions of concern
1. Osteoporosis (falls, frailty)
2. Cardiac disease
3. emphysema or COPD w/ continued smoking
4. Chronic Illness
5. Co-morbid condition (i.e, DM and heart disease)
6. Polypharmacy - multiple prescriptions
7. Tx protocols (e.g., current physical therapy)
8. Chronological ages vs physiological age (i.e., appearance vs actual attained age)
60
LTC - Underwriting - Medical - 4 factors that maintain an individuals personal independents
1. Working, either full or part time
2. Living with a spouse who is in good health, or living with other family members or friends
3. Participating in hobbies and activities outside the home
4. The ability to drive, travel, or visit without accompaniment or assistance.
61
LTC - Underwriting - Medical - Cognitive Status
Problems with attention, affect, memory, or loss of intellectual capacity that results in the need for personal supervision and/or assistance.
Signs of possible impairment include - changes in ordinary activities such as giving up driving or social isolation.
62
LTC - Underwriting - Medical - Tools to assess cognitive status
1. Delayed Word Recall (DWR) - screening short term memory loss. Recall as many as possible of 10 common nouns after a specific interval (i.e., 5 mins). Accuracy of the test is about 95%
2. The Enhanced Mental Skills Test (EMST) - focused on encoding and retrieval of information. Accuracy of 97%.
3. The Short Portable Mental Status Questionnaire (SPMSQ) - long term memory, practical survival, and mathematical ability.
4. Telephone or In-Person Interview - conducted by a nurse or trained professional and consists of medical or lifestyle questions. Will comment on observed mobility problem, status of the home environment, and presence in the home of any assistive devices (walker or cane).
63
LTC - Underwriting - Medical Requirements
Does not usually have any medical requirements. Reply on application and APS.
64
LTC - Underwriting - Family History
Consider family hx carefully. Look for Huntington's Disease or PKD.
65
LTC - Underwriting - Avocation and Occupation
Consequences of hobby/sport in relation to ADLs. Accidents can lead to paralysis or other impairments that can result in an inability to perform ADLs.
Same is considered for occupational duties - debilitating injury
66
LTC - Underwriting - Financial
Premiums should be affordable relative to income. Most insurers limit the amount of LTC insurance a person can have to a certain max.
History of bankruptcy causes concerns with respect to the client's ability to pay premiums and greater concern of policy lapsing - usually needs to be discharged for 1 year before consideration.
67
LTC - Underwriting - Counteroffers
Similar to those for disability insurance and include
1. Adding an extra premium rating
2. Increasing the waiting period
3. Decreasing the benefit period, decreasing the benefit amount
4. Some combination of the above.
Exclusion riders are not generally used.
68
Critical Illness
A product designed to help the insured recover financially from burdens that could present themselves while suffering from a critical illness. Funds can be used for any purpose including specialized medical treatment, rehab, expenses, payment of debts, covering day to day expenses, or making modification to the home following illness.
Once paid the policy is terminated.
Some offer partial benefits for conditions such as early-stage breast cancer and prostate cancer. In this case, the policy will remain in force but with reduced benefit amount.
Individuals who do not qualify for DI d/t income, occupation, or non-CI related hx may qualify for CI insurance.
Max issue age is 65.
69
CI - Products - Original CI covered
MI, coronary artery bypass surgery, stroke, and cancer.
70
CI - Products - Most common covered conditions
1. MI
2. Stroke
3. MS
4. Kidney failure
5. Blindness
6. Deafness
7. Coronary artery bypass surgery
8. Life-threatening cancer
9. Loss of limbs
10. Paralysis
Some companies cover over 40 conditions.
71
CI - Products - Base policy
Can be non-cancelable or guaranteed renewable.
Premium structures vary including 10 year increasing term, level premiums to age 75 and level premiums.
Proceeds generally become payable after 30 days of dx.
Policies usually include a 90 day "moratorium" for cancer means no benefit is paid for cancer dx w/in 90 days of issue/reinstatement.
72
CI - Products - General Exclusion Riders
Not payable for a covered condition incurred secondary to:
1. a self-inflicted injury while sane or insane
2. use of illegal or illicit drugs or substances, or misuse of medication obtained with or without prescription, or abuse of alcohol.
3. the commission of or the attempt to commit a criminal offence
4. an act of declared or undeclared war
73
CI - Products - Definition of the covered illness should include
1. a clear and precise description of the event for which a benefit is payable.
2. the evidence required for claims validation
3. any exclusions specific to the definition for which benefits would not be payable.
74
CI - Products - Business
Key employee amounts are based on multiple of the individuals compensation and there should be CI coverage on all key persons.
Buy-sell CI is based on the current FMC of the proposed insured's share plus conservative inflation and growth factors based on industry and management of the company.
75
CI - Underwriting
Increased risk of anti-selection d/t a lump some payment while the insured is still living. PAS are important.
1. Medical
2. Avocation and Occupation
3. Financial
4. Counteroffers
76
CI - Underwriting - Medical
Important factors - FHx (specifically age of onset), CVD, and some conditions that increase the risk of certain cancers.
CVD risk should look at: build, BP, lipids, blood sugar, and smoking.
Cancer risk - those with dysplastic nevi, benign breast or prostate conditions
77
CI - Underwriting - Avocations and Occupations
Car Racing, skydiving, scuba diving, and mountain climbing.
Assess the significance of the sport/hobby in relation to the policy's covered conditions. (i.e., paralysis, coma, burns, stroke, etc).
Cancer is a risk for occupations where worker are exposed to hazardous chemicals or airborne particles.
78
CI - Underwriting - Financial
Coverage amounts are based on each company's internal g/l and can take into consideration the income and the age of the individual and any o/s mortgage balances.
79
CI - Underwriting - Counteroffers
Can apply an extra rating or an exclusion rider. Exclusions can be applied for one or more of the covered conditions. The exclusion can be expanded to include any secondary dx that could result in claim under one of the remaining covered conditions.
80
Accelerated Death Benefits
An advance cash payment made by a life insurance company to an insured who has been determined to be terminally ill from a medical perspective. Designed to make the insured's life more comfortable during the final stages. Amount paid depends on the predicted life expectancy of the insured.
81
Accelerated Death Benefits - Products
Benefits are considered accelerated if they are paid to the insurer before her dies. Terminal illness is defined as death within 12-24 months.
Some companies do not charge for the option unless it is used.
Authorization may be required where there is collaterally assigned or has an irrevocable bene.
82
Accelerated Death Benefits - Underwriting
Exclusion endorsement that has been added to the coverage will also apply to the accelerated death benefits. I.e., exclusion for avocation - if terminally ill d/t a results of the particular avocation is would be excluded.
83
Definition - Accelerated Death Benefit
An advance cash payment of a life insurance death benefit paid by a life insurance company to an insured who is terminally ill.
84
Definition - ADL
Activities that people do independently every day including eating, bathing, dressing, transferring location, maintaining bowel and bladder continence, and toileting.
85
Definition - Any Occupation
A definition of total disability that defines Total Disability as the insured's inability, due to injury or sickness, to perform the important duties of any gainful occupation for which he/she is reasonably qualified. The insured must be under the regular care and attendance of a legally qualified medical practitioner.
86
Definition - Benefit Period
The max length of time an insured is eligible to collect benefits while on a disability claims.
87
Definition - Cognitive Impairment
Problems with attention, affect, memory, or other loss of intellectual capacity.
88
Definition -Collateral Assignment
The legal transfer of one's interest in a policy to a creditor as security for a debt. Under a collateral assignment, the creditor is first entitled to reimbursed out of policy proceeds for the amount owed. The beneficiary is then entitled to any excess of policy proceeds over the amount due the creditor in the event of the insured's death.
89
Definition - Conditionally Renewable
Policy type in which the company can change the premium, policy provisions, or cancel the policy as long as it does so for all insured's within a specific class who own the contract (referred to as "cancelable").
90
Definition - COntractual Exclusion Rider
Riders that are included in the wording of every policy of a particular type and outline situations where benefits would not be payable. e.g., no benefit would be payable if the claim resulted from the insured's participation in an illegal act.
91
Definition - Death Benefit
Life insurance proceeds payable upon proof of the insured's death.
92
Definition - Delayed Word Recall
A memory exercise designed to be used as a screening tool for short-term or primary memory loss. The rest requires a person to recall as many as possible of 10 common nouns after a specific interval. Can be used to assess the cognitive status of long term care insurance proposed insured's.
93
Definition -Exclusion Rider
A rider attached an insurance policy that excludes losses arising from certain conditions or avocations.
94
Definition - Facility Care
Health or personal care services required on a long-term basis in a facility, such as a nursing home.
95
Definition - Guaranteed Renewable
Policy type in which the insurance company cannot cancel the policy, change any provision, or add any restrictions as long as premiums are paid. The premiums cannot be changed for an individual policyholder but can be changed for all policies of that type or in the specific class.
96
Definition - Home care
Services provided in the insured's home by skilled caregivers; individuals who can assist with home management or other services to main tan individuals function ability, speech, occupation, and/or physical therapist.
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Definition - IADLs
Social survival skills that must be performed either one a household or individual basis. Activities related to independent living including managing finances, using the telephone, doing housework, preparing meals, shopping, using transportation, taking medication.
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Definition - Irrevocable Beneficiary
A beneficiary whose interest in an insurance policy cannot be revoked without that individual's written consent.
99
Definition - Key Person
An employee whose unique skill sets are considered so essential to a company that the employee would be difficult to replace if they were unable to work.
100
Definition - Legally competent
A person of legal age and sound mind who is recognized by law as being able to contract with others.
101
Definition - LTC facility
An institution licensed as a convalescent or skilled nursing facility, a convalescent hospital or unit thereof, a custodial care facility, retirement home, home for the aged or lodge.
102
Definition - Morbidity
The prevalence of disease or disability within a population
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Definition - Morbidity Risk
The risk of a particular individual contracting a disease, or other disabling condition, at any given time, when compared to other individuals of the same age and sex.
104
Definition - Mortality
The number of deaths that occur at a given time, in a given group, or from a given cause.
105
Definition - Mortality Risk
The risk of a particular individual dying, at any given time, compared to other individuals in the same age and sex.
106
Definition - Motivation
For the purpose of disability insurance can be defined as the desire of the individual to work. Some factors influence an individual's motivation to work can include their work ethic, type of occupation, personal situation (e.g., married, children), work environment, and income level.
107
Definition - Non-cancelable
A policy type in which, as along as premiums are paid on time, the company cannot cancel the policy, increase premiums, add restrictive riders, change policy provisions, or make any change to the policy.
108
Definition - Office Overhead Expense Insurance
A type of disability business insurance where the month benefit payable is contingent on the covered business expenses incurred by the business during each month of disability.
109
Definition - Own Occupation
A definition of total disability, which defines Total Disability as the insured's inability, due to injury or sickness, to perform the important duties of his/her own occupation. The insured must be under the regular care and attendance of a legally qualified medical practitioner.
110
Definition - Regular Occupation
A definition of total disability, which defines Total Disability as the insured's inability, due to injury or sickness, to perform the important duties of his/her own occupation. The insured is not working in any other reasonable occupation. The insured must be under the regular care and attendance of a legally qualified medical practitioner.
111
Definition - Short Portable Mental Status Questionnaire
Test used to assess cognitive status: memory, practical survival skills, and mathematical ability.
112
Definition - Unearned income
Income that would continue in the event of an insured's inability work such as income from investments, alimony, rental income, royalties, pension income, trust income, and capital gain.
113
Definition - Viatication
Purchasing insurance policies for cash from terminally ill policyholders.
114
Definition - Waiting Period
The amount of time that must elapse between the onset of a disability of loss of the ability to perform two or more ADLs, and when the proceeds of the policy become payable.
