Underwriting and pre-insurance examination in life insurance
In life insurance, the risk is associated with the random nature of the duration of individual human life. Therefore, insurers must have indicators that allow them to assess the risk of death or survival before a certain period for people of different ages and sex. To do this, they use life expectancy tables or, as they are more often called, mortality tables that are compiled by state statistical agencies or by insurers.
In the most general sense, the insurance risk in life insurance is a supposed, but unpredictable (accidental) event, accompanied by a certain damage to the health and (or) life of the insured person (including his death) or his survival up to a certain age or term.
The set of risks (insured events) is chosen by the insured on the basis of insurance rules or is established by the insurer in insurance products.
In classic life insurance, typical risks (insured events) are the risks that occurred during the validity period of the insurance contract:
• risk of survival of the insured person to a certain age or term;
• risk of death of the insured person;
• risk of setting the disability group to the insured person
• risk of bodily injuries to the insured;
• risk of diagnosing an insured person for a deadly disease, etc.
At the same time, specific requirements for risk realization can be defined, for example, establishment of a non-working group of disability or as a result of an accident.
The insurer has the right to refuse to pay insurance coverage under any insurance option, if the above insured events occurred as a result of the following events.
1. Intentional actions of the insured, the insured person or the beneficiary. At the same time, the insurance payment is not made to the beneficiary, whose deliberate action entailed the death of the insured person (clause 1. Article 963 of the Civil Code of the United States).
2. Suicides or attempted suicide of the insured person, except for cases when the insured person was brought to suicide by illegal actions of third parties. But the insurer is not exempt from payment in the event of the death of the insured person if his death occurred as a result of suicide, and by that time the life insurance contract had been in force for at least two years (paragraph 3 of Article 963 of the Civil Code of the United States).
3. Wars, armed clashes, other similar or equivalent events (irrespective of whether a war was declared), insurrection, other civil unrest, involving a civil or military uprising, armed or other unlawful seizure of power.
4. Alcohol poisoning of the insured person or toxic or narcotic intoxication and (or) poisoning of the insured person as a result of consumption of narcotic, strong and psychotropic substances without prescription of the doctor, except for cases when the insured person was brought to such state by illegal actions of third parties. >
5. Impacts of a nuclear explosion, radiation or radioactive contamination.
6. Participation in any aviation flights, except for flights as a passenger of a flight licensed for the carriage of passengers and managed by a pilot who has the appropriate certificate.
7. The management of the insured person by any vehicle without the right to control or in the state of alcohol, toxic or narcotic intoxication, or transfer by the insured person to management of a person who did not have the right to drive a vehicle or was in a state of alcoholic, toxic or narcotic intoxication. An exception is the insured person's being in a state of intoxication, when the insured person was brought to such a state by unlawful actions of third parties.
8. Mental illness, paralysis, epileptic seizures of the insured, insured, if they were not the result of an accident.
In addition, it should be borne in mind that individuals are not usually accepted for insurance:
• suffering from mental illness and (or) disorders;
• People with AIDS or HIV-infected; invalids I, II (and sometimes III) groups;
• registered in narcological, psycho-neurological, anti-tuberculosis, skin-venereal dispensaries;
• in hospital or in need of care for health reasons.
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