Life Insurance Clauses Determine Your Coverage (2024)

Most life insurance policies are multiple pages of hard to read or difficult to understand jargon and clauses. After looking through the document you may be wondering if you're covered and if so to what extent and in what circ*mstances.

Perhaps you ran across the incontestable clause, spendthrift clause or reinstatement clause and were completely confused on what these mean and if they apply to your coverage.

Key Takeaways

  • Understanding the clauses in your life insurance policy is important to understanding the extent of your coverage.
  • These key parts of your policy will ensure that your family is covered.
  • Grasping the clauses may give you a sense of security, a confidence that you're covered for any eventuality.

Life insurance is a wealth-generating tool. It eases your surviving family's financial burdens in your absence and may also provide periodic income. This temporary source of funds can take care of needs like mortgage payments, medical emergencies, and educational needs. However, to make sure that your life insurance policy will provide for your family when you can't, you need to understand the product you are buying.

Read on to get a better understanding of the clauses contained in most life insurance policies and find out what they mean to your coverage.

Beneficiary Clause

The main aim of life insurance is to transfer wealth to your heirs or to provide liquidity to your family. For that reason, you need to name a beneficiary who will receive the life insurance proceeds after your death. This beneficiary can be your spouse, children or relatives. You also can change the recipient anytime during the term of the policy.

However, if you haven't nominated a beneficiary, your family will be in for trouble when proceeds are paid out. The insurance money will go to your estate and the probate fees needed to settle your estate can dig a hole in your surviving family's savings.

Therefore, it is always practical to have a primary and a contingent (secondary) beneficiary in your policy. For example, you can choose your spouse as a primary beneficiary and your children as contingent beneficiaries. That way, in case your spouse also dies, your children will qualify for the insurance money.

You pass through various phases in your life: marriage, divorce, a new business, the birth of your child and more. Consequently, you need to periodically update your beneficiaries to adjust for those events.

Preference Beneficiary Clause

If you haven't nominated a beneficiary in your policy, your insurance company will disburse the life insurance money to the individuals listed in your policy. Presume that the order of priority in your policy is as follows:

  1. Your spouse
  2. Your children
  3. Your parents.

If the proceeds are distributed, they will go to the first living individual which, in most cases, will be your spouse.

Survivorship Clause

According to this clause, after your death, the policy proceeds will go to the beneficiary— for example, your wife—but only if the beneficiary survives you by a stated number of days.

Misstatement of Age Clause

Your age plays an important role in determining adequate life insurance coverage. The older you are, the higher the premium that is charged. Therefore, if you lie about your real age to reduce your premiums you may pay a huge price for it. In this situation, your insurer may choose to cancel your policy entirely, increase your premiums or adjust your policy amount.

Incontestable Clause

Your insurance company is entitled—usually during the first two years of the policy—to challenge the validity of your policy on the basis that you held back material information. If you are found guilty of concealment, your insurer will void the policy and return the premiums.

For instance, if you concealed the important fact that you are a heavy drinker to get a lower premium and your insurer finds out about this deception, it will not pay the claim on your death if it occurs during the first two years of the policy.

However, after the two-year period, your insurer cannot revoke the policy and has to pay the insurance money to your family without any opposition.

Despite this clause, there are exceptions where the insurance company will not have to pay the claim. Such instances include those of deliberate fraud, where your insurer may opt to contest your policy even after the two-year period.

The incontestable clause is one of the most important clauses of your life insurance policy.

Spendthrift Clause

If you have named your gambler son as a beneficiary, there is a chance that upon your death, your son's creditor may pounce on your life insurance proceeds. The spendthrift clause gives the insurer the right to hold back the proceeds and protect the funds from creditors. In this case, your insurer may prefer to pay the insurance money in installments to your son rather than as a lump sum.

Suicide Clause

The suicide clause in your policy specifies that the insurance company will not pay the benefit if the insured attempts to, or commits, suicide within a specified period from the beginning of the coverage. If the insured's death is a result of suicide, an insurer will only return previously paid premiums to the family.

If you or someone you know is suffering from depression or mental health issues, get help now. You are not alone. If you or a loved one is contemplating suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 or vialive chat. It’s available 24 hours a day, seven days a week, and provides free and confidential support.

War Clause

Normally, insurance companies do not compensate for death due to war or war-related developments. As per this clause, if you are a victim of war, your insurer will not pay out the benefits to you. In its place, your insurer will reimburse the previously paid premiums to your family.

Aviation Clause

According to this clause, your insurer will not pay compensation to your surviving family due to death due to air travel or while on an airplane. However, if you are an airline employee, you can buy aviation insurance by paying higher premiums.

Free Examination Period

If you are not satisfied with the terms and conditions of the policy, you can return the policy within a specified period after receiving it and your premiums will be fully refunded. Here, the time frame will vary depending on your insurer.

Grace Period Clause

There are times when you cannot pay the premiums as a result of financial troubles. In these circ*mstances, the "grace period" provision works in your favor. Your insurance company will provide a grace period within which you can make the necessary monetary arrangements and pay your premiums. During this time, you will continue to be covered by your insurance policy. If you still do not pay your premiums, your policy may be canceled.

If you die within the grace period, your insurer will pay the insurance money after subtracting the unpaid premium from that money.

Reinstatement Clause

If your policy has lapsed due to non-payment of premium, you can revive it by paying all the past outstanding premiums along with interest. However, you need to prove to your insurer that you continue to enjoy good health to qualify for this provision.

What are life insurance clauses?

Clauses are sections of the insurance policy. They define the insurer's responsibilities to the policyholder, circ*mstances under which claims will and maybe won't be paid out, as well as the policyholder's responsibilities. Sometimes called exclusions, these are designed to help the customer and the company.

Why should consumers care about clauses?

Being familiar with them will help the covered individual understand the product they are buying. Insurance policies are filled with jargon, and since the devil is in the details, understanding them will protect the consumer at critical times.

Bottom Line

If you haven't yet taken the time to understand your insurance policy, you should do so as soon as possible. Life insurance is an asset if you know how to make the most of it, but many choose not to bother with insurance jargon and instead blindly follow their insurance advisors and this choice can have serious consequences for you and your family. Your knowledge of the insurance clauses described above can give you an upper hand when purchasing life insurance and can help you ensure that your insurance coverage works in the best interests of your family.

Life Insurance Clauses Determine Your Coverage (2024)

FAQs

How is life insurance coverage determined? ›

Based on the value of your future earnings, a simple way to estimate this is to consider 30X your income between the ages of 18 and 40; 20X income for age 41-50; 15X income for age 51-60; and 10X income for age 61-65. After age 65, coverage is based on net worth instead of income.

How do you decide how much coverage you need? ›

To determine how much coverage you need, take an inventory of your belongings, especially items with higher value like jewelry, electronics and collectibles. Once you understand what you have and its value, you can decide if the predetermined limits on your policy offer adequate coverage.

What factors should be considered when determining the appropriate coverage amount? ›

Talk with your financial professional about how your age, family status, income level and liabilities impact your need level. Age is a determining factor for how much life insurance you could have. Typically, the younger you are, the lower your life insurance premium could be.

What is the clause in a life insurance policy? ›

Beneficiary Clause - This clause is fairly straightforward. If the insurer does not have anyone listed as a beneficiary in their contract, then the other people listed in the contract as dependents will receive the payout, such as children or a spouse. War Clause - This clause is completely up to the insurance company.

What are three methods used to determine the amount of life insurance needed? ›

There are many ways to determine a client's life insurance needs, and we'll cover four here: multiple-of-income approach, the DIME method, human life value approach, and capital needs analysis.

What are life insurance premiums determined by quizlet? ›

Avocation (hobby). Life insurance premiums are determined by several factors pertaining to the insured, such as age, occupation, and avocation (hobby). A beneficiary has just received a claim payment for a life insurance policy.

What are 3 factors that insurance companies look at to determine how much your insurance is going to cost? ›

Some factors that may affect your auto insurance premiums are your car, your driving habits, demographic factors and the coverages, limits and deductibles you choose. These factors may include things such as your age and your driving record.

How do insurance companies determine how much you should pay for your insurance coverage? ›

Insurance premiums vary based on the coverage and the person taking out the policy. Many variables factor into the amount that you'll pay, but the main considerations are the level of coverage that you'll receive and personal information such as age and personal information.

How to calculate insurance coverage ratio? ›

Life Insurance Coverage Ratio = (Net Worth + Death Benefits)/Annual salary or Annual income Your net worth is your total assets - total liabilities.

What is the rule of thumb for life insurance? ›

Most insurance companies say a reasonable amount for life insurance is at least 10 times the amount of annual salary. If you multiply an annual salary of $50,000 by 10, for instance, you'd opt for $500,000 in coverage. Some recommend adding an additional $100,000 in coverage per child above the 10x amount.

How much life insurance is enough? ›

2. Buy 10 times your income, plus $100,000 per child for college expenses. This formula adds another layer to the "10 times income" rule by including additional coverage for your child's education. College and other education expenses are an important component of your life insurance calculation if you have kids.

How do insurance companies decide what to cover? ›

Understanding how health insurance providers determine coverage is crucial in making informed decisions about your healthcare. Many factors go into determining what your health insurance policy covers, including the type of plan you have, your age, your medical history, and the type of treatment or medication you need.

What is a coverage clause? ›

Insurance Clause (Annotated) Editor's Note: This clause specifies the insurance coverage that one or both of the parties are required to maintain during the term of the agreement and allocates protection costs between them. It may be found in sale of goods as well as commercial services contracts.

What are the primary clauses in the insurance agreement? ›

The primary and noncontributory clause is a common provision in insurance contracts, particularly in liability insurance policies. It defines how and to what extent different insurance policies should interact when there are multiple providers covering the same risk or claim.

What are some common clauses and exclusions in life insurance contracts? ›

Important Clauses and Exclusions One Should be Aware of
  • Grace period. The grace period dictates that the policy will not be forfeited in case of missed premium payment. ...
  • Free Look period. The Free Look period is another clause that benefits the policy owner. ...
  • Revival clause. ...
  • Suicide exclusion clause.

How much is $100,000 in life insurance a month? ›

How much is $100,000 life insurance per month? Healthy adults who don't smoke usually pay less than $20 monthly for $100,000 term life insurance, which can last from 10-40 years. However, monthly rates increase to $200 or more for a permanent policy, which lasts your entire life.

How long do you have to have life insurance before you can use it? ›

How Long do You Have to Pay Into a Life Insurance Policy Before It Pays Out? Life insurance will pay out upon the death of the insured as soon as it is in force. This usually counts as the first premium payment.

What is the cash value of a $10,000 life insurance policy? ›

The $10,000 refers to the face value of the policy, otherwise known as the death benefit, and does not represent the cash value of life insurance policy. A $10,000 term life insurance policy has no cash value.

What kind of death does life insurance not cover? ›

Life insurance covers any type of death. But if you commit fraud or die under excluded circ*mstances — such as suicide within the first two years — your policy might not pay out. Tory Crowley. Previously, she worked directly with clients at Policygenius, advising nearly 3,000 of them on life insurance options.

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