Life Insurance Clauses Determine Your Coverage

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 circumstances.

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 via live 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 circumstances, 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, circumstances 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.

Article Sources
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  1. Insurance Information Institute. "A Guide to Insurance: What It Does and How It Works," Page 84.

  2. International Risk Management Institute. "Misstatement of Age Provision."

  3. Insurance Information Institute. "A Guide to Insurance: What It Does and How It Works," Page 101.

  4. Insurance Information Institute. "A Guide to Insurance: What It Does and How It Works," Page 121.

  5. Insurance Information Institute. "A Guide to Insurance: What It Does and How It Works," Page 122.

  6. International Risk Management Institute. "War Exclusion."

  7. International Risk Management Institute. "Aviation Hazard."

  8. Insurance Information Institute. "A Guide to Insurance: What It Does and How It Works," Page 98.

  9. Insurance Information Institute. "A Guide to Insurance: What It Does and How It Works," Page 117.