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UND 386 — Underwriting Life and Health Insurance

Course Type: Course Portal
Topics: Operations & Administration
Designations: PFLP, Underwriting Essentials
Language: English, Portuguese, Spanish


Overview

UND 386 introduces risk assessment principles applied to underwriting individual and group life and health insurance, including specialized policies and supplemental coverages.

Topics

  • Principles of Underwriting
  • The Underwriting Position
  • Legal Aspects of Underwriting Individual Policies
  • Underwriting Activities and Technology
  • Underwriting Individual Life Insurance: Medical Risk Factors
  • Underwriting Individual Life Insurance: Financial Risk Factors
  • Underwriting Individual Life Insurance: Personal Risk Factors
  • Underwriting Business Insurance, Specialized Policies, Replacements, and Supplemental Benefits
  • Underwriting Individual Health Insurance
  • Legal Aspects of Group Insurance Underwriting
  • Group Insurance Underwriting Activities
  • Risk Assessment for Group Insurance

Module 1: Introduction to Underwriting (Chapters 1–4)

Chapter 1: Principles of Underwriting

Risk Pooling and the Law of Large Numbers

Goal of Underwriting

Sound Underwriting

Mortality and Morbidity Gain

Persistency

Risk Assessment

Individual Underwriting

Group Underwriting

Underwriting Philosophy and Underwriting Guidelines

Equitable to the Insureds

Profitable to the Insurer

Deliverable by the Producer

Ethics in Underwriting

Chapter 2: The Underwriting Position

Underwriting Job Positions

Job Competencies of a Successful Underwriter

Knowledge Required for Underwriting

Skills and Abilities Required for Underwriting

Underwriter Training

Initial Training of an Underwriter

Ongoing Training of an Underwriter

Decision Options and Authority Levels of Underwriters

Authority to Approve Specified Coverage Limits

Authority to Rate or Decline Cases

Organization of the Underwriting Unit

Case Assignment System

Work Division System

Combination System

The Relationship of Underwriting to Other Insurance Functions

Outside Individuals and Entities

Underwriting Interactions within an Insurance Company

Chapter 3: Legal Aspects of Underwriting Individual Policies

Contract Law Issues That Affect Individual Underwriting

Creating a Valid Insurance Contract

Other Issues

Regulatory Compliance Issues That Affect Underwriting

Privacy Protection

Nondiscrimination

Medical Testing

Replacements

Money Laundering

Underwriting Standards

Handling Applications

Acting Promptly on Applications

Documenting Underwriting

Chapter 4: Underwriting Activities and Technology

Underwriting as Part of New Business

Field Underwriting

Teleunderwriting

Gathering Additional Information

The Numerical Rating System

Underwriting Manual

Making an Underwriting Decision

Policy Issue

Reinsurance Underwriting

Underwriting Technology

Data Mining

Business Rules Engines

Document Management Systems

Automated Workflow Systems

Module 2: Underwriting Individual Life and Health“ “Insurance (Chapters 5–9)

Chapter 5: Underwriting Individual Life Insurance: Medical Risk Factors

Sources of Medical Information

Application for Insurance

MIB Group Inc.

Physicians

Medical Tests

Inspection Reports

Pharmaceutical Databases

Assessing Medical Risk Factors

Medical Terminology

Impairments

Age

Sex

Build

Underwriting Substandard Risks

The Table Rating Method

The Flat Extra Premium Method

Combining Methods

Chapter 6: Underwriting Individual Life Insurance: Financial Risk Factors

Risks That Financial Underwriting Deters

Lapse

Antiselection

Speculation

Money Laundering

Sources of Financial Information

Application for Insurance

Producer

Inspection Report

Tax Documents

Financial Questionnaire

Financial Statements

Financial Worksheet

Assessing Need and Financial Risk Factors

Financial Status

Insurance in Force

Tools to Determine the Appropriate Amount of Life Insurance

Factor Tables

Percentage-of-Income Rule

Chapter 7: Underwriting Individual Life Insurance: Personal Risk Factors

Sources of Personal Information

Application for Insurance

Producer

Motor Vehicle Record

Inspection Report

Personal Questionnaires

Assessing Personal Risk Factors

Occupation

Driving History

Avocations

Tobacco Use

Alcohol Use

Substance Abuse

Physical Abuse

Criminal History

Civilian and Military Aviation

Military Status

International Residence and Travel

Immigrants and Citizens of Foreign Countries

Chapter 8: Underwriting Business Insurance, Specialized Policies, Replacements, and Supplemental Benefits

Underwriting Business Insurance

Financial Assessment of a Business

Business Valuation

Ability to Pay Premiums

Commercial Fraud

Buy-Sell Agreements

Key-Person Life Insurance

Employee Benefit Plans

Creditor Insurance

Underwriting Specialized Policies

Multilife Policies

Juvenile Insurance Policies

Policies Marketed through Nontraditional Distribution Systems

Underwriting Policy Replacements

Underwriting Supplemental Benefits

Waiver of Premium for Disability Benefit

Accidental Death Benefit

Family Benefit

Guaranteed Insurability Benefit

Chapter 9: Underwriting Individual Health Insurance

Sources of Information

Insurance Application and Agent’s Statement

Gathering Additional Information

Making an Underwriting Decision

Policy Modifications

Exclusions

Premium Rating Methods

Underwriting Factors

Age and Sex

Health History and Family History

Existing Insurance Coverage

Finances

Occupation

Avocations

Driving History

Alcohol and Substance Abuse

Foreign Travel or Residence

Foreign Citizenship

Underwriting Individual Disability Income (DI) Insurance

Antiselection

Health History

Occupation

Finances

Underwriting Individual Long-Term Care Insurance

Field Underwriting

Sources of Underwriting Information

Underwriting Factors

Module 3: Underwriting Group Life and Health Insurance (Chapters 10–12)

Chapter 10: Legal Aspects of Group Insurance Underwriting

The Group Insurance Contract

Negotiation of the Contract

Formation of the Contract

Regulatory Compliance Issues Affecting Group Insurance Underwriting

Eligible Groups

Policy Provisions and Policy Standards

Federal Regulatory Requirements

Chapter 11: Group Insurance Underwriting Activities

Information Sources

Request for Proposal

Proposal Attachments

Agent’s Statement

ERISA Documents

The Proposal for Insurance

The Master Application

Rating Methods

Manual Rating

Experience Rating

Blended Rating

Rating Approaches for Small Groups

Post-Issue Underwriting

Underwriting of Late Enrollees

Renewal Underwriting

Chapter 12: Risk Assessment for Group Insurance

The Proposed Group

Reason for the Group’s Existence

Type of Group

Size of the Group

Turnover of Group Membership

Participation by Group Members

Geographic Location

Nature of Business

Employee Classes

Age

Sex

Expected Persistency

Prior Coverage and Claim Experience

The Proposed Coverage

Plan of Insurance

Plan Administration

Mode of Commission Payment

Glossary

Index

Course Format

Course Portals include the following elements:

  • PDFs of the assigned course materials that can be printed or read online
  • The same interactive Practice Questions and Sample Exams currently found in LOMA Test Preparation Guides (TPGs)
  • Recommended study plans to help learners set goals and manage their study schedule
  • A variety of additional media-oriented features designed to enhance the study and review process

Exam Format

The UND 386 exam has 50 questions and a time limit of 2 hours. The exam is available in I*STAR, Prometric and Paper formats.

Study Materials

Life and Health Insurance Underwriting, Third Edition (LOMA, 2013)
ISBN 978-1-57974-417-5

Test Preparation Guide for UND 386 (LOMA, 2013)
ISBN 978-1-57974-416-8

Optional printed textbook (not included in bundled fee).

Life and Health Insurance Underwriting, Third Edition (LOMA, 2013)
ISBN 978-1-57974-415-1
PBD Order # 386-10-13

About Bundled Study Materials

Some courses ("bundled courses") include study materials with your enrollment. A growing list of English-language courses include access to bundled study materials.

For some of these courses, once you enroll, you gain access to the study materials through your My Learning page in LOMANET. These include the Course Portal courses and the Need 2 Know courses.

How to Enroll

Enrolling for Exams and Bundled Courses

LOMA requires proctored examinations for many of its professional designation courses. Exams are administered in LOMA member organizations and in independent testing locations. This section provides information about exam formats, enrollment procedures for both exams and bundled courses, and exam fees.

LOMA exams vary in length from two–three hours. Consult your Test Preparation Guide (TPG) or see the Designation Study Materials Roadmap for specific information about the length of your exam. As new or revised LOMA courses are released, the number of examination questions for some course examinations may change. If you enroll for a bundled course delivered through a LOMA Course Portal, the assigned study materials are included in your enrollment and are accessible via the Course Portal. Your enrollment process will depend on the type of examination you choose to take:

LOMA offers two options for exam enrollment:

  • Online enrollment via LOMANET, our Internet-based education administration system
  • Enrollment forms for paper exams, for use by independent students only, can be found here.

I*STAR and Paper Exam Center Directories for testing at third-party locations

Retakes

Students who fail exams must pay full dates to retake the exams, in most cases. However, bundled courses (those courses that include exam fees and study materials) have a reduced rate to retake the exam. See LOMA’s Education & Training Catalog for fees.