[초단기 합격보장] 26년 생명보험시험 기본강의 제 2강(총 6강 완성)

Main ideas / lessons

1) New rules around premium nonpayment, contract termination, and reinstatement

The lecture explains changes related to civil settlement / collection-related abolition or adjustment and how insurers must handle notice and deadlines when premiums aren’t paid.

Key timing concept

• Count 14 days from “receipt” (reception), not “transmission.”
• Contract termination occurs the day after the maximum payment period ends.

Reinstatement (revival)

• Reinstatement restores the contract’s effectiveness to the state it had before termination.

General reinstatement rules

• Possible within 3 years from the termination date.
• Only if the policyholder has not already received the cancellation refund.

Incorrect-option traps

• “Simplified procedures + immediate reinstatement by simply paying” is treated as incorrect.
• Reinstatement still requires the same type of procedures as pre-contract medical disclosure (e.g., weight/height/smoking/drinking/surgery/health status) to prevent adverse selection.

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2) Two special types of reinstatement

The video focuses on:

1. Special reinstatement
2. Reinstatement due to unfair contract conversion

(1) Special reinstatement

When it applies

• Termination happens due to compulsory execution / collection procedures for delinquent taxes.

Even if the cancellation refund was paid

• Reinstatement can still be possible if:
  • The beneficiary obtains the policyholder’s consent, and
  • The beneficiary deposits the insurer-paid money back into the insurer using their own funds.

Notice + deadline process

• The company must notify the beneficiary within 7 days.
• The beneficiary must complete reinstatement within 15 days from receiving the notice.

Memory traps

• In the question narrative, “insured” should not appear (if it does, that option is likely wrong).
• Options like:
  • “the insured becomes the policyholder”
  • “the insured obtains consent” are incorrect.

(2) Unfair contract conversion reinstatement (unfair switching)

Scenario

• A planner persuades you to switch to a newer product, but the old policy is actually better in some aspects.

Unfair conversion conditions

• Existing and new contracts must have similar coverage for the insured.
• The coverage gap period between the two contracts is within 1 month.

Timing examples

• The new contract is entered within 1 month after the old contract ended, or
• The old contract ended within 1 month after the new contract was signed while the old was still in effect.

If recognized as unfair

• Reinstatement request for the existing contract can be made within 6 months from when it expired.
• Similarly, the later new contract can be cancelled within 6 months.

Important restriction

• Unfair conversion is recognized only when the existing and new contracts are with the same company.

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3) Changes to contract details

Change in subscription amount

• Called reduction: reducing coverage/benefits.
• The reduced portion is treated like a partial cancellation with a cancellation refund.
• Increasing coverage:
  • Not possible within an existing contract
  • Adding coverage generally requires a new contract

Changing contract holder (policyholder)

• Requires company approval.
• The company checks qualifications (lecture notes emphasize income).

Changing beneficiary

• Generally requires no special qualifications; changes can be made without company approval.
• But changing the beneficiary is possible only with the insured’s consent before the accident.
• The insured cannot be changed (exam emphasis).

Voluntary cancellation

• Request cancellation by phone or internet.
• Cancellation is performed by the contract holder who paid premiums.
• They can cancel at any time before the contract expires.
• The lecture also mentions cancellation can be possible without special requirements if the company determines a reason based on incorrect answers (as described in the lecture).

Withdrawal of insured’s written consent (special cancellation mechanism)

• In life insurance, the death payout requires an insured.
• The insured can withdraw consent (even after enrollment) when they no longer want to be insured.
• This is not retroactive removal; it’s allowed in preparation for a funeral (as described).
• When the insured withdraws written consent:
  • The cancellation benefit is paid to the policyholder (who paid the money).

Exam takeaway

• This is a “new fact” highlighted by the instructor: insured can cancel via written consent withdrawal.

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4) Other terms and conditions

Statute of limitations (claims/rights)

• If the wording involves money/return: rights exercised within 3 years
• For insurance premiums received by the company: rights up to 2 years

Memorization

• “gold/return” → 3 years
• “premium” / “ration(s)” → 2 years

Liability for damages

• Insurer is responsible for wrongs by their own employees / “their own people.”
• Not responsible for damages caused by brokers not employed by them.
• Also not responsible for accidents unrelated to the insurance purpose (example: breaking pottery in a home).

How insurance benefits are received

• Can receive benefits in installments instead of a lump sum.
• Installments vs lump sum effect (via comparison principle):
  • Installments → total received tends to increase (official interest added)
  • Lump sum → total received tends to decrease (discounting due to earlier payment)

Insurance age calculation (Korea)

• Uses international age concept:
  • Fractions ≥ 6 months are rounded up to 1 year
• Contract date acts like a “birthday”:
  • Age increases again on the corresponding contract date each year
• Exam emphasis: contract date becomes the day age increases.

Protection rule related to death benefit voidness before age 15

• For deaths under 15 with certain mental capacity conditions, the contract is void.
• Lecture emphasizes “generally known age of 15,” not “insurance age.”
• Conclusion: strong protection against exploiting death insurance risks until 15 full years.

Insurance policy loans

• General secured loans require collateral; death benefits and voluntarily paid premiums aren’t treated as collateral value.
• For insurance policy loans:
  • Surrender value serves as collateral
• No typical “repayment schedule/overdue” concept:
  • If loan interest isn’t paid, later termination deducts the interest from the cancellation refund
• Repayment can be made at any time.

Exam trap

• If an option says loans are possible within the range of paid premiums, it’s incorrect; it’s within surrender value.

Interpretation of terms and info materials

• Interpret terms fairly.
• If unclear/ambiguous → interpret in favor of the contracting party
• If “thick” detailed terms conflict with “thin” summary info:
  • Apply the more favorable interpretation to the contract holder first

Underwriting vs claims (important conceptual distinction)

• Underwriting: occurs at enrollment / enrollment screening
• Claims: occurs after an accident → investigation + payment
• Many incorrect options mix underwriting terminology into claims.

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5) Underwriting

Goals

• Select risks to determine premium and benefit limits.
• Prevent adverse selection / manage risk margin profits.

Terminology clarification

• Underwriting is “bottom writing” (signature-like idea), meaning the insurer’s contract screening/selection process.

Decision process and roles

• Underwriter makes the final decision.
• A suitability verification team may conduct onsite verification; they provide results but do not decide finally.

Assessment categories

• Environmental: occupation, driving, smoking
• Physical: age, gender, physique, medical history
• Moral: carelessness/negligence
• Financial: income (frequently asked)

Risk classification

• Standard body
  • generally safe / not particularly unhealthy
• Substandard body
  • higher risk than standard
  • Common exam types:
    • Somatic risks: present but increase over time
    • Homeostatic risks: risk doesn’t decrease
  • Use premium surcharge method
• Diminishing risk over time
  • Use payout reduction method (lower benefits for a period; then back to standard)
• Preferred / Superior body
  • reduced premiums and increased coverage limits

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6) Claims

When claims start

• After an accident:
  • claim reception, accident investigation, review of investigative authority, litigation-related tasks, handling provisional attachments, etc.

Claims handler qualifications

• Practical experience
• Ability to interpret/apply insurance laws, regulations, and contract terms
• Significant medical knowledge to discuss with doctors

Procedure question pattern

• Stages: preparation → progress → conclusion
• Most questions appear in the progress stage
• If the word “Confirm” appears, treat it as the “Proceed” step for solving

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7) Insurance sales ethics

Core principle

• Protect consumer rights/interests as highest priority.

Incorrect-option trap

• If it emphasizes company growth or designer growth, it’s wrong.

Stages

• Solicitation stage
  • explanatory documents provided
• Subscription stage
• Management stage
  • General insurance: at least once per year
  • Variable insurance: at least once per quarter (more frequent updates)

“Three basics to follow”

• Provide application form for policyholder’s records
• Deliver insurance terms and conditions and explain important details
• Guide and verify the handwritten signature

Proxy signature rule

• Proxy signatures are strictly prohibited, even between spouses/family.
• If violated → contract can be cancelled within 3 months.

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8) Insurance premium collection errors

When receiving premiums:

• Issue a receipt under the company name
• Irregular collection methods (e.g., daily collection) are not allowed
• Issuing a receipt under the planner’s name instead of company name is incorrect

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9) Insurance fraud: types, examples, penalties, and prevention

Two broad categories

• Soft fraud (“gentle” / lighter type)
  • Examples:
    • Inflating claims beyond actual damage
    • Claims like “fake patient” (claiming organs after full recovery)
    • Violating disclosure obligations with minor lies (e.g., slightly lying about weight at signup)
  • Often described as having no direct victim in the classic sense
• Hard fraud (planned/intentional malicious)
  • Example: intentionally causing an accident; arson or murder to harm the insured
  • Malicious and may lead to additional crimes/damage

Exam method

• Solve case studies by distinguishing soft vs hard fraud.

Penalties (Special Act on Prevention of Insurance Fraud)

• Imprisonment up to 10 years or fine up to 50 million won
• Compared with earlier Criminal Act penalties (up to 10 years or fine up to 20 million won), the special act is more severe
• Aggravation
  • Habitual offenders or fraud amount exceeding 500 million won → aggravated punishment
• 2024 amendment
  • Allows switching between imprisonment and fines

Exam warning (life insurance exams)

• Answer choices for penalties/fines are absent.
• If a fine/penalty appears as an option → it’s automatically not correct.

Historical notes

• First insurance fraud case in Korea: 1923
• First murder case motivated by insurance money: 1975 (as stated)

Adverse selection vs moral skepticism (terminology distinction)

Both involve information asymmetry:

• Adverse selection: asymmetry before contract (e.g., hiding prior surgery)
• Moral skepticism (moral hazard): asymmetry after contract (e.g., being less cautious after buying fire insurance)

Characteristics of fraud (exam clues)

• High-value policies or multiple policies relative to income
• Incorrect assumption traps:
  • Multiple different types with the same company is not automatically fraud
  • Duplicate medical indemnity insurance is not automatically fraud by itself (proportional compensation)
  • Fraud may involve non-related voluntary contracts

Impact and evolving nature

• Evidence is hard to find because claims can be made within 3 years
• Fraud is becoming more diversified/organized (not simplified/personalized)
• Increased fraud harms innocent policyholders:
  • premiums calculated by averages → burden shifts to good-faith policyholders → rising public costs
• Soft fraud may increase again due to survival pressures

Prevention bodies (memory framework)

• Investigation → National Police Agency (via Insurance Crime Investigation Council / “investigation” wording)
• Reporting → Financial Supervisory Service (English phrasing; “Insurance Crime Reporting Center” reports to it)
• Public relations/promotion → Life Insurance Association / Non-life Insurance Association
• Insurance companies use special investigation teams
• Financial Services Commission is not involved in fraud prevention activities (as stated)

Suicide prevention / respect for life (government vs insurance)

Exam focus

• Distinguish government efforts vs insurance-industry efforts.

Keyword rule

• If “Korea” appears → government effort
• If “insurance” appears below → insurance-industry effort

Government-level examples

• reporting, listening, speaking out
• gatekeepers analyze causes of death and support bereaved families

Insurance-industry examples mentioned

• SOS Life Line installed in Hangang-ri
• Youth suicide prevention apps:
  • “I’ll Listen to You Healing Talk Talk”
  • “Mind Nurturing”
  • “Emotion Shop”
• Support for suicide-risk group:
  • up to 1 million won per person for trauma/psychological treatment of bereaved families

Werther effect

• Fans imitate/follow celebrity suicides due to psychological conformity
• Lecture notes this as the answer concept when asked

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Speakers / sources

• Teacher Kim Tori (김토리) (primary lecturer; referenced throughout)
• Life Insurance Association (mentions underwriting certification program; exam question-setting)
• National Police Agency (investigation body in fraud prevention)
• Financial Supervisory Service (reporting body)
• Life Insurance Association / Non-life Insurance Association (public relations/promotion)
• Financial Services Commission (explicitly stated as not involved in fraud prevention)