New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter III - Policy and Certificate Provisions
Subchapter A - Life, Accident and Health Insurance
Part 41 - Accelerated Payment Of The Death Benefit Under A Life Insurance Policy
Section 41.7 - Actuarial requirements
Universal Citation: 11 NY Comp Codes Rules and Regs ยง 41.7
Current through Register Vol. 46, No. 39, September 25, 2024
(a) The statement of self-support required by Insurance Law section 4228(h) shall indicate that the cost of providing accelerated death benefits was considered in the demonstration of self-support.
(b) A nonforfeiture memorandum signed by a qualified actuary shall be submitted with the policy form filing. The memorandum shall include a discussion of any impact, both before and after acceleration, on nonforfeiture values due to the existence of the accelerated death benefit provision. If there is no impact, then the memorandum shall include an explanation as to why there is no impact.
(1) Policies and certificates or portions
thereof that are not subject to the exemption in Insurance Law section
4240(d)(3) shall be in compliance with Insurance Law section 4221(l).
(2) Policies and certificates or portions
thereof that are subject to the exemption in Insurance Law section 4240(d)(3)
shall be in compliance with Part 54 of this Title.
(c) Reserves.
(1) General.
(i) When benefits are provided through the
acceleration of death benefits under group or individual life policies or
riders to such policies, policy reserves shall be determined in accordance with
Insurance Law sections 4217 and 4517. A ll valuation assumptions used in
constructing the reserves shall be determined as appropriate for statutory
valuation purposes by the qualified actuary. Mortality tables and interest
currently recognized for life insurance reserves under Insurance Law sections
4217 and 4517 may be used as well as appropriate assumptions for the other
provisions incorporated in the policy. The qualified actuary should ascertain
that the reserves in the aggregate are sufficient to cover:
(a) policies upon which no claim has yet
arisen; and
(b) policies upon which
a claim has arisen.
(ii)
A reserve formula should consider all relevant factors.
(iii) Approximations to develop a single
decrement table which utilize all relevant factors except for voluntary
termination rates are acceptable for policies subject to this subdivision
provided it can be demonstrated that the approximations used produce
essentially similar reserves, conservative reserves, or negligible reserves.
The calculations should take into account the reduction in life insurance
benefits due to prior acceleration. In no event shall the reserves for these
benefits and the life insurance benefit when taken together be less than the
reserves for the life insurance benefit assuming no accelerated benefit
feature. In the development and calculation of reserves for policies subject to
this Part, due regard shall be given to the applicable policy provisions,
marketing methods, administrative procedures and all other considerations which
have an impact on projected claims costs, including, but not limited to the
following:
(a) definition of qualifying
events;
(b) premium waiver
provision;
(c) marketing
method;
(d) underwriting
procedures;
(e) maximum
benefit;
(f) optional nature of
benefit; and
(g) guaranteed
insurability options.
(2) Nondiscounted accelerated benefit.
(i) Prior to an accelerated benefit claim,
the use of an additional premium and the loss of interest by the insurer in
prepaying the benefit suggests a reserve in addition to the basic reserve. In
the case of traditional life insurance, the basic mortality table may be
conservative enough to cover any additional benefit. The qualified actuary
should test the need for any additional reserves. In the case of universal life
insurance, adding any additional premium and subtracting any additional cost
factors may be considered when calculating the reserves.
(ii) After an accelerated death benefit claim
has arisen:
(a) A liability for accelerated
death benefits payable in a lump sum should be set up until paid.
(b) A liability for accelerated death
benefits payable in installments shall be equal to the present value of
remaining installment payments discounted at an appropriate valuation interest
rate but not discounted for mortality.
(c) If the reserve (whether expressed as the
full reserve or in parts as a standard reserve and a substandard extra reserve)
for any remaining death benefit not accelerated for such policy is not
specifically based on an appropriate valuation interest rate and a substandard
mortality table reflecting the policy life expectancy, the qualified actuary
shall make appropriate tests to determine whether the aggregate reserves for
all policies make sufficient provision for all policies, including those on
which accelerated death benefit claims have been approved, in light of the
aggregate amount of remaining death benefits under all policies upon which a
portion has been accelerated, the total insurance in force and reserves,
distribution of risk and conservatism in the valuation mortality table used
compared to the insurer's own mortality experience.
(3) Discounted accelerated death
benefit.
(i) Prior to an accelerated benefit
claim, the basic life insurance reserves based on section
4217 or
4517 of the
Insurance Law are generally considered good and sufficient in the aggregate.
However, due to the nature of a particular insurer's block of business or
supporting assets, the qualified actuary may need to test for adequacy and, if
necessary, set up additional reserves.
(ii) After an accelerated death benefit claim
has arisen, the liability and reserve shall be as stated in subparagraph
(2)(ii) of this subdivision.
(4) Lien approach with an interest accrual.
(i) Prior to an accelerated benefit claim,
minimum statutory reserves for policies containing interest accrual provisions
are the same as for policies with identical death benefits that do not contain
interest accrued lien provisions, provided that the method of determining the
interest rate to be charged, as specified in the policy provisions and
actuarial memorandum, results in an interest rate at least equal to the
valuation interest rate applicable to the policy. If such is not the case, an
extra reserve may be necessary on such policies, if it is determined that the
aggregate reserves are not good and sufficient.
(ii) After a claim for an accelerated benefit
is approved and the lien effected, if the policy reserve (whether expressed as
the full reserve or in parts as a standard reserve and a substandard extra
reserve) held for the full amount of death benefit is not specifically
determined based upon a substandard mortality table reflecting the policy life
expectancy, the qualified actuary shall make appropriate tests to determine
whether the aggregate reserves for all policies make sufficient provision for
all policies, including those on which accelerated death benefit claims have
been approved, in light of the aggregate amount of remaining death benefits
under all policies upon which a portion has been accelerated, the total
insurance in force and reserves, distribution of risk and conservatism in the
valuation mortality table used compared to the insurer's own mortality
experience. Since a policy lien is considered an asset, the policy reserve
should be at least equal to the policy lien; otherwise, any excess of policy
lien over policy reserve shall be considered as a nonadmitted asset.
(5) The additional morbidity risk
assumed by the insurer in providing the benefit suggests a reserve should be
held in addition to the basic reserve prior to an actual claim for policies
that provide for periodic payments for long-term care services or accelerated
death benefit payments to an individual who is chronically ill. The qualified
actuary shall test the need for any additional reserves if the policies that
accelerate the death benefit to pay for long-term care services or accelerated
death benefit payments to an individual who is chronically ill are a material
portion of the insurer's life policies.
(6) After a claim for an accelerated benefit
payable in installments has arisen, a reserve liability equal to the actuarial
present value of remaining installment payments, using an appropriate valuation
interest rate, mortality and morbidity in accordance with section
4217 or
4517 of the
Insurance Law, shall be recognized. If the reserve (whether expressed as the
full reserve or in parts as a standard reserve and a substandard extra reserve)
for any remaining death benefit not accelerated for such policy is not
specifically based on an appropriate valuation interest rate and a substandard
mortality table reflecting the policy life expectancy, the qualified actuary
shall make appropriate tests to determine whether the aggregate reserves for
all policies make sufficient provision for all policies, including those on
which accelerated death benefit claims have been approved, in light of the
aggregate amount of remaining death benefits under all policies upon which a
portion has been accelerated, the total insurance inforce and reserves,
distribution of risk and conservatism in the valuation mortality table used
compared to the insurer's own mortality experience.
Disclaimer: These regulations may not be the most recent version. New York may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.