INSURANCE

How to Spot Unethical Insurance Sales Practices
Ginger Applegarth
Decision Center

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GLOSSARY

Insurance illustrations
A life insurance policy "illustration" is a set of projections, prepared by the actuarial department of the insurance company. It shows how your policy will perform over your lifetime, and includes financial projections for each year.
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hances are you don't spend a lot of time thinking about life insurance. For many people, thinking about death isn't the scary part - it's dealing with the insurance agent.

It turns out that consumers had very good reason to fear some agents and some companies in the 1980s and early '90s because of rampant fraud and abuse. But now it's the insurance companies who are running scared; the tables have turned and revenge is at hand.

Life insurance as an investment

In the late 1970s, insurance regulatory changes and high interest rates made companies develop new "investment-related" products such as universal life insurance and agents started to sell life insurance as an investment. Policyholders began to consider permanent life insurance products as part of their investment portfolios.

Additionally, the advent of computer software led some companies to aggressively distribute insurance illustration software, assuming interest rates of up to 13 percent or 14 percent throughout the policy's life. Other companies figured out a way to override the maximum assumed interest rate and plug in their own numbers of as much as 19 percent. If the software would not allow this override, the agent would pay to have a simple spreadsheet program of his own developed for use in marketing permanent life insurance policies.

The "vanishing" premium

With these assumed high interest rates, illustration premiums would seem to "vanish" in as little as four or five years. Normally, premiums vanish because the dividends (if it's a whole life policy) or interest (in the case of universal life) are enough to keep the policy in force by paying the premiums from the cash buildup. This is especially true for universal life insurance, because unlike whole life insurance (which has a fixed premium), a person could pay less than the recommended premium - sometimes even skipping a year. But what really happened was disastrous: As actual interest rates dropped, premiums did not vanish, but continued for up to a decade or longer.

Even worse, some policyholders found that their vanishing premiums suddenly "reappeared," and, in some cases, they were unable to pay them. Many agents aggressively marketed this vanishing premium (or "premium offset") method of paying for insurance. There is nothing wrong with the vanishing premium concept, provided that a reasonable interest rate of 6 percent to 8 percent is used in the illustration as the assumed dividend rate. Under this analysis, the premium might vanish after 15 years or so.

Churned policies

Additionally, some agents "churned" policies. This means they convinced policy holders with old life insurance policies containing large cash values to buy replacement policies, thereby earning the agent hefty commissions on the new sales. These new policies usually had a much higher death benefit, and the sales illustrations (using unrealistically high interest-rate assumptions) would show little or no additional premium payments required, because the cash values from the old policies were supposed to be enough to fully fund the new ones. It looked like a great deal to the policyholders - higher death benefits with little or no out-of-pocket expense - but those new commissions and other new policy expenses took a big bite out of the built-up cash values, and of course interest rates dropped. The result? Many victims of churning were faced with unexpected, ongoing premium payments just to keep the policies in force. They had to pay up - and keep on paying - or let the policies lapse and lose the death benefit altogether.

There is no justification for churning policies. People started contacting their attorneys and attorneys started realizing there could be big money at stake - possibly a class action suit.

You could be affected if:

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You purchased a policy and then let it lapse.

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You cashed in one permanent life insurance policy and used the cash value to buy a new policy (churning). It should be kept in mind, however, that in some circumstances this actually was a better deal for the consumer.

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Your insurance illustration assumed that the premium would vanish and it used an unrealistic interest rate higher than 8 percent or 9 percent as the "best case scenario."

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You bought permanent insurance policies from 1979 through the mid-1990s. This could automatically qualify you for some restitution, even if you were not a victim of these practices.

How to find out if you are a victim:

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First, get out any documentation you might have on any permanent life insurance policy you've purchased since the late 1970s. The sales illustrations that you got from the agent at the time you bought the policy are very important.

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If you are part of a class action suit, you likely have already been notified or you will be notified when one is filed.

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In the meantime, call your life insurance company and ask to speak to someone in the legal department. They can tell you whether there is a class action lawsuit pending in your state. The legal aspects of these class action suits are complicated because insurance companies are regulated by the state. Some of these settlements are for policyholders within specific states.

If you are part of a suit and your situation was particularly egregious, you can opt out and seek restitution through another procedure. This is sometimes called the "alternate dispute resolution process," and it deals on a case-by-case basis with the sale of life insurance policies. You are only better off opting out of the class action suit if you can show fraud or egregious behavior by the life insurance agent.

When all is said and done, who are the winners?

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Life insurance agents. Unfortunately, the biggest winners are the agents who earned large commissions and who, for the most part, are now out of the life insurance business They either walked away on their own or they were terminated by their companies for their sales tactics.

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Some policyholders. With a company that is owned by stockholders, such as Equitable of Iowa, it's clear the policy owners will win and the stockholders will lose. But mutual insurance companies are owned by their policyholders, and most of the big companies being sued or that have settled are mutual companies - Prudential, Sun Life of Canada, John Hancock and Metropolitan Life.

The losers:

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Permanent life insurance policy owners who aren't part of the class action suit. Huge losses are being absorbed by their life insurance companies. The companies have to pay certain policyholders; if the other policyholders are owners, those settlements are coming out of their own future dividends or interest. Unfortunately, those permanent life insurance policies bought before 1980 are likely now owned by older people who are actually using their cash value and dividends to live on.

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The life insurance companies being sued and forced to settle. Many of them are settling just so that they can avoid further adverse publicity. Class action settlements and lawsuits are not good public relations and that shows up in the marketplace: Prudential individual life insurance sales are down for the first half of 1997.

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Ethical life insurance agents who put their policyholders' interests first. That is a shame, because many of them knew what was going on and tried to bring it to the attention of general agents and the company itself, to no avail. Their only consolation is that they did what was right at a time when it was easy to do wrong.

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The life insurance industry itself. Its reputation has been damaged, perhaps irreparably. It is hard to imagine that before the 1970s, the life insurance industry was extremely well-respected. That is certainly not the case today.

The sheer results in terms of restitution and company penalties are staggering:

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Prudential. Leads the pack with an agreement to pay $410 million to affected policyholders and more than $60 million in fines and other costs.

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John Hancock. Its recent class action settlement was $350 million and the "class" included 3.7 million life insurance policies sold between Jan. 1, 1979 and Dec. 31, 1996.

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Equitable of Iowa. Agreed to a $22 million settlement of a class action suit.

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Metropolitan Life. The first to settle, it paid about $70 million in restitution to policyholders and in fines.

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Sun Life of Canada. Agreed to pay $65 million to Canadian policyholders (up to 400,000 people) for premium offset policies sold between 1980 and 1995.

With these kinds of numbers at stake, it's not surprising there are more than 30 class action suits pending. Many industry analysts think this is just the tip of the iceberg. Many insurers are bracing themselves for lawsuits like these and are putting "pro-active" policies in place to deal with a lawsuit the moment it is filed.

The policyholders who are part of the class action lawsuits do not get big checks in the mail. They usually have a variety of options from which to choose, including: extra dividend or interest payments, a low-interest rate loan to pay off debt incurred by borrowing from the policies, the waiver of premiums on all future policies, and additional cash value put into policies.

Lessons learned

The only good that comes out of this debacle is that it forces life insurance agents to sell in a more ethical manner and it forces life insurance companies to supervise and train their agents better.

Supervision is the key because many of the companies being sued have said that they cannot control what the individual agent shows its prospective policyholders. Many companies now require that the sales illustrations be attached to the policy application.

Most of us do need life insurance of some kind and a good life insurance agent can be as important as a good financial planner. Some of the older life insurance companies have been around for more than a hundred years, and most sell insurance for what it is -protection against death, with a savings account built in (if you buy permanent insurance with cash values building up). Most life insurance agents are ethical and most life insurance companies are good ones, but a company cannot control what an agent does face-to-face with a prospective client.

Hopefully, the industry will redeem itself in the eyes of the public so that consumers can once again believe what they are being told when purchasing a policy.

Unfortunately, the biggest winners are the agents who earned large commissions and who, for the most part, are now out of the life insurance business.

It's not surprising there are more than 30 class action suits pending. Many industry analysts think this is just the tip of the iceberg.   green square
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Illustration by James O'Brien  Copyright 1998 Microsoft Corporation