Viatical Settlement Provider Data Inquiry
1This should indicate how long the policy had been in force.
2The answer should be given in months. The life expectancy of the policyholder means the average number of months that the insured was expected to live at the time of the settlement as determined by the viatical settlement provider, considering medical records and appropriate experiential data. If life expectancy was over 24 months state “24+”. If no determination of life expectancy was made, state “N/A.” If no life expectancy determination was made but policyholder has since died, insert date of policyholder’s death.
3As of the date of settlement, less any outstanding loan(s) against the policy.
4Refer to K.A.R. 40-2-20. Indicate amount of Accelerated Death Benefit available to policyholder at time of settlement, less any outstanding loan(s) against the policy. If none, state “None.”
5See footnote 4.
6Indicate amount of outstanding loans against the policy which was deducted from the settlement amount.