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What is Critical Illness Policy?

Critical illness insurance, otherwise known as critical illness cover or a dread disease policy, is an insurance product in which the insurer is contracted to typically make a lump sum cash payment if the policyholder is diagnosed with one of the specific illnesses on a predetermined list as part of an insurance policy .Critical illness Insurance is a living benefit that is paid to the insured in case Insured suffers from Critical illness.

Critical illness policy guarantees the payment of a tax-free lump-sum benefit if the insured survives more than 30 days after the diagnosis of a critical illness or after a surgery covered by the contract.

Why you need Critical illness Policy?

More and more Canadians are afflicted by a critical illness at a younger and younger age. In addition to having to face a serious illness, several important costs related to medical treatments remain uncovered by provincial health insurance plans.

    Some of the shocking statistics for Critical illness are revealed as under:
  • 1 Canadian out of four will develop heart disease during their lifetime.
  • 1 person out of two who is a heart attack victim is under 65 years of age.
  • 1 person out of three will develop some form of cancer during their lifetime.
  • 1 woman out of nine will develop breast cancer during her lifetime.
  • Every 750,000 persons in Canada could suffer from Alzheimer's disease between now and the year 2031.

What can be main protection focus for Critical illness?

Critical illness are intended for individuals who wish to protect themselves from the financial worries resulting from a critical illness, in order to maintain their quality of life and financial security. It is paid during the lifetime of the insured and can be used for the following:

  • To obtain home nursing care.
  • To pay the medical expenses for specialized treatments here and abroad.
  • To reduce their financial obligations (mortgage, personal debts, etc.)
  • Replace the income of the ill parent
  • Enable the spouse to take a leave without pay to be by your client's side.
  • To take early retirement.
  • Provide for child care
  • To make investments for future income
  • Adapt the home or purchase specialized appliances

What are the Pros and Cons of Critical illness Policy?
    Pros:
  • Tax-free lump sum: after 30 days of being diagnosed with a life-threatening illness, a critical illness insurance policy pays out a tax-free lump sum;
  • Family protection: Critical illness insurance is essential for those that have a mortgage to pay or young family to protect;
  • Covers up to 26 diseases: While the specifics of what is covered by critical illness cover vary between policies, all should cover: cancer, heart attacks, coronary artery bypass and strokes;
  • Peace-of-mind: While nobody expects to get a life-threatening illness, critical illness cover provides a family with peace-of-mind as to God forbid in the case family is struck with family member with Critical illness all they have to worry about is health conditions and recovery and not about finances.
  • Guaranteed premiums: While renewable premiums tend to be cheaper to begin with, however it becomes expensive to renew. It is advisable to get longer term like till age 65 or till age 75 where premiums don't change.
  • Cons:
  • Additional costs: Those struggling to pay general living expenses may find that it is difficult to afford critical illness insurance, life insurance and other forms of cover deemed essential.
  • Exclusion of certain diseases: Most policies no longer cover lymphoma or Kaposi's sarcoma in the presence of HIV, non-invasive skin cancers, and less advanced cases of prostate cancer. Always check critical illness insurance cover policies for specific details as they can vary considerably between policy providers.
  • Existing medical conditions: Should certain close family members have a high incidence of a specific life-threatening illness, premiums may be increased or the disease excluded. Those that have already suffered a life-threatening illness will find that it is excluded from the policy.
  • Under-writing process: Once application for CI is completed and submitted for processing, underwriters during process of underwriting a critical illness insurance policy may put exclusions to pre-existing conditions.
What is the process to make claim for Critical illness Policy?

You can make a claim as soon as a physician, licensed to practice medicine in Canada and specializing in your particular illness, diagnoses you with a critical illness or disease covered by your policy. The same needs to be submit to the Insurance Company along with your claim.

Generally, a lump-sum benefit payment will be made to you 30 days after the claim has been approved. There are no restrictions on how you use the money. Once your claim is paid, your critical illness insurance policy ceases. .

Is critical illness insurance same as disability insurance?

No. Disability insurance, also known as "income replacement" insurance, provides a monthly income replacement benefit if you become disabled and can no longer perform the normal duties of your work. Generally, the benefit is limited to a percentage of your regular income and ceases once you earn an income or you no longer meet the definition of disability in the contract.

Unlike critical illness insurance which provides the full policy benefit in a lump sum payment on diagnosis of a critical illness, long-term disability policies may have a waiting period from the onset of disability. Also critical illness benefits, long-term disability benefits may be affected by other income you receive or by your full recovery from the illness.

What illness is usually covered under Critical illness?

The illness covered differs from company to company so it is always advisable to check which company covers what and how much. Mostly the following illness will be covered:

  • Alzheimer's Disease
  • Loss of Independent Existence
  • Aortic Surgery
  • Loss of Limbs
  • Aplastic Anemia
  • Loss of Speech
  • Bacterial Meningitis
  • Mojar Oragan Failure on Waiting List
  • Benign Brain Tumour
  • Major Organ Transplant
  • Blindness
  • Motor Neuron Disease
  • Cancer(Life-threatening)
  • Multiple Sclerosis
  • Coma
  • Occupational HIV Infection
  • Coronary Artery Bypass Surgery
  • Paralysis
  • Deafnesss
  • Parkinson's Disease
  • Heart Attack
  • Severe Burns
  • Heart Valve REplacement
  • Stroke(Cerebrovascular Accident)
  • Kidney Failure
  • Under what condition the benefit on Critical illness policy will not be paid?

    - No benefit will be paid in the following insured,s condition:

    • Results from self-inflicted injuries or an attempt to commit suicide, whether or not the insured was conscious of his or her actions;
    • Results from voluntary absorption of medications, drugs, steroids, narcotics or toxic substances,unless taken as prescribed by a licensed physician;
    • Results from wars, armed conflicts, riots, insurrections or public demonstrations, regardless of whether or not the insured was an active participant;
    • Results from service in the armed forces, engaged in surveillance, training, peacekeeping duties or war, whether war be declared or not;
    • Occurs while committing, attempting to commit or provoking a criminal offence;
    • Occurs while driving a vehicle under the influence of narcotics or with a proportion of alcohol in the insured's blood higher than 80 milligrams per 100 millilitres of blood.