FAQ on Critical Illness Insurance
1. What happens if I do not survive the 30 day waiting period?
The premiums that you pay into the policy will be refunded to your estate. Some insurance companies offer this feature as a standard component of their policies, while others offer it as an optional feature.
2. What if I never make a claim?
Most policies offer a "return of premium" feature whereby you will get most or all of your premiums refunded to you after a specified period of time, usually 10 to 15 years.
3. I have long-term disability coverage through my employer. Is Critical Illness insurance necessary?
Disability coverage will provide you with income during your disability after a specified waiting period. The payment is calculated as a percentage of your after tax income and is only paid for a limited time, regardless of your needs or expenses. It does not compare to the substantial tax free cash you will receive from critical illness insurance.
4. I have life insurance – why do I need this?
Life insurance pays a benefit when you die. Critical illness insurance is about you surviving a serious illness and recovering. It will provide you with money to use for treatment, recovery, debts, rehabilitation, or any way you see fit.
5. Is this coverage based on my income or my ability to work?
The amount of coverage you can buy needs to be reasonable for your circumstances, but is not dependent on your ability to work.
6. What if I die in an accident before making a claim?
Most policies will refund all of your premiums to your estate.
7. What if I need coronary angioplasty? Is this a covered condition?
Many policies do not cover coronary angioplasty as a full benefit, but some offer a "partial benefit" in the event of coronary angioplasty, and early stage prostate and breast cancer.
8. Does it matter if I am a smoker?
As with other types of insurance (life, disability), smokers pay higher premiums than non-smokers.
9. My mother had a heart attack. Can I still get Critial Illness insurance?
Most likely. Family medical history is an important component of the qualification processs, however, unless 2 or more immediate family members (mother, father, sister, brother) have had the same condition or illness, you should still qualify for critical illness insurance. The insurance company may charge a higher premium or exclude certain illnesses based on your family history.
10. Will my premiums ever increase?
This depends on the policy you buy. Policies can have guaranteed premiums to either age 75 or life, or there are 10 or 20 year renewable programs, where the premiums increase every 10 or 20 years. Your ZLC Advisor will help you to determine which type of policy is best for you.
11. Does it matter how old I am when I apply?
Typically, coverage is available from ages 0 to 65. The younger you are, the lower the cost, and less medical evidence is needed.
12. Do I have to have medical tests done?
The amount of medical evidence you have to provide depends on your age and the how much coverage you want. Most plans require a paramedical, blood and urine test.
13. Why should I buy this now when I’m young and healthy?
Critical Illness insurance providers indicate that guaranteed premiums may not be around for much longer and some features may be removed from typical plans all together. Given that premiums also increase with age, it makes sense to buy coverage now while you can still lock in today's lower guaranteed rates. Besides, our health and that of our family, can change quickly, so it is important to apply while you are still eligible.
14. Do I have to spend the cash on my health care?
The critical illness benefit is tax free money that can be used for any purpose.
15. What if I want to go to a private clinic or to the United States for treatment?
Freedom of choice is one of the major benefits of this plan. Critical illness insurance provides you with the cash to make these options available to you. This gives you control over your treatment, recovery, and rehabilitation.
16. Aren’t all my medical expenses covered by the government?
Some new drugs and alternative treatments are not covered by our provincial health care system, and there are certainly many “indirect” costs associated with having a critical illness. Modifications to your home, loss of income, travel expenses, and home care are examples of expenses that may not be covered by the government.
17. What if something happens to me when I’m away from home?
Typically, you are covered as long as the condition is diagnosed by a physician licensed to practice in Canada or the United States. You are also covered if your diagnosis is made in another jurisdiction, subject to certain conditions outlined in the policy contract.
18. What if I need help finding the right treatment?
Most Critical Illness insurance plans offer a service called Best Doctors which will help you locate the top professionals and medical facilities relating to your particular illness or condition.
19. What if I need money before the 30 day waiting period?
Some plans offer a Recovery Benefit which is an advance of up to $10,000, paid to you as soon as your claim is received.
20. If I decide to cancel my coverage, can I get my money back?
Most policies offer a “return of premium” feature whereby you get most or all of your premiums refunded to you after a specified period of time, usually 10 to 15 years.
21. What if I’m off work on disability and can’t afford my payments?
Most plans offer an optional waiver of premium feature that will cover the cost of your premiums while you are disabled.
