Critical Illness Insurance

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Critical Illness Insurance
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Critical Illness Presentation

• Introduction
• Facts
• Advantages of Group Critical Illness Insurance
• Benefits to Employee
• Plan Highlights

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Introduction

• Originated in South Africa
• 70 of new policies sold in UK have this benefit
• 50 of UK companies offer this product
• Sold as a rider to a Life policy
• Various diseases (most include heart attack,
  cancer stroke)

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Facts

• 1 in 4 will contract heart disease
• 70 of open-heart operations are for coronary
  bypasses
• 1 in 20 run the risk of having a stroke before
  age 70
• 1 in 3 will develop some form of life-threatening
  cancer
• 125,000 new cancer cases each year

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Advantages

• It is a living benefit.
• Claim adjudication is a simple one-time process.
• It is not based on inability to work or on the
  severity of the condition.
• Full recovery does not affect payment.
• Non-taxable benefit.

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Benefits to Employee

• It replaces reduced earnings
• Help pay off existing debts / pay off mortgage
• It can be used to pay off personal debts
• It provides cash for alternative medical
  treatment / costs.
• Home maintenance / renovations
• It provides funds for a holiday to recuperate
• Benefits are non-taxable.

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Plan Highlights

• Eligibility
• All employees and their spouses, under the age of
  65.
• Once individual coverage is in place, coverage
  may be continued to age 70, provided employee
  remains actively employed.
• Retirees under age 65 are also eligible.

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Plan Highlights

• Participation is Optional
• Amount of Insurance
• Option to purchase in units of 10,000 up to a
  maximum of 150,000
• Guarantee Issue Limit
• Up to 50,000

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Plan Highlights

• 21 Covered Illnesses
• Heart Attack
• Coronary Artery Bypass Surgery
• Stroke
• Life Threatening Cancer
• Parkinsons Disease
• Alzheimers Disease
• Multiple Sclerosis
• Kidney Failure
• Paralysis
• Blindness
• Deafness

• Loss of Speech
• Benign Brain Tumour
• Coma
• Major Burns
• Major Organ Transplant
• Major Organ Failure Requiring Transplant
• Motor Neuron Disease
• Aorta Surgery
• Heart Valve Replacement
• Loss of Limbs

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Plan Highlights

• Pre-Existing Condition
• the existence of symptoms which would cause an
  ordinarily prudent person to seek diagnosis, care
  or treatment within twelve (12) months period
  preceding the Insured Persons effective date of
  coverage, or
• an illness or condition for which the Insured
  Person, during twelve (12) months prior to the
  effective date of his coverage incurred medical
  expenses, received medical treatment, took
  prescribed drugs or medicine or consulted a
  physician.
• If you apply for coverage within 31 days of the
  plan effective date or
• within 31 days of your hire date, the
  pre-existing condition will be
• waived.

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Plan Highlights

• Survival Period
• Payment of benefit is subject to the insured
  persons surviving the survival period.
• Survival Period means thirty (30) days following
  the date of Diagnosis or the date of surgery for
  Coronary Artery Bypass Surgery and Major Organ
  Transplant.

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Plan Highlights

• Life Threatening Cancer
• There shall be no coverage under this definition
  if within 90 days following the Insured Persons
  effective date
• a diagnosis of cancer is made or
• any symptoms or medical problems commenced and
  initiated investigations leading to the
  subsequent diagnosis of any cancer.

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Plan Highlights

• Premium Payment
• Premiums are paid through payroll deductions
• Beneficiary
• Payable to the Insured Person.

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Plan Highlights

• Application Process Guarantee Issue Limit
• Complete Enrollment Card
• Submit to Human Resources
• Coverage is effective 1st of the month following
  receipt of signed Enrollment Card

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Plan Highlights

• Application Process Excess of 50,000
• Complete Enrollment Card Application (includes
  medical questionnaire)
• Submit Application to AXA
• Confirmation of approval / decline from AXA
  within 30 days
• Coverage is effective 1st of the month following
  approval by AXA

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Rates

• Monthly Rates per 10,000

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Premium Examples

• Example 1

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Premium Examples

• Example 2

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Premium Examples

• Example 3

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Frequently Asked Questions

• Am I covered while my medical information is
  reviewed?
• Until AXA confirms acceptance, any applicant who
  has applied for an amount greater than the
  guaranteed benefit of 50,000 will be insured for
  the guarantee amount on an interim basis, so
  payroll deductions should be set-up accordingly.

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Frequently Asked Questions

• When does coverage take effect?
• If you have applied for coverage in excess of
  50,000 and submitted the necessary medical
  evidence, coverage will take effect on the 1st
  of the month following confirmation of acceptance
  by AXA. If you have applied for an amount up to
  the guaranteed benefits amount of 50,000,
  coverage shall take effect on the 1st of the
  month following receipt of your application by
  your employer.

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Frequently Asked Questions

• How do I make changes to my insurance?
• To increase your amount of insurance, a new
  application must be completed and submitted to
  AXA for consideration. Contact the Human
  Resources Department for all other changes.

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Frequently Asked Questions

• How do I qualify for the reduced non-smoker
  rates?
• In order to qualify for the reduced non-smoker
  rates you must not have used smoking materials
  (cigarettes, cigars, pipe, etc.) or used tobacco
  in any other form within the last 12 months.

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Frequently Asked Questions

• Does a Critical Illness payment affect my benefit
  entitlement under Long Term Disability (LTD)?
• Your LTD benefits are not affected when you
  receive a lump sum payment under this plan.

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Frequently Asked Questions

• Does my coverage remain in force if I have
  received a lump sum payment under the plan?
• No, coverage ceases on the date your lump sum
  payment has been made.

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Questions

• ?

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Thank you