Insurance Company's Critical Illness policies help fill the financial gaps not covered by traditional health, disability, life and accident insurance. If a life-threatening illness occurs, the Critical Illness Insurance may pay the insured a benefit to help protect his or her quality of life.

A Critical Illness Insurance policy maybe an individual or group health policy that pays a lump sum benefit upon diagnosis of one of the covered illnesses as defined in the policy. A partial benefit maybe also paid for a specific illness or specified surgical treatment as defined in the policy.  

Critical Illness Insurance provides you with:

• "Cash up front" paid in a lump sum
• Financial freedom and flexibility
• An ability to plan for the unexpected
• Money when you need it most
• Immediate benefit payment for you to have a higher quality of life

How should you compare Critical Illness Insurance products when deciding what to buy? The following checklist summarizes the some important features for you to consider. To learn more about our Critical Illness Insurance, click on any of the topics below:

• Issue Ages & Benefit Information
• Covered Illnesses
• Partial Benefits
• Return of Premium
• Premiums & Renewability
• Available Riders
• Underwriting Process
• Elimination Period
• Payment Options & Modes
• Survival Period

Issue Ages & Benefit Information - Critical Illness Insurance policies maybe available to individuals or groups for issue ages 18-69. this can vary by plan, state and carrier. Some insurance companies have maximum issue ages of 65, 70 or 75.

The policy benefit amount maybe paid in a lump sum benefit. Such a benefit enables you to have a higher quality of life and provides the opportunity to live independently. Critical Illness Insurance gives you choices because your money can be used for anything you please. You may want to use the money to:

• Pay off debts.
• Supplement lost income.
• Consider Alternative treatments.
• Arrange for childcare while recovering.
• Take a required trip.
• Maintain your quality of life.

Covered Illnesses - The Number and Types of Covered Illnesses may vary in covering up to six (6) illnesses at 100% percent and three (3) illnesses at 25% percent, as shown below.  Insurance Companies vary what specific illnesses and percentages are going to be paid and covered.

Some carriers offer a Critical Illness Insurance policy that pays upon first diagnosis 100 percent of your maximum benefit, if you:

• Have a heart attack (myocardial infarction).

• Are diagnosed with life-threatening cancer (malignant neoplasm). (Subject to limitations set forth if first diagnosed within 90 days after the policy date or date of last reinstatement.)

• Have a stroke.

• Are diagnosed with advanced Alzheimer's disease.

• Go on a recipient list for a major organ transplant.

• Are diagnosed with end-stage renal failure.

Some carriers Critical Illness Insurance policy may pay a limited percent (25%) of your maximum benefit, if you:

• Have a first coronary angioplasty (surgical treatment).
• Are diagnosed with a malignant tumor (first carcinoma in situ). (Subject to limitations set forth if first diagnosed within 90 days after the policy date or date of last reinstatement.)
• Have first coronary artery bypass surgery (surgical treatment).

Benefits Amounts - Minimum and Maximum Offered - The minimum benefit amount may range from $5,000 and up, while the maximum benefit may range from $50,000. Some companies go as high as $1 million or more, subject to additional limitation, exclusions and / or a more stringent and comprehensive underwriting process.

Partial Benefits - Should a partial benefit percentage be paid, the face amount will be reduced in amount equal to the partial percent payment and the premium may be reduced to that which is appropriate for the new face amount. Any additional partial benefit percentage paid on the policy will continue to reduce the current face amount of the policy by the amount of the partial payment.

Benefit Reduction Age and Amount - some carriers may apply a reduced benefit up to a specified percent (50% or more) at some later of age (65i.e.) and /or restrict the number of years a policy may be issued (five years), based on the issue age of the applicant. Percentages, effective date and the length of the policy vary with selected plans and insurance companies.

 

Return of Premium - Feature - this feature usually applies at death only. Upon the insured's death, some carriers may return all Critical Illness Insurance premiums less claims paid. Other companies vary in their offering of this feature. 

Example:  What if the insured is not diagnosed with cancer and does not suffer a heart attack, stroke or any other covered illness?

(1)     Upon the insured's death, if the policy is in force, the carrier may return to the owner or to the owner's beneficiary if the owner is deceased or to the owner's estate if there is no beneficiary, 100% of all premiums, less the amount of any partial payments paid.

(2)     The premiums to be returned will be calculated: 1) without interest and 2) after all pending claims have been settled. If the sum of the benefits paid is equal to or greater than the sum of the premiums paid, there will be no return of premium.

Premiums & Renewability - Premiums are based on age at issue and are intended to be level throughout the insured's life. However, some insurance carriers may have alternative payment options allowing rate adjustments based on the experience of the pool of policyholders and their covered individuals. These policy rates are file for rate increases on a state-by-state basis if experience dictates such action is necessary. Critical Illness Insurance maybe guaranteed renewable for life without evidence of insurability.

Premium Guarantee - Critical Illness Insurance premium rate maybe guaranteed for period of one or more years, depending on the selected plan and insurance company. Any / and all policy rates and changes are subject to review and approval by each state departments of insurance.

Guaranteed Renewable "To Age" - generally a Critical Illness Insurance policy may be issued for life, while other companies' policies usually terminate coverage at age specified by the carrier.

Available Riders  - Riders Offered by critical illness policies may offer other benefits such as an Accidental Death Benefit Rider only. Other companies offer a variety of riders.  An Accidental Death Benefit (ADB) Rider, maybe available for issue ages 18-60, this rider pays a death benefit to the policy's beneficiary if the insured's death is a direct result of an accident, as defined in the policy.

Multiple Policies Discounts - Some insurance carriers may offer a "companion policy" discount" when both spouses purchase.  Selected carriers may offer a policy discount in lieu of a spouse rider.  The companion policy discount may apply to the spouse only and provides that if both Critical Illness Insurance applications are received at the same time, the insurance carrier may reduce the policy fee and or provide a preferred rate, subject to state filing and approval.

Underwriting Process  -  Underwriting Rules / Criteria / Outcome for carrier may vary specific to their underwriting protocols to determine coverage and may be as simple accept / reject. The underwriting process for Critical Illness Insurance involves an acceptance or rejection based on the answers to the questions on the policy application. Depending on the selected carrier, an applicant maybe either accepted and issued a policy or rejected and denied coverage.  In some instances, an independent medical exam (IME) maybe requested as part of the underwriting process, which may vary among different companies.  More than one policy on an individual maybe permitted by some carriers as long as the total Critical Illness Insurance coverage does not exceed the maximum face amount of as specified by the carrier for any individual policyholder.

Elimination / Waiting Period - the number of days following issue / reinstatement before full benefits are provided. The waiting period may vary by plan and selected carrier based on each states, where the plan is filed. The number of days may vary from 90 days in most states, 30 days in some and may apply only to cancer - compared to other policies that have a 90-day waiting period for all covered illnesses. Some carriers may pay a percentage of the benefit, return premiums and cancel the policy for diagnosis of cancer during the waiting period.

Conditions for Payment - specific criteria that maybe used or required before the benefit is paid. For example, carriers may pay the major organ transplant benefit once an insured goes on the donor list, whereas most other companies require the transplant to be completed.  In addition, a number of carriers may also require an EKG and a cardiac enzymes report for diagnosis of a heart attack.

Payment Options & Modes - Some carriers offer a variety of payment plans form installment based on multiple pay periods in a calendar year to a lump sum payment. Payment options may include:

·          Direct billing

·          Pre-authorized checking withdrawal and

·          Credit card (available for initial premium payment only; afterwards, you must either pay via bill or automatic withdrawal).  

Note:      Traditional installment options are available payable annually, semiannually, quarterly or   monthly.

Survival Period - the number of days the Insured must live following diagnosis in order to receive the benefit. Some insurance carriers may have a survival period. Others may pay the full benefit is upon diagnosis.
 
Death Benefit - some carriers may return premiums less any claims paid.