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Critical Illness Insurance

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CRITICAL ILLNESS INSURANCE
What is Critical Illness Insurance?
Critical Illness Insurance provides a lump-sum, tax-free payment if the insured is diagnosed with a life-threatening condition covered under the policy (e.g., cancer, stroke, or heart attack). The benefit is paid regardless of treatment or recovery status.
How is Critical Illness Insurance different from Disability Insurance?
How is Critical Illness Insurance different from Disability Insurance?
What can the CI benefit be used for?
The benefit can be used however the client chooses, including:

Private medical care or alternative treatments

Income replacement

Paying off debts (e.g., mortgage, credit cards)

Hiring in-home support or childcare

Travel for treatment or recovery

Who should consider getting Critical Illness Insurance?
CI is particularly recommended for:

Self-employed individuals

Families with young children

Business owners

Clients with high financial responsibilities

Anyone without group benefits or with limited savings
What illnesses are typically covered?
Coverage varies by insurer, but commonly includes:

Cancer (life-threatening)

Heart attack

Stroke

Coronary bypass surgery

Multiple sclerosis

Kidney failure

Organ transplant
Some policies include partial payouts for early-stage conditions.
What is the survival period?
Most policies require the insured to survive for at least 30 days after diagnosis to be eligible for the benefit.
Can I get my money back if I don’t use the insurance?
Yes, some policies offer Return of Premium (ROP) options:

On death: premiums are returned if the client passes without a claim

At maturity: premiums are returned if the policy ends without a claim
Can CI be added as a rider to another insurance policy?
Yes. Many insurers allow CI to be added as a rider to a life insurance policy (Term, Whole Life, or Universal Life), which may be more cost-effective.
How can I explain the value of CI to skeptical clients?
Focus on the financial gap that occurs when illness strikes:
Even with health insurance, clients face income loss, out-of-pocket costs, and unexpected lifestyle changes. CI provides the financial flexibility and peace of mind to focus on healing — not money.
Is the lump-sum benefit from CI Insurance taxable?
No. In Canada, the Critical Illness Insurance benefit is paid out tax-free, which means the full amount is available to the policyholder without any deductions.
Can a claim be denied even after a diagnosis?
Yes, in certain situations. Common reasons for claim denial include:

Failure to meet the survival period

Non-disclosure of pre-existing conditions

Diagnosis not matching the policy definition This is why accurate underwriting and full disclosure are essential during application.
Can someone have both CI and Disability Insurance?
Absolutely. In fact, combining both provides stronger protection.

CI gives immediate cash for recovery-related expenses

Disability Insurance provides income if the client can’t return to work
Together, they address different but complementary risks
Are there waiting periods before coverage begins?
Yes. Most policies have:

A 30-day survival period (after diagnosis)

A 90-day waiting period (after policy issuance) before some conditions like cancer are eligible for claims
Advisors should clarify these details during the sales process.
What’s the difference between standalone CI and a CI rider?
A standalone CI policy offers full flexibility and usually broader coverage.

A CI rider is attached to another policy (e.g., life insurance) and may be more affordable, but could have limited features or be dependent on the base policy.
Can CI be purchased for children?
Yes. Many insurers offer Child CI riders or policies that cover over 20 childhood conditions, such as:

Congenital heart disease

Cystic fibrosis

Type 1 diabetes
This can be added to a parent’s policy and is often very affordable.
What happens if the client develops an illness not listed in the policy?
If the condition is not explicitly covered, no benefit is paid. That’s why reviewing the list of covered conditions and explaining it clearly to clients is essential.
Can a client apply for CI Insurance after a serious diagnosis?
Usually no — CI is underwritten based on current health. A major diagnosis like cancer, stroke, or heart disease would typically result in a decline or exclusion. That’s why it's important to apply before any health issues arise.
What happens if a client cancels their policy early?
If the policy has no return-of-premium option, the client loses all paid premiums.

If it has ROP on surrender or maturity, they may receive a portion or full amount back — depending on the terms.
How often should CI coverage be reviewed?
It’s best to review CI coverage:

During annual financial check-ins

After major life events (marriage, children, new business)

If health or income changes significantly
Coverage may need to be adjusted to reflect the client’s evolving needs.
Course details
Lectures 6
Quizzes 1

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Working hours

Monday 9:30 am - 6.00 pm
Tuesday 9:30 am - 6.00 pm
Wednesday 9:30 am - 6.00 pm
Thursday 9:30 am - 6.00 pm
Friday 9:30 am - 5.00 pm
Saturday Closed
Sunday Closed