Group Critical Illness Insurance (Critical Choice Care)

Recent advances in medical care and medical technology have now made it possible to survive a CRITICAL ILLNESS that might once have been fatal. Axa Assurances Inc. offers its customers an insurance policy designed to meet both immediate and long-term health care and altered lifestyle needs.

Why is the coverage right for me?

Reluctant as we may be to accept these facts, statistics show that in the course of just one year:

75,000 Canadians will suffer a heart attack
125,000 new cases of cancer will be diagnosed
50,000 of us will suffer a stroke

Critical illness can strike the healthiest among us, but modern medical care usually ensures that we will recover to a greater or lesser extent and may live for many years.

But what quality of life will we enjoy if we find ourselves with an on-going need for special care or accommodations and don't have the resources?

Take a moment to look over the comprehensive protection package offered by the Coverage for Critical Illness. - Give yourself some peace of mind.

It is important to include Critical Illness Insurance to your Life Insurance Portfolio!

ELIGIBILITY
BENEFIT AMOUNTS
PREMIUM RATES
PRODUCT FEATURES
COVERED CONDITIONS
DEFINITION OF COVERED CONDITIONS
GENERAL INFORMATION

Eligibility

Employees of an "accredited businesses" with the Better Business Bureau serving Mainland BC and their spouses are eligible to apply for Critical Illness Insurance. Employees do not have to be insured in order for a spouse to apply for coverage.

All applicants must be resident in Canada and less than 70 years of age.

Accredited business, as defined under the plan, includes employees of an Employer Company who is an "accredited business" of the Better Business Bureau serving Mainland BC.

Employee means a person who is employed by an Employer Company that is in good standing and an accredited business of the of the Better Business Bureau serving Mainland BC.

Spouse means the legal or common-law spouse of an eligible Employee. Legal spouse means a person who is legally married and cohabiting with the Employee and with whom there is no formal or informal agreement of separation. Common-law spouse means a person who has been cohabiting in a marriage-like relationship with the Employee for at least 12 consecutive months.

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Benefit Amounts

Guaranteed Issue: Employees and/or Spouses can each apply for a benefit not exceeding a maximum "Guaranteed Issue" amount of $10,000.
Optional Coverage: Employees and/or Spouses can each apply for a benefit not exceeding a maximum face amount of up to $150 000.

NOTE! A completed medical application is required for increased limites over $10,000. Kindly contact Pat Anderson Agencies for your application.

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Premium Rates

Critical Choice Care Rates (Monthly Rates - per $1,000)
Age at Last Birthday	MALE Non-Smoker	MALE Smoker	Age at Last Birthday	FEMALE Non-Smoker	FEMALE Smoker
Under 25	0.110	0.124	Under 25	0.090	0.100
25-29	0.159	0.189	25-29	0.163	0.196
30-34	0.178	0.224	30-34	0.209	0.281
35-39	0.205	0.293	25-39	0.256	0.405
40-44	0.290	0.488	40-44	0.350	0.658
45-49	0.517	1.039	45-49	0.504	1.066
50-54	0.841	1.947	50-54	0.664	1.475
55-59	1.358	3.431	55-59	0.913	1.995
60-64	2.335	5.827	60-64	1.301	2.596
Age 65	2.569	6.410	Age 65	1.431	2.856
Age 66	2.826	7.051	Age 66	1.574	3.142
Age 67	3.109	7.756	Age 67	1.731	3.456
Age 68	3.420	8.532	Age 68	1.904	3.802
Age 69	3.762	9.385	Age 69	2.094	4.182

*Non-Smoker rates apply to individuals who, at the time of application, have not used any tobacco, marijuana or nicotine products within the last 12 months and who have provided satisfactory evidence of insurability.

**The premiums shown for ages 65 to 69 are for renewal of existing coverage only.

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Product Features

Payment of Benefit

If you are faced with one of the eighteen covered medical conditions before the age of 70, and survive for 30 days (180 days for paralysis, 180 days for multiple sclerosis or loss of speech) after first being diagnosed, you can receive a tax-free lump sum benefit. Full recovery may be made and the benefit is not dependent on your ability or inability to work.

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Covered Conditions

You and your eligible spouse, if under the age of 70, will be protected by the Critical Choice Care policy if you are diagnosed* with a Critical Illness:

"Critical Illness" means:

Heart Attack
Coronary Artery Bypass Surgery
Stroke
Life Threatening Cancer
Parkinson's Disease
Alzheimer's 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

*Because this coverage is designed to provide care for your recovery, you become eligible for your benefits following a survival period of 30 days.

A living benefit is paid to the insured or to the beneficiary, as a Tax Free Lump Sum. Your benefits can be used to get the care you need, when and where you need it, to pay for medical expenses not covered under provincial health care, or to adapt your home to meet your special requirements. Pay off debts or mortgages, take a much-needed holiday to speed your recovery, or simply use the benefits to replace lost income.

Critical Choice Care benefits will preserve your future by ensuring that your investments aren't swallowed up by unexpected illness

Critical Choice Care benefits are not modified, even if there is a complete recovery, and are not based on occupational conditions.

You and your eligible spouse can buy any amount of principal sum in units of $10,000 to a maximum of $150,000.

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Definition of Covered Conditions

Heart Attack means the Diagnosis of the death of a portion of the heart muscles, resulting from the blockage of one or more coronary arteries due to atherosclerotic heart disease. The Diagnosis must be based on all of the following criteria occurring at the same time: a) new episode of typical chest pain or equivalent symptoms, b) new electro-cardiographic (ECG) changes indicative of an acute myocardial infarction and c) biochemical evidence of myocardial necrosis (heart muscle death) including elevated cardiac enzymes and/or troponin. Lesser acute coronary syndromes including unstable angina and acute coronary insufficiency are specifically excluded.

Coronary Artery Bypass Surgery means the undergoing of heart surgery to correct narrowing or blockage of one or more coronary arteries with bypass grafts. The surgery must be recommended by a cardiologist licensed and practicing in Canada.

Non-surgical techniques NOT covered by this definition include:

Balloon angioplasty;
Laser embolectomy; or
Other non-bypass techniques.

Stroke means the unequivocal Diagnosis by a neurologist of the death of brain tissue caused by thrombosis, embolism or hemorrhage. The Diagnosis must be based on all of the following: a) sudden onset of new neurological symptoms, b) new objective neurological deficits on clinical examinations persisting continuously for at least sixty (60) days following the Diagnosis of the stroke and c) new findings on CT scan or MRI, if done, consistent with the clinical diagnosis. This definition specifically excludes Transient Ischemic Attacks (TIA's).

Life Threatening Cancer means the Diagnosis of a malignancy, which is characterized by the uncontrolled growth of cancer cells with invasion of tissue. The following conditions are excluded under this definition:

Early prostate cancer, Diagnosed as T1A N0 M0 and T1B N0 M0 or equivalent staging;
Non-invasive cancer (in situ);
Pre-malignant lesions, benign tumours or polyps;
Any skin cancer other than invasive malignant melanoma greater than 0.75 mm.;
Any tumour in the presence of any Human Immunodeficiency Virus (HIV).

There shall be no coverage under this definition if within ninety (90) days following the Insured Person's effective date of coverage: a) a Diagnosis of Cancer is made or b) any symptoms or medical problems commenced and initiated investigations leading to the subsequent Diagnosis of any cancer.

Parkinson's Disease means the Diagnosis by a neurologist of primary idiopathic Parkinson's Disease which is characterized by the clinical manifestations of two or more of the following: (a) tremour; (b) rigidity; (c) Bradykinesia. All other types of Parkinsonism are excluded.

Alzheimer's Disease means a progressive degenerative disease of the brain. The Diagnosis of Alzheimer's Disease must be made by a neurologist. The insured must exhibit loss of intellectual capacity involving impairment of memory and judgment which results in significant reduction in mental and social functioning such that the insured requires supervision for daily living. All other dementing organic brain disorders and psychiatric illnesses are excluded.

Multiple Sclerosis means an unequivocal Diagnosis by a neurologist of at least two (2) episodes of well-defined neurological abnormalities lasting for a continuous period of at least six (6) months and confirmed by modern imaging techniques.

Kidney Failure means the Diagnosis of an irreversible failure of both kidneys which necessitates treatment by regular dialysis or kidney transplantation.

Paralysis means the Diagnosis by a physician of complete and permanent loss of use of two or more limbs through paralysis for a continuous period of one hundred-eighty (180) days.

Blindness means the Diagnosis of permanent loss of sight in both eyes, as confirmed by an ophthalmologist. The corrected visual acuity must be worse than 20/200 in both eyes or the field of vision must be less than twenty (20) degrees in both eyes.

Deafness means the Diagnosis of permanent loss of hearing in both ears with an auditory threshold of more than ninety decibels (90db), as confirmed by an otolaryngologist.

Loss of Speech means the Diagnosis by an appropriate specialist of total, permanent and irreversible loss of the ability to speak for a continuous period of six (6) months due to physical injury or physical disease.

Benign Brain Tumour means the Diagnosis of a benign tumour within the substance of the brain. Cysts, granulomas, meningiomas, malformations of the intracranial arteries or veins, or tumours of the cranial nerves, pituitary or spinal cord are excluded from this definition.

Coma means the Diagnosis by a neurologist of a state of unconsciousness with no reaction to external stimuli for a continuous period of at least ninety-six (96) hours.

Major Burns means the Diagnosis by a plastic surgeon of a third degree burn covering at least twenty percent (20%) of the surface area of the body of the Insured Person.

Major Organ Transplant means the undergoing of a surgery, as a recipient by transplant of any of the following organs or tissues: heart, liver, lung, kidney or bone marrow.

Major Organ Failure Requiring Transplant means the irreversible failure of the heart, liver, bone marrow, both lungs or both kidneys requiring receipt of a transplant of that organ, resulting in the Insured Person being accepted into a recognized transplant program in Canada. The Insured Person must survive at least thirty (30) days following the date of enrolment into the transplant program.

Motor Neuron Disease means an unequivocal Diagnosis of amyotrophic lateral sclerosis (Lou Gehrig's disease), primary lateral sclerosis, progressive spinal muscular atrophy, progressive bulbar palsy, or pseudo-bulbar palsy. Other variations of motor neuron disease are specifically excluded.

Survival Period means thirty (30) days following the date of Diagnosis or thirty (30) days following the date of surgery for Coronary Artery Bypass Surgery, Major Organ Transplant Surgery or enrollment in the transplant program in Canada.

Diagnosis means the certified diagnosis of a Critical Illness by a medical practitioner or specialist who is licensed and practising medicine in Canada, other than the Insured Person, a business associate or a relative.

Principal Sum means the amount indicated in Item 3 of the Master Application as being applicable to the Insured Person, or the amount stated on the Insured Person's most recently signed enrolment card on file with the Policyholder, or the amount approved by the Insurer.

Pre-existing Condition means: a) the existence of symptoms which would cause an ordinarily prudent person to seek diagnosis, care or treatment within a twenty-four (24) month period preceding the Insured Person's effective date of coverage, or b) an illness or condition for which the Insured Person, during twenty-four (24) months prior to the effective date of his coverage incurred medical expenses, received medical treatment, took prescribed drugs or medicine or consulted a physician.

This applies only to persons with the Guaranteed Issue limit of $10,000. No pre-existing condition for cases medically underwritten.

The male pronoun will be construed as the feminine when the person is a female.

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General Information

Conditions for Payment

When the Insured Person is Diagnosed with a Critical Illness while the policy is in force as to Insured Person whose Critical Illness is the basis of claim, the Insurer shall pay the Principal Sum subject to survival by the Insured Person of the Survival Period.

Beneficiary Designation

The Principal Sum payable in the event of a Critical Illness will be payable to the Insured Person or the Insured Person's Estate.

Individual Terminations

Insurance of an Insured Person provided under this policy will immediately terminate on the earliest of the following dates:

on the date this policy is terminated.
on the premium due date if the Policyholder fails to pay the required premium, except as the result of an inadvertent error.
on the next premium due date following the date the Insured Person reaches under 70 years of age.
on the next premium due date following the date the Employee ceases to be an active employee of the Policyholder on account of resignation, dismissal or retirement.
on the date the Principal Sum payment has been paid.

Conversion To An Individual Insurance Contract

If, with the exception of policy termination, an Insured Person's insurance is terminated due to:

termination of employment,
cessation of eligibility for insurance under this policy or,
cessation of a period of total disability after which the Insured Person did not return to work for the Policyholder,

and prior to attainment of under 70 years of age, the Insured Person makes a written application to the Insurer within thirty-one (31) days of said termination, the Insurer will, without evidence of insurability, issue on the life of such Insured Person an individual Critical Illness policy. The amount of insurance that may be converted will not exceed the Insured Person's amount of insurance then in effect on the date of termination or a total aggregate of twenty five thousand dollars ($ 25,000) for all such conversions with the Insurer.

Premiums for such an individual Critical Illness policy being issued in compliance with the aforementioned condition will be calculated at the Insurer's manual rates then in force for the attained age of the Insured Person at the date of conversion. Premiums will be payable annually in advance and the individual Critical Illness policy will be issued on an annually renewable basis.

Exclusions

The Principal Sum will not be paid if a Critical Illness results directly or indirectly from any one or more of the following causes:

Within ninety (90) days following the effective date of coverage of the Insured Person a) Diagnosis of Cancer is made, or b) any symptoms or medical problems commenced and initiated investigations leading to the subsequent Diagnosis of Cancer.
An intentionally self-inflicted injury or sickness, whether the Insured Person is sane or insane.
The use of illicit drugs other than as prescribed and administered by or in accordance with the instruction of a legally licensed medical practitioner.
From a Pre-existing Condition except if such Critical Illness is Diagnosed twenty-four (24) months after the Insured Person's effective date of coverage.

Area of Diagnosis

Should a Critical Illness occur or be diagnosed outside of Canada, payment of the Principal Sum may be considered upon the Insured Person's return to Canada for medical assessment and confirmation of the Diagnosis of a Critical Illness.

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DISCLAIMER:

This information summarizes the terms and conditions of the program. All rights and obligations are determined in accordance with the group policy. For detailed information, please contact your employer or Pat Anderson Agency Ltd.