For residents of New York, this policy must be referred to as Specified Disease. As such, each reference to “critical illness/critical illnesses” found in this article should be assumed to be replaced with “specified disease/specified diseases” in regard to coverage for New York residents.
Product Description
Critical Illness insurance provides a lump-sum cash benefit paid directly to the insured if they are diagnosed with a covered condition, such as heart attack, cancer or stroke. It is not a replacement for health insurance and does not reimburse medical care expenses.
Issue Ages
18 – 70 (age last birthday)
Underwriting Classes
Male/Female, Tobacco/Non-Tobacco
Benefit Amounts
Simplified Underwriting: $5,000-$75,000. Benefit amount reduced by 50% in the later of the third policy year and the policy year following the insured’s 70th birthday.
Additional Diagnosis Benefit
The insured may receive benefit for each different critical illness covered if the date of diagnosis or procedure is separated from the prior critical illness by at least 6 consecutive months, and the new critical illness is not caused by or contributed to by a critical illness for which benefits have already been paid.
Covered Conditions
- Heart Attack* - 100%
- Coronary Artery Bypass Surgery – 25%
- Angioplasty – 25%
- Stroke – 100%
- Invasive Cancer – 100%; Invasive Cancer and Non-Invasive Cancer combined cannot exceed 100%
- Non-Invasive Cancer – 25%; Invasive Cancer and Non-Invasive Cancer combined cannot exceed 100%
- Kidney (Renal) Failure – 100%
- Major Organ Transplant (liver, kidney, lung, entire heart or pancreas) – 25% payable when the insured person is placed on the registry with the United Network for Organ Sharing (UNOS) and 75% payable upon completion of the organ transplant surgery
- Advanced Alzheimer’s Disease – 100%
- Paralysis – 100%
- Coma – 100%
* Heart attack does not include established (old) myocardial infarction occurring prior to the issue date, sudden cardiac arrest, cardiac arrest or cardiopulmonary arrest.
Return of Premium Upon Death
Returns all policy and rider premiums paid (except the Spouse Critical Illness Rider if the conversion option is exercised) less any benefits paid under the policy and riders, if the insured person dies from a cause other than a specified critical illness.
Waiting Period
No benefits will be paid for diagnosis of Invasive Cancer or Non-Invasive Cancer during the first 30 days of the policy. If cancer is diagnosed during the 30-day waiting period, benefits will be paid for a subsequent diagnosis of cancer if the insured person is symptom and treatment-free for at least 12 consecutive months and in complete remission prior to the subsequent diagnosis. Coverage begins immediately for all other covered conditions.
Renewability
Guaranteed renewable for life. Benefit amount reduced by 50% in the later of the third policy year or the policy year following the insured’s 70th birthday.
Optional Riders (additional premium, not available in all states)
- Accidental Death Benefit Rider
- Additional Critical Illness Rider
- Spouse Critical Illness Rider
- Child Critical Illness Rider
- Critical Accident Rider
- Disability Waiver of Premium Rider
- Increasing Benefit Rider
- Loss of Independent Living Rider
- Reoccurrence Rider
- Return of Premium Rider
Policy Fee
$25, non-commissionable
Producers selling Critical Illness Insurance must have a health insurance license.
15-015-021701-21