Healthy            
 Living         
 Benefits
GPF Services & Planning Corporation

 

 
 


Why are they called HEALTHY LIVING BENEFITS?

They are called HEALTHY LIVING BENEFITS because you have to be healthy to get them. They come into effect if or when your health fails, and then provide you with benefits.


How do they work?

Long Term Disability will pay you an income if you become disabled and thus are unable to work at your regular occupation or your own occupation because of illness or injury.

Cancer, Heart Attack, Stroke Insurance will pay you a sum of money if you are diagnosed with Cancer, suffer a Heart Attack or Stroke, 30 days after the diagnosis or event. About a dozen other illnesses are also covered. The Big Three have so far in Canada accounted for about 98% of all claims. It is often called Critical Illness insurance.

triAccess will provide you with: Immediate access to a Centre of Excellence in the United States capable of treating your condition, and the funding to pay for it.

Long Term Care will provide funds to pay for care in a Nursing home, or for a nurse to come to your home, should you need such care later in life.

I've heard that lots of people have trouble collecting on LTD.

You get what you pay for. Insurance companies hire lawyers by the busload. They are craftsmen of words, and small words mean the difference between whether or not the company has to pay, or not. ( See the examples below.)

Why do your policies cost more than others?

These are individual policies. They are individually underwritten, taking into account the personal medical and health history of you the individual. They are more liberal than other policies such as Association or Group policies, and do not have the same small words that allow the company not to pay.

OK, what is this fine print?

I'll give you four examples:

What is the difference between the words in each of the following collections?

a. Own, Regular, Any

b. Waiting, Elimination, Qualifying

c. Accumulation, Continuous

d. Partial, Residual, Total

The first collection, Own, Regular, Any refers to the Definition of Disability. This is the most important part of an LTD policy. Own Occupation means that if the individual becomes disabled and is unable to work, the insurance company will pay an income. They will continue to pay the full amount even if the individual, out of boredom takes a job at say Chapters Bookstore, just to get out of the house. These policies are generally restricted to professionals. The decision to work is made voluntarily by you.

Regular Occupation means the regular occupation that you are in when you become disabled. In this case, if you go to work at Chapters bookstore, the amount that the insurance company would pay you is reduced by the amount that you earn at Chapters. The decision to work is made voluntarily by you.

Any Occupation means just that. If you are capable of performing any occupation, you will not be considered disabled. A job does not have to be available, but if you could do one if it were, you are not disabled.
No payments will be made.


The second collection, Waiting, Elimination, Qualifying refer to the periods of time that must elapse before a payment will be made. The first two terms are synonymous,and mean exactly the same thing. Some companies use the term Waiting period, and others use the term Elimination period. Both periods can usually be satisfied with either Partial or Total Disability, or a combination of both. The longer the Waiting or Elimination period, the lower the premium. Qualifying period has, however, a very different meaning. It means the period of time that someone must be Totally disabled before being eligible for payments. Totally disabled essentially means that someone is wheelchair bound, or bedridden. Only about 15% of all disabilities are Total disabilities. The great majority, 85% are Partial disabilities. This is a screening word that insurance companies put into their policies to prevent having to make payments.


The third collection, Accumulation, Continuous refers to how the days may be counted for the Waiting, Elimination, or Qualifying periods. Accumulation allows someone who is off work for a number of days, and then returns to work, and then is off and on and off and on again, to add up all of the days off. As long as they were for the same or related causes, and not separated by a certain time back at work, say six or 12 or 24 months, they can all be added together. This is important when things like cancer or kidney disease are active, as someone may feel badly for a few days, then well again and so on. Continuous means that the time off work must be continuous. Every time someone goes back to work, the counter re-sets to zero. This makes it very difficult to satisfy the required number of days.


The final collecton of words, Partial, Residual, Total refers to the degree of disability that someone might have. Partial disability means that someone can do some of the tasks of his or her regular job, but usually for not more than 50% of the time normally required. In this case, the policy would pay 50% of the benefit amount. Residual disability means that the individual can work either part time, or even full time, but at a reduced level of productivity. In the latter instance, the individual would usually have a reduction in his pay. The residual provision would mean that the disability policy would pay him an amount equal in % to the loss of income. Thus if he or she lost 40% of his or her income, the policy would pay 40%. Likewise a loss of 65% would provide for a payment of 65% of the benefit amount. Total disability is at the extreme end. It means that the individual can do little or none of his regular occupation dues to illness or injury. A loss of income greater than 80% would qualify for total disabillity, and the full amount of the benefit would be paid.


My brother-in-law, neighbor, best friend has CHASI. It seems to be a
lot simpler to understand. Why is that?


It is simpler to understand because it is a simpler policy. It covers only a few specific illnesses, and does not depend upon the ability to work. There is no need to classify your occupation, nor the degree of illness that you have. You are covered for the 15 or 16 or 17 illnesses listed, and nothing else. If you acquire an illness that is not on the list of covered illnesses, then you are not covered and no payment will be made.

OK, who is CHASI best for?

It is best for the following situations:

a. For those who cannot get LTD;
b. For those who have a high debt load;
c. Stay at home moms;
d. Those who have no job, and no other coverage;
e. For young people in their early 20s or 30s, and still prone to doing extreme activities.



The Health Care System in Canada is the best in the world, why would
one want to go elsewhere?


Parts of it are very good. The problem is access. There are long waiting times to see specialists. Then there are long waiting times to get a diagnosis, and more waiting time again for treatment. If you want a second opinion, it is extremenly difficult, because you have to navigate this whole process of waiting to see a specialist and for him or her to complete his or her diagnosis all over again. This access to information
and to the expertise of the Best Doctors in the world is available through triAccess. Further, there is immediate access to treatments and facilities that are not available in Canada.

Who are Best Doctors?

Best Doctors is a worldwide listing of the best doctors in a wide variety of medical practices. There are about 50,000 Dr.s listed. They were selected by asking a large number of Dr.s the question: "If you or one of your immediate family had a specific illness or injury, who would you go to as the best doctor to treat it?" Doctors know who is good in the various fields of medicine, and who is not. They are the ones who have selected the Best Doctors, and renew the listings annually.