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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.