Podcast
Questions and Answers
Which group of individuals is least likely to benefit from purchasing individual accident and sickness insurance?
Which group of individuals is least likely to benefit from purchasing individual accident and sickness insurance?
- Individuals seeking better coverage terms
- Self-employed persons
- Employees with access to a robust group plan (correct)
- High-income employees
What is the impact of a longer elimination period on the insurance policy's premium?
What is the impact of a longer elimination period on the insurance policy's premium?
- The premium may decrease. (correct)
- The premium increases.
- The premium remains unchanged.
- The premium becomes variable.
In which situation would 'Any Occupation' disability coverage provide no benefits?
In which situation would 'Any Occupation' disability coverage provide no benefits?
- If the individual remains unemployed.
- If the individual can work in another occupation. (correct)
- If the individual cannot perform their own occupation.
- If the individual is still able to perform their regular duties.
What defines the 'Benefit Period' in an accident and sickness insurance contract?
What defines the 'Benefit Period' in an accident and sickness insurance contract?
Which of the following accurately describes 'Own Occupation' coverage?
Which of the following accurately describes 'Own Occupation' coverage?
What will happen to an insurance contract if the applicant has no insurable interest when the contract is in effect?
What will happen to an insurance contract if the applicant has no insurable interest when the contract is in effect?
Which of the following is NOT considered an insurable interest under the stated conditions?
Which of the following is NOT considered an insurable interest under the stated conditions?
What does Long Term Disability coverage typically start after?
What does Long Term Disability coverage typically start after?
After how many years are statements on an insurance application typically incontestable, barring certain exceptions?
After how many years are statements on an insurance application typically incontestable, barring certain exceptions?
Which expense is NOT covered under Major Medical coverage options?
Which expense is NOT covered under Major Medical coverage options?
When might an insurer deduct unpaid premiums from a claim payment?
When might an insurer deduct unpaid premiums from a claim payment?
Which aspect is NOT typical for weekly indemnity coverage in disability income insurance?
Which aspect is NOT typical for weekly indemnity coverage in disability income insurance?
What is a potential consequence of losing one's health according to the information provided?
What is a potential consequence of losing one's health according to the information provided?
What does Accidental Death and Dismemberment insurance equate to?
What does Accidental Death and Dismemberment insurance equate to?
Which limitation could affect accident and sickness insurance contracts?
Which limitation could affect accident and sickness insurance contracts?
What is the primary reason insurers set a maximum amount of income insured?
What is the primary reason insurers set a maximum amount of income insured?
Which of the following factors is NOT taken into account when determining premiums for individual accident and sickness insurance?
Which of the following factors is NOT taken into account when determining premiums for individual accident and sickness insurance?
Which type of individual insurance policy ensures the insured has coverage until age 65?
Which type of individual insurance policy ensures the insured has coverage until age 65?
What impact does an applicant's age have on claims costs for insurance policies?
What impact does an applicant's age have on claims costs for insurance policies?
How is the definition of disability in a policy related to claim costs?
How is the definition of disability in a policy related to claim costs?
Which of the following does NOT contribute to the determination of insurance premiums?
Which of the following does NOT contribute to the determination of insurance premiums?
What is included as part of the insurance contract?
What is included as part of the insurance contract?
Which factor is generally considered to lead to higher potential claim costs in accident and sickness policies?
Which factor is generally considered to lead to higher potential claim costs in accident and sickness policies?
What is the maximum duration for a single trip travel insurance policy?
What is the maximum duration for a single trip travel insurance policy?
Which of the following factors does NOT affect travel insurance premiums?
Which of the following factors does NOT affect travel insurance premiums?
What defines a 'dependent child' under travel insurance policies?
What defines a 'dependent child' under travel insurance policies?
Which of the following coverages is typically NOT included in a travel insurance policy?
Which of the following coverages is typically NOT included in a travel insurance policy?
What type of illness or condition might not be covered by travel insurance due to previous existence?
What type of illness or condition might not be covered by travel insurance due to previous existence?
In terms of travel coverage territory, when is coverage usually activated?
In terms of travel coverage territory, when is coverage usually activated?
What is generally excluded from travel insurance policies?
What is generally excluded from travel insurance policies?
What kind of accident is defined as unforeseen and out of the insured’s control under travel insurance?
What kind of accident is defined as unforeseen and out of the insured’s control under travel insurance?
What type of insurance protects insureds before their date of departure?
What type of insurance protects insureds before their date of departure?
Under what condition might a pre-existing condition be covered in travel insurance?
Under what condition might a pre-existing condition be covered in travel insurance?
Flashcards
Individual Accident and Sickness Insurance
Individual Accident and Sickness Insurance
Insurance for self-employed or non-group-insured individuals covering accidents and illnesses.
Disability Income Policy
Disability Income Policy
A type of accident and sickness insurance providing monthly income during disability.
Broad Definition of Disability
Broad Definition of Disability
If you can't do your specific job but can work in another role, benefits continue.
Limited Definition of Disability
Limited Definition of Disability
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Elimination Period
Elimination Period
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Benefit Period
Benefit Period
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Insurable Interest
Insurable Interest
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Incontestability
Incontestability
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Group Insurance Overview
Group Insurance Overview
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Weekly Indemnity
Weekly Indemnity
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Major Medical Coverage
Major Medical Coverage
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Travel Insurance Essentials
Travel Insurance Essentials
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Coverage Territory
Coverage Territory
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Pre-existing Conditions
Pre-existing Conditions
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Study Notes
Individual Insurance
- Self-employed individuals and employees without group insurance are prime candidates for individual accident and sickness insurance.
- High-income earners may seek better coverage terms than available through group plans.
Disability Income Policy
- Most common type of individual accident and sickness insurance.
- Provides monthly income during a period of disability from sickness or accident.
Definition of Disability
- Broader Definition ("Own Occupation"): Benefits continue if the insured cannot perform their specific job but can work in another occupation.
- Limited Definition ("Any Occupation"): No benefits if the insured can work in any job suitable based on education, training, or experience.
Key Contract Features
- Elimination Period: Time between the disability's onset and when benefits start; longer periods lead to lower premiums.
- Benefit Period: Duration for which benefits are available, ranging from 1 year to until age 65.
Premium Determination Factors
- Claims Costs: Influenced by policy type and potential claim costs based on benefits, elimination period, and definition of disability.
- Operating Expenses: Costs associated with administering the insurance.
- Investment Earnings: Insurers invest premiums, affecting the overall pricing.
Characteristics of Insurance Contracts
- Application Inclusion: Contracts entail application forms, policy documents, and amendments.
- Insurable Interest: Vital for contracts to be valid; applicants must have an insurable interest in the insured individual’s life.
- Incontestability: Application statements become uncontestable after two years, except for fraudulent claims or age misstatements.
- Unpaid Premiums: Insurers can deduct any overdue premiums from claims.
Group Insurance Overview
- Employers purchase group insurance policies to cover all employees.
- Weekly Indemnity: Short-term coverage, often covering the first few days of sickness or accidents for up to 52 weeks.
- Long Term Disability: Starts after weekly indemnity coverage ends, lasting until age 65.
Major Medical Coverage
- Reimbursement for expenses outside provincial coverage, such as dental care and prescription drugs.
Importance of Accident and Sickness Insurance
- Protects against loss of health, future earnings, and the insurability of individuals.
- Covers financial losses that can occur during prolonged illness or disability.
Travel Insurance Essentials
- Provincial health plans may have varying agreements; hence the importance of travel insurance.
- Policies can be single trip or annual, covering durations from a few days to 180 days.
Coverage Details
- Coverage Territory: Generally applies when more than 500 km from home; may vary by policy.
- Definitions: Accidents are unforeseen events; emergencies require urgent medical attention.
Pre-existing Conditions and Coverage
- Illnesses prior to travel may not be covered unless under control for a specified time frame.
- Coverage typically covers emergency medical services and may include trip cancellation protection.
Important Exclusions
- Common exclusions involve pregnancy, acts of war, suicides, or engaging in hazardous activities.
- Travel policies adhere to provincial statutory conditions.
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