Disability Insurance

Disability insurance gives you money if you can’t work because you become disabled.

Individual disability insurance is very important for self-employed people and for people who don’t have a group disability plan at work.

An employer may offer Short Term or Long Term disability coverage (or both) to employees. You may pay your own premiums or your employer may pay premiums for you.

If you have paid into Employment Insurance (EI) or Canada Pension Plan (CPP), you may be able to get disability benefits from EI or CPP.

You may have disability insurance on your mortgage or car loan.

When you make a claim for disability insurance, all of these kinds of insurance work together so that you get benefits up to 60-80% of your income.

Types of Disability Insurance

There are three kinds of individual disability insurance.

Noncancellable policies mean the insurer must renew the policy and the premiums can’t go up.

Guaranteed renewable policy premiums can go up.

Commercial policies let the insurer refuse to renew the policy. The insurer can also change the premiums when you renew.

Dismemberment coverage gives you money if you lose a limb, vision, or hearing.

Critical Illness insurance covers you if you become disabled because of illnesses such as cancer, heart attack, or multiple sclerosis.

Long Term Care coverage helps to pay for care if you become very ill and need to be looked after 24 hours a day.

Benefit Payments

Some plans pay benefits based on loss of income and some pay based on ability to work.

Some plans pay if you can’t work in your own occupation.

Some plans only pay if you can’t work in any occupation.

Some only pay if you can’t work in any occupation for the rest of your life (called total and permanent disability).

Often, plans combine these definitions of disability and give time limits.

For example, a plan may pay benefits for two years if you can’t work in your own occupation. After two years, the plan may only pay if you can’t work in any occupation.

Most disability insurance gives you monthly payments while you are ill.

Critical illness insurance pays the whole amount in one payment.

Questions to ask:

· How does this policy define a disability?

· Will I be paid if I can’t do my current job or any job?

· Is the policy noncancellable, guaranteed renewable, or commercial?

· Are there limitations or exclusions?

· How long will I get benefits? How much will I get paid?

· What is the waiting period before I can claim benefits?

· If I go back to work part-time, can I get partial benefits?

· Are the benefits taxable?

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Life Insurance

You may want to buy life insurance to pay for expenses if you die.

Life insurance is important if you have children or other dependants, so that they will have money to live on if you die.

The person who will get the money when you die is the beneficiary.

There are two kinds of life insurance.

Permanent life insurance covers you for your entire life, until you die.

Term life insurance covers you for a fixed number of years or until you are a certain age (such as 60 or 65). Term insurance is less expensive in the beginning but you will pay higher premiums if you renew the policy after it expires.

Term life insurance is good if you have bigger expenses now and not too much money for insurance (such as if you have a young family).

Make sure that your term life insurance is renewable (you can get a new term at a higher premium without a health examination).

Make sure it is also convertible (you can change it to permanent life insurance later on without a health examination).

Most life insurance policies will let you cancel without a penalty if you change your mind in the first 10 days after you get the written policy.

If you return the policy to the company within 10 days, you will get back any premium you paid.

Questions to ask:

· How long has the company been in business?

· What qualifications does the salesperson have?

· What is guaranteed in the policy (premiums, benefits, riders)? What is not guaranteed?

· What is the difference between the policies you are looking at?

· For term policies, how much will it be to renew in the future? Are renewal rates guaranteed? When does the policy expire? When does any conversion right expire?

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Health Insurance

Almost everyone in Canada has basic government health insurance.

You can buy extra health insurance for the things that government health insurance does not cover, like buying glasses and prescription medicine.

A few companies sell health insurance for visitors to Canada and returning Canadian residents who can’t get basic government health insurance yet.

The insurance is often just for emergency medical treatment.

Extended health plans often cover prescription medicine, ambulance services, and vision care.

Check your policy to see what it covers.

Dental plans usually cover check-ups, cleaning, fillings, and dental x-rays.

Usually health insurance covers the plan member and dependants (spouse or partner and children under 19). Older children may be covered if they are full-time students or if they are disabled.

Usually you pay a deductible every year ($25 or $50 per person).

Some plans have a deductible every time you use a service (such as $5 for every prescription).

Some plans have co-insurance, which means you pay part of the expenses (from 10% up to 50%).

Many plans also have a maximum amount you can claim per year for a kind of service (like glasses).

Some plans don’t cover expenses for a pre-existing condition (a health problem you had before you got the insurance).

Making a Claim

Usually you pay the bill, and then you fill out a form and attach a receipt to make a claim. The insurance company pays you back.

Sometimes the insurance company pays the pharmacy or dentist for your claim, and you only pay the part that is not covered by your insurance. The insurance company gives you a card with your policy information to show at the pharmacy or the dentist.

Usually you get money back quickly from your claim.

Some insurance companies pay by direct deposit and some pay by cheque.

Questions to ask:

· What does the plan cover? What does it not cover?

· Do I need a medical examination?

· How much is the deductible?

· Is there co-insurance? How much do I pay?

· Does it cover expenses for a pre-existing condition?.

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Health Insurance

Almost everyone in Canada has basic government health insurance.

You can buy extra health insurance for the things that government health insurance does not cover, like buying glasses and prescription medicine.

A few companies sell health insurance for visitors to Canada and returning Canadian residents who can’t get basic government health insurance yet.

The insurance is often just for emergency medical treatment.

Extended health plans often cover prescription medicine, ambulance services, and vision care.

Check your policy to see what it covers.

Dental plans usually cover check-ups, cleaning, fillings, and dental x-rays.

Usually health insurance covers the plan member and dependants (spouse or partner and children under 19). Older children may be covered if they are full-time students or if they are disabled.

Usually you pay a deductible every year ($25 or $50 per person).

Some plans have a deductible every time you use a service (such as $5 for every prescription).

Some plans have co-insurance, which means you pay part of the expenses (from 10% up to 50%).

Many plans also have a maximum amount you can claim per year for a kind of service (like glasses).

Some plans don’t cover expenses for a pre-existing condition (a health problem you had before you got the insurance).

Making a Claim

Usually you pay the bill, and then you fill out a form and attach a receipt to make a claim. The insurance company pays you back.

Sometimes the insurance company pays the pharmacy or dentist for your claim, and you only pay the part that is not covered by your insurance. The insurance company gives you a card with your policy information to show at the pharmacy or the dentist.

Usually you get money back quickly from your claim.

Some insurance companies pay by direct deposit and some pay by cheque.

Questions to ask:

· What does the plan cover? What does it not cover?

· Do I need a medical examination?

· How much is the deductible?

· Is there co-insurance? How much do I pay?

· Does it cover expenses for a pre-existing condition?

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Buying Insurance

Buying Insurance

Make sure you know what your policy doesn’t cover. Ask questions until you understand any exclusions.

If you are comparing prices between companies, make sure it is for the same level and kind of insurance.

An insurance company that has much lower prices may not want to pay if you make a claim.

Be careful to tell the truth on your insurance application.

If you don’t tell the insurer something important, you may pay your premiums and not be paid when you make a claim.

For example, you can’t say you are a non-smoker if you smoke a few cigarettes every month.

Changing Insurance Companies

If you cancel your policy before it comes up for renewal, you may pay a penalty.

If you want to cancel your policy or change companies, tell your insurer in writing.

Don’t stop paying your premium until you tell the company, or you will be charged a higher rate because you are a ‘bad risk.’

If you are changing companies, make sure your new policy is issued before you cancel your old policy.

Buying Insurance

Make sure you know what your policy doesn’t cover. Ask questions until you understand any exclusions.

If you are comparing prices between companies, make sure it is for the same level and kind of insurance.

An insurance company that has much lower prices may not want to pay if you make a claim.

Be careful to tell the truth on your insurance application.

If you don’t tell the insurer something important, you may pay your premiums and not be paid when you make a claim.

For example, you can’t say you are a non-smoker if you smoke a few cigarettes every month.

Changing Insurance Companies

If you cancel your policy before it comes up for renewal, you may pay a penalty.

If you want to cancel your policy or change companies, tell your insurer in writing.

Don’t stop paying your premium until you tell the company, or you will be charged a higher rate because you are a ‘bad risk.’

If you are changing companies, make sure your new policy is issued before you cancel your old policy.

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Who Sells Insurance?

Agents sell insurance for one company.

Direct sellers sell insurance for one company by telephone or over the internet.

Brokers sell insurance for more than one company.

An agent or broker who sells life and health insurance may also sell savings and investment plans, and is often called an advisor.

Group plans can be for many kinds of groups, like people who work together or people who went to the same university.

Group plans are usually less expensive than individual plans.

You get group insurance with your employer or with an association.

But when you are not a member of the group any more (such as when you leave a job), your group insurance may stop. You may be able to get an individual policy that continues the benefits of your group insurance.

Any person acting as an agent or broker must have a licence to sell insurance in Canada. The licence should be from your province.

Some companies offering insurance (such as payday loan companies or car dealers) may not be licensed.

Ask to see the agent’s or broker’s insurance licence before you buy.

You can check to see if the person has a licence by calling your province’s Superintendent of Insurance or Financial Services.

Safety Tips

You may see an ad offering cheap insurance, but it may not be true.

Some people pretend to be insurance agents or brokers.

They tell you that you can have a much lower premium for your insurance.

They ask you for a payment or charge you a fee in cash or by wire transfer.

They may just take the money and not get insurance for you at all.

They may call a real insurance agent and pretend to be you. They may lie about your application to get a lower rate.

If you don’t have valid car insurance and the police stop you or you are in a car accident, you will pay a big fine.

You may have to pay to fix the other car and for medical costs for anyone who got hurt in the accident.

This could be many thousands of dollars.

If an agent or broker fills out an application for you, check to make sure everything is true before you sign it.

Don’t sign a blank form for the agent or broker to fill in later.

If anything is not true on your application, the insurance company can refuse to pay any benefits if you make a claim.

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Paying for Insurance

Paying for Insurance

The amount you pay for the insurance is the premium.

The insurance company decides on the premium using the information in your application.

For life and health insurance, the application will ask questions about your health.

You may need to have a doctor or nurse examine you or have your doctor give the insurance company some information.

The insurance company will decide on your premium depending on your age, gender, whether you smoke, and other information.

For property insurance, the application will ask you to describe the property and tell how you use it.

For example, if you drive your car to work every day, you will probably pay a higher premium than if you only use it on evenings and weekends.

Making a Claim

If you have a loss, you make a claim to the insurance company.

You need to show proof of the loss, such as receipts for health care expenses or a death certificate for a life insurance claim.

For property insurance, an adjuster from the insurance company will decide on the value of the damage to the property.

For property and health insurance, you pay for part of the loss – the deductible. The amount of the deductible is in your policy.

For example, if your claim is for $3,500 and your deductible is $200, the insurance company will pay you $3,300.

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