PolicyMe Critical Illness Insurance Product Summary
Official Product Name:
PolicyMe Critical Illness Insurance
Insurer:
Securian Canada
1400-25 Sheppard Avenue West
Toronto, ON, Canada, M2N 6S6
Email: service@canadianpremier.ca
Phone (Toll-free): 1-855-883-6176
Website: https://securiancanada.ca/
AMF Client Number: 2000829775
AMF Website: http://lautorite.qc.ca/en
Distributor:
PolicyMe Corp.
1300-207 Queens Quay W, Suite 400,
Toronto, ON M5J 1A7
AMF Client Number: 3002916818
General Inquiries: info@policyme.com
Phone: 1-866-999-7457
Website: www.policyme.com
What is this product:
Critical illness insurance coverage provides a living benefit for you if you are ever diagnosed with a critical illness, such as heart attacks, stroke or cancer. Our insurance also covers you from select early-stage conditions that are detected early so that you can focus on your recovery. You can use the cash to help replace your income while you take time off work or to pay for out-of-pocket medical expenses that aren’t covered by your provincial healthcare plan.
How do I apply?
You may apply for PolicyMe Critical Illness Insurance on www.policyme.com directly using the online website application. All aspects of the application will be done completely online, and any communication will be done via email, text, or calls. You are required to answer health and lifestyle questions as part of the application and you may need to complete a nurse visit or other medical requirements, if deemed necessary during the underwriting process.
Sample policies of the PolicyMe Critical Illness Insurance product can be found at: www.policyme.com/legal/policyme-critical-illness-insurance-sample-policy.
1. Product Details
The below table has an overview of the PolicyMe Critical Illness Insurance product:
The PolicyMe Critical Illness Insurance product will pay out to you once a claim for the critical illness benefit is submitted and approved by Securian Canada.
The premiums on this policy are payable until the term length ends. You can cancel at any time, without fees or penalties. The policy will remain active until a claim for the critical illness benefit is submitted or until you cancel.
2. Product Benefits
Critical Illness Benefit
- If you are diagnosed with any of the 27 fully covered critical illness conditions, you’ll receive a lump-sum payment in the amount of your total coverage.
- There will only be one payout per policy.
Early Condition Benefit
- If you are diagnosed with any of the 15 early-stage conditions and the waiting period is met, you’ll receive 15% of your policy’s coverage amount up to a maximum of $50,000 in critical illness benefit.
- If you require either of the 2 ablation surgeries and the waiting period is met, you’ll receive 30% of your policy’s coverage amount up to a maximum of $100,000 in critical illness benefit.
- Payment of an early condition benefit does not reduce the total critical illness benefit payable.
- Only one claim is available per early condition, and up to 4 early conditions are available in total.
3. Product Benefits
3.1. Fully Covered Conditions
3.2. Early Intervention Conditions (Partial Coverage)
The following conditions would be partially covered and pay out 15% of the policy’s coverage amount(up to a maximum of $50,000):
The following ablation surgeries would also be partially covered and pay out 30% of the policy’s coverage amount (up to a maximum of $100,000):
4. Product Exclusions
4.1. Standard Exclusions
PolicyMe’s Critical Illness Insurance includes the following industry standard terms in it:
- The coverage for cancer applies to new cancers developed after the first 90 days of this policy being active.
- The coverage for Parkinson’s and Multiple Sclerosis only applies to these conditions if they are developed after the first year of this policy being active.
It also doesn’t cover conditions due to:
- intentional self-inflicted injuries,
- committing or attempting to commit a criminal offense,
- operating a motor vehicle while blood-alcohol concentration exceeds 80 milligrams of alcohol in 100 millilitres of blood,
- intentional use or intake of any drug, intoxicant, narcotic or poisonous substance except as prescribed by a physician or as directed by the manufacturer in the case of non-prescribed medication,
- war, or any act or incident of war, whether declared or not, or any conflict between the armed services of countries or international organizations,
- No Critical Illness Benefit or Early Intervention Benefit will be paid by the policy for any cancer condition if the policyholder has any signs, symptoms or investigations that lead to the diagnosis of cancer, or the diagnosis itself, occur within the first 90 days of the Effective Date or the most recent Effective Date of Reinstatement.
In addition, covered conditions will come with their own condition-specific exclusions that will follow the industry standard.
4.2. Waiting Periods
The required waiting period will vary depending on a given condition. Half of the covered conditions do not require a waiting period. Most cardiovascular conditions will have 30-day waiting periods. The remaining conditions covered will have waiting period criteria included within their definition. Please refer to a sample policy for more details.
5. Product Eligibility
5.1. Financial Eligibility
PolicyMe bases the financial eligibility to buy the PolicyMe Critical Illness Insurance product on the customer’s income, mortgage, net worth, existing insurance coverage, and whether any existing coverage will be replaced with the insurance they have applied for.
5.2. Term Lengths & Eligibility
- You must be a Canadian resident.
5.3. Coverage Amounts
Coverage amounts for the PolicyMe Critical Illness Insurance must fall between $10,000 to $1,000,000.
6. How to make a claim
To claim the Critical Illness Benefit or Early Condition Benefit, you may visit: www.policyme.com/make-a-claim for instructions on how to submit a claim.
You should submit a claim to us no later than 30 days from the date that the policyholder meets all requirements of a Covered Critical Illness Condition or Covered Early Condition.
The benefits provided for in this policy will be paid upon receipt of proof satisfactory to us. The policyholder shall, within 90 days from the date a claim arises under this policy, furnish such proof to PolicyMe, as is reasonably possible in the circumstances, including:
- the cause, nature or duration of a Covered Critical Illness Condition or Covered Early Condition;
- the right of the claimant to receive payment;
- the claimant’s age; and
- if required, a satisfactory certificate to the cause, nature or duration of the Covered Critical Illness Condition or Covered Early Condition.
6.1. How is the benefit paid?
A cheque will be delivered to the rightful claimant.
6.2. What if I want to appeal Securian Canada’s claim decision?
If your claim were to be denied, you may appeal the decision by writing to the PolicyMe within 2 years of the date of denial.
7. Complaints
PolicyMe and Securian Canada are committed to providing you with the best customer experience to purchase critical illness insurance. If you are unhappy with your PolicyMe insurance and wish to make a complaint, you can do so by notifying PolicyMe in writing, either by email or letter, detailing the nature of your complaint and providing any relevant documentation.
Upon receipt of the complaint, PolicyMe will acknowledge your communication and initiate an investigation.The company will review your complaint and may request additional information if necessary. PolicyMe will aim to resolve your complaint in a timely and fair manner and provide you with a written response detailing the outcome of the investigation.
If you are not satisfied with the outcome of the investigation, you may escalate your complaint to PolicyMe at www.policyme.com/legal/complaints.
It is important to note that PolicyMe is committed to treating all complaints seriously and will work to ensure that any issues are resolved as quickly and effectively as possible.
CPL-PM-CI-06-EN-PS