PolicyMe Critical Illness Insurance Sample Policy
Your coverage details
Canadian Premier Life Insurance Company, operating under the brand name Securian Canada (“Securian Canada”, “we”, “us” or “our”) has issued PolicyMe Critical Illness Insurance Policy [Policy #] (“Policy”) to [Customer Name] (“Policyholder”, “you”, “your”).
This Policy supersedes any policy previously provided to you under Policy [Policy #].
If you are not satisfied with this Policy, you may cancel it by submitting a Cancellation Request Form to PolicyMe (the Administrator) at any time. If you submit a Cancellation Request Form within 30 days of the Effective Date, you will receive a full refund of any premiums you have paid.
Policyholder
[Customer Name]
[Address Line 1]
[Address Line 2]
[Phone Number]
[Email Address]
20-Year Critical Illness Insurance Policy
About Securian Canada
Securian Canada is the brand name used by Canadian Premier Life Insurance Company and Canadian Premier General Insurance Company to do business in Canada. Your life insurance will be underwritten by Canadian Premier Life Insurance Company – an AM Best, A rated insurance company.
Canadian Premier Life Insurance Company is a licensed insurance company in Canada, a wholly owned and independently operated subsidiary of US-based Securian Financial. For more than 65 years, we have been committed to giving families the confidence to face life’s uncertainties and make the most of every day.
For more about Securian Canada, visit securiancanada.ca or contact 1 (844) 894-0378 or service@securiancanada.ca.
Questions?
PolicyMe Corp. (“PolicyMe”) is the Administrator for your Policy. Any requirement outlined in this Policy to submit a form or provide a notification should be completed by contacting the Administrator directly at servicing@policyme.com or by phone at 1 (866) 999-7457.
1. How your Policy works
1.1 When your coverage begins
Your coverage will begin at 12:01 a.m. Standard Time at your address on the later of:
- the Effective Date shown on your coverage details page;
- the date your identification is verified;
- the date we receive payment for your first premium; or
- the date you receive an email notification from the Administrator confirming that your coverage has been reviewed, is complete, and that your coverage has begun and is in force.
1.2 When your coverage ends
Your coverage terminates at 12:01 a.m. Standard Time at your address on the earlier of:
- the business day we receive your request to cancel the coverage through a submitted Cancellation Request Form;
- the day you receive the Critical Illness Benefit payout from this Policy, excluding any Early Condition Benefit payout;
- the date of death of the Policyholder for this Policy;
- 30 days after your Policy enters the grace period, if you have not paid the overdue premium amount in full by the end of the grace period;
- as described under Section 2.2 – Contestability, if applicable; or
- the Expiration Date shown on your coverage details page. If the Waiting Period for a Critical Illness Benefit or Early Condition Benefit has begun, but has not yet been completed at that time, then your coverage will expire as described below:
- If the Waiting Period is subsequently fully completed, we will pay that Critical Illness Benefit or Early Condition Benefit for that coverage, subject to all the terms of this policy. The coverage expires on the date that Critical Illness Benefit or Early Condition Benefit becomes payable for that coverage; or
- If the Waiting Period is not subsequently fully completed, we will not pay that Critical Illness Benefit or Early Condition Benefit for that coverage. The coverage expires on the first day that the Policyholder no longer meets the definition of Waiting Period as defined in Section 3.
We will not pay any other Critical Illness Benefit or Early Condition Benefit for that coverage other than that Critical Illness Benefit or Early Condition Benefit, if payable.
1.3 Coverage Details
Critical Illness Benefit
This Policy provides critical illness coverage with level premiums guaranteed to not increase for the term length of your Policy.
If you are diagnosed with or have surgery for any of the Covered Critical Illness Conditions listed in Section 1.4 while this Policy is in force and have satisfied the Waiting Period for that Covered Critical Illness Condition, we will pay you the Critical Illness Benefit, subject to all the terms of this Policy. The Critical Illness Benefit is equal to the Policy Coverage Amount listed on the coverage details page.
You may keep this Policy in force until the Expiration Date. Prior to that time, other than as provided in this Policy or under governing law, we will not:
- cancel your Policy;
- place any restriction on your coverage while your Policy is in force; or
- refuse a premium paid on or before the due date or within the grace period.
This Policy is non-participating, which means you will not receive dividends or other participation in a distribution of surplus or profits from it.
Only one Critical Illness Benefit is available for this Policy.
Early Condition Benefit
This benefit can help by providing partial coverage for conditions that have been diagnosed at an early stage.
If you are diagnosed with any of the Covered Early Conditions listed in Section 1.5 while this Policy is in force and have satisfied the Waiting Period for the Covered Early Condition, we will pay you the Early Condition Benefit, subject to all the terms of this Policy. We will not pay you the Early Condition Benefit if you meet all the requirements for a Critical Illness Benefit.
The Early Condition Benefit amount is equal to 15% of your Policy Coverage Amount for all Covered Early Conditions, up to a maximum of $50,000 for this Policy, except for both ablation surgeries (Carcinoma In-Situ(CIS) of the Breast Treated with Total Mastectomy and Early-Stage Prostate Cancer Treated with Radical Prostatectomy).
There are two Covered Early Conditions that are ablation surgeries. The Early Condition Benefit for both ablation surgeries (Carcinoma In-Situ (CIS) of the Breast Treated with Total Mastectomy and Early-Stage Prostate Cancer Treated with Radical Prostatectomy) is equal to 30% of your Policy Coverage Amount, up to a maximum of $100,000 for this Policy, minus any prior Early Condition Benefit paid or pending for an Early-Stage Breast Cancer or an Early-Stage Prostate Cancer.
Only one Early Condition Benefit is available per Covered Early Condition. Up to four Early Condition Benefits are available for this Policy. Payment of the Early Condition Benefit does not reduce the Critical Illness Benefit amount.
Limits for Early-Stage Breast Cancer and Early-Stage Prostate Cancer
There are two Covered Early Conditions for Early-Stage Breast Cancer under your Policy. The combined Early Condition Benefit for these two (Early-Stage Breast Cancer and Carcinoma in-Situ (CIS) of the Breast Treated with Total Mastectomy) shall not exceed 30% of your Policy Coverage Amount, up to a maximum of $100,000 for the lifetime of this Policy.
There are two Covered Early Conditions for Early-Stage Prostate Cancer under your Policy. The combined Early Condition Benefit for these two (Early-Stage Prostate Cancer and Early-Stage Prostate Cancer Treated with Radical Prostatectomy) shall not exceed 30% of your Policy Coverage Amount, up to a maximum of $100,000 for the lifetime of this Policy.
1.4 Covered Critical Illness Conditions
1.5 Covered Early Conditions
1.6 Exclusions
The exclusions in this Section 1.6 and the condition-level exclusions in Sections 1.4 and 1.5 take precedence over any other provision or condition of this Policy. We will pay the Critical Illness Benefit and the Early Condition Benefit if you are diagnosed with or have surgery for a Covered Critical Illness Condition or Covered Early Condition respectively, while this Policy is in force and all this Policy’s terms and conditions have been met, excluding the following:
- The condition is a result of intentional self-inflicted injuries;
- The condition is a result of or is associated with you committing or attempting to commit a criminal offense;
- The condition is a result of you operating a motor vehicle while your blood-alcohol concentration exceeds 80 milligrams of alcohol in 100 millilitres of blood;
- The condition is a result of war, or any act or incident of war, whether declared or not, or any conflict between the armed services of countries;
- The condition is a result of your intentional use or intake of any drug, intoxicant (including alcohol), narcotic or poisonous substance except as prescribed by a physician or as directed by the manufacturer in the case of non-prescribed medication; or
- The date of the diagnosis or the end of the Waiting Period is on or after the date of death of the Policyholder.
1.7 Moratorium for cancer conditions
No Critical Illness Benefit or Early Condition Benefit will be paid under any cancer-related condition if, within the first 90 days following the later of, the Effective Date, or the date of the last Reinstatement of the Policy, the Policyholder has any of the following:
- Signs, symptoms, or investigations leading directly or indirectly to the diagnosis of any cancer (covered or not covered under the Policy), regardless of when the diagnosis is made; or
- A diagnosis of any cancer (covered or not covered under the Policy).
Medical information about the diagnosis and any signs, symptoms or investigations leading to the diagnosis must be reported to us within 6 months of the date of the diagnosis. If this information is not provided within this period, we have the right to deny any claim for any cancer condition or any Covered Critical Illness Condition or Covered Early Conditions caused by any cancer condition or its treatment.
1.8 How waiting periods work
We will only pay a Critical Illness Benefit or Early Condition Benefit if the Waiting Period for that Covered Critical Illness Condition or Covered Early Condition is met, as specified in Sections 1.4, 1.5 and 3.
1.9 Coverage outside of Canada
If the Policyholder is diagnosed with or undergoes surgery for a Covered Critical Illness Condition or Covered Early Condition outside of Canada, the Critical Illness Benefit and Early Condition Benefit will be payable if the Policyholder satisfies the following conditions in addition to satisfying all other terms and conditions outlined in this Policy:
- the Policyholder’s complete medical records are made available to us; and
- based on these medical records, we are satisfied that:
- the same diagnosis would have been made if the Covered Critical Illness Condition or Covered Early Condition had occurred in Canada;
- the physician making the diagnosis was licensed to practice in the jurisdiction in which the diagnosis was made and had credentials equal to any defined for that condition in your Policy;
- the diagnosis is fully supported by all appropriate tests and other investigations which would normally be completed in Canada or the United States (including those required by the specific definition of the Covered Critical Illness Condition or Covered Early Condition); and
- the same surgery or medically necessary non-surgical interventional procedure would have been administered if treatment had taken place in Canada; and
- the Policyholder must undergo an independent medical examination by a physician appointed by us if we make such a request. In the case of elective surgery, such an examination must be undergone before surgery occurs.
1.10 How to claim any benefit listed in this Policy
To claim the Critical Illness Benefit or Early Condition Benefit, the Policyholder should contact the Administrator. The Policyholder will then be given instructions about the documents we require to enable us to adjudicate the claim.
The Policyholder shall submit a claim to the Administrator 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 the Administrator, 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.
Failure to give notice or proof
Failure to submit a claim or furnish proof for a claim within the time prescribed in this section does not invalidate the claim if:
- the claim submission is given as soon as reasonably possible, and in no event later than 1 year from the date the Policyholder meets all requirements for a Covered Critical Illness Condition or Covered Early Condition if it is shown that it was not reasonably possible within the time prescribed;
- the submission of proof for a claim is given as soon as reasonably possible and in no event later than 1 year from the date a claim arises under this Policy if it was shown that it was not reasonably possible within the time prescribed; or
- in the case of the death of the Policyholder, if a declaration of presumption of death is necessary, the claim submission or claim proof is given no later than 1 year after the date a court makes the declaration.
1.11 Converting your Policy
At any point before the fifth anniversary of the Effective Date, you can convert your Policy to a new policy with a longer available term length and the same Policy Coverage Amount, without providing Evidence of Insurability.
This means that:
- A 10-year policy can be converted to a new 15-year, 20-year, 25-year or 30-year policy;
- A 15-year policy can be converted to a new 20-year, 25-year or 30-year policy;
- A 20-year policy can be converted to a new 25-year or 30-year policy; or
- A 25-year policy can be converted to a new 30-year policy.
The premium of the new policy will be based on the Policyholder’s age on the birthday closest to the day the new policy becomes in force, and the Premium Class or comparable risk category and underwriting decisions applicable to the original Policy. Any term length conversion will be subject to our rules regarding maximum Issue Ages.
1.12 Cancelling your Policy
If you are not satisfied with this Policy, you may cancel it at any time by submitting a Cancellation Request Form to the Administrator.
If you cancel within 30 days of the Effective Date, you will receive a full refund of any premiums you have paid.
If you cancel after this 30-day period, you will only receive a pro-rated refund of any premiums you have prepaid, if applicable. You will not be charged any cancellation fees or penalties.
1.13 Payment of premium
We determine the premium payable by you for this Policy based on the Policy Coverage Amount and term length you selected and your personal information. This information is shown on the coverage details page. We will not increase your premiums unless you make a change to your coverage.
All premiums due by the terms of this Policy shall be paid by the Policyholder in Canadian dollars on or prior to the day they are due.
You have the choice to pay your premiums annually or monthly.
If paying monthly, payments are due on the monthly payment date shown on your coverage details page.
If paying annually, payments are due on the anniversary of the Effective Date.
Payments will be made using the latest payment information that you have authorized the Administrator to charge on a recurring basis.
If at any time you wish to stop payments from being charged, you must notify the Administrator at least seven days prior to the day the next premium is due.
1.14 Grace period
Starting after your first premium payment, if a premium is not paid when due, this Policy shall be in default. We will allow a 30-day grace period to pay each premium, during which time this Policy stays in force. A notice will be sent to you at least 15 days prior to the expiration of the grace period. If your premium is not paid before the end of the grace period, this Policy shall automatically terminate. If you are diagnosed with a Covered Critical Illness Condition or Covered Early Condition during the grace period, any of your payable benefits, as applicable, will be reduced by the amount owing to us as of the date of your diagnosis.
2. General provisions
2.1 Entire contract
The Policy, the Application, and any endorsements and attachments form the entire contract of insurance. Noagent has authority to change this Policy or waive any of its provisions. No change to this Policy will be valid unless approved by an officer of Securian Canada and such approval is endorsed hereon or attached hereto.
You or any claimant may request a copy of this Policy, the Application and any written Evidence of Insurability(other than confidential information exempted from disclosure by applicable law) by contacting the Administrator.
2.2 Contestability
You have an obligation to disclose every fact that might influence our decision to issue or reinstate this Policy or influence its terms (a Material Fact). The information we rely on from you includes anything you provide in the Application and any other Evidence of Insurability. We use this information to make our decision and we have the right to contest the validity of this Policy and deny any claim if you misrepresent or fail to disclose a Material Fact.
All statements made in your Application and any other Evidence of Insurability will be deemed representations and not warranties. No statement will be used to void this Policy or be used in defense of a claim unless it is contained in your Application or any other Evidence of Insurability.
We will not contest this Policy after it has been in force during your lifetime for two years from the Effective Date or the most recent Effective Date of Reinstatement, except for fraud, ineligibility due to misstatement of age, or if you do not pay premiums.
2.3 Misstatement of date of birth or gender
If your date of birth or gender at birth has been misstated, your Critical Illness Benefit or Early Condition Benefit will be adjusted to the amount that would have been provided for the premiums paid based on your correct age or gender at birth. If you would have been ineligible for coverage had the correct information been provided in your Application at the time coverage became effective, this Policy is void and we will return all of the premiums paid.
2.4 Reinstatement
This Policy may be put back in force after it has been terminated if all of the following requirements are met:
- you have not been diagnosed with a Covered Critical Illness Condition or Covered Early Condition during the period that this Policy was terminated;
- a Request for Reinstatement has been submitted within two years of the date this Policy was terminated;
- the term length of your Policy has not yet expired;
- Evidence of Insurability is acceptable to us;
- all past due premiums are paid; and
- interest is paid by you on all past due premiums at the then applicable prime rate posted by the Bank of Canada (not to exceed six percent per annum).
You can obtain a Request for Reinstatement Form by contacting the Administrator.
The two-year incontestability period described in Section 2.2 – Contestability will restart on the most recent Effective Date of Reinstatement.
2.5 Legal action
Every action or proceeding against an insurer for the recovery of insurance money payable under the contract is absolutely barred unless commenced within the time set out in the Insurance Act (for actions or proceedings governed by the laws of Alberta and British Columbia), The Insurance Act (for actions or proceedings governed by the laws of Manitoba), the Limitations Act, 2002 (for actions or proceedings governed by the laws of Ontario), or in other applicable legislation. For those actions or proceedings involving residents of Saskatchewan, New Brunswick, Nova Scotia, Newfoundland, P.E.I., Yukon, Northwest Territories and Nunavut: No legal action may be brought against Securian Canada unless it is brought within the longer of: (a) 12 months from the date you are notified in writing that no benefits are payable; or (b) the shortest applicable limit of time established by law in the province in which you reside.
If any time limitation specified is less than that permitted by the law of the province or territory in which you reside at the time of the Effective Date, then the time limitation will not be less than that provided for by such provincial or territorial law.
2.6 Waiver
We shall not be deemed to have waived any term or condition of this Policy either in whole or in part, unless the waiver is clearly expressed in writing and signed by us.
2.7 Policy not assignable
Neither this Policy, nor any of your rights or interests under this Policy, are assignable, in whole or in part, to any person.
2.8 Governing laws
This Policy shall be governed by and interpreted in accordance with the laws of the province or territory of your residence on the Effective Date. Any terms of this Policy which are in conflict with the requirements of such laws are amended to conform to the minimum requirements thereof.
2.9 Changes to administrative rules
We may change the Administrator for this Policy and our administrative rules (such as how your premium is collected) from time to time. You will be notified of any such changes and they will not affect the amount of your Critical Illness Benefit or Early Condition Benefit provided by this Policy.
2.10 Complaints
To obtain information about how to make a complaint and our complaints handling process, please contact the Administrator.
2.11 Communication methods
You agree that all communications made pursuant to this Policy, including all notices and documents that we or the Administrator are required to provide under applicable law, will be exchanged through email, downloads available through a link to a website that we provide, or via any other electronic means existing now or in the future and that these electronic communications are the legal equivalent of paper documents. You also agree that the electronic consents associated with the electronic documents that we and the Administrator exchange with you authenticate those documents and are the legal equivalent of manual signatures.
2.12 Contact information
Any requirement outlined in this Policy to submit a form or provide a notification, should be completed by contacting the Administrator at the email address or phone number below.
Administrator
PolicyMe Corp.
servicing@policyme.com
1 (866) 999-7457
www.policyme.com
3. Definitions
Product Code CPL-PM-CI-06-EN-SAMPLE (03/2025)