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Critical Illness Insurance – Loss of Independence

Loss-of-Independence
This is part VI of VII in our series of covered conditions of critical illness insurance in Canada. In this article we look at loss of independence

Loss of Independence
a definite diagnosis of:

  • a total inability to perform, by oneself, at least 2 of the following 6 Activities of Daily Living, or
  • Cognitive Impairment, as defined below,
    for a continuous period of at least 90 days with no reasonable chance of recovery.

The diagnosis of Loss of Independent Existence must be made by a Specialist.

Activities of Daily Living are:

  • Bathing – the ability to wash oneself in a bathtub, shower or by sponge bath, with or without the aid of equipment.
  • Dressing – the ability to put on and remove necessary clothing including braces, artificial limbs or other surgical appliances.
  • Toileting – the ability to get on and off the toilet and maintain personal hygiene.
  • Bladder and Bowel Continence – the ability to manage bowel and bladder function with or without protective undergarments or surgical appliances so that a reasonable level of hygiene is maintained.
  • Transferring – the ability to move in and out of a bed, chair or wheelchair, with or without the use of equipment.
  • Feeding – the ability to consume food or drink that already has been prepared and made available, with or without the use of adaptive utensils.

Cognitive Impairment is defined as “mental deterioration and loss of intellectual ability, evidenced by deterioration in memory, orientation and reasoning, which are measurable and result from demonstrable organic cause as diagnosed by a Specialist. The degree of cognitive impairment must be sufficiently severe as to require a minimum of 8 hours of daily supervision. Determination of a Cognitive Impairment will be made on the basis of clinical data and valid standardized measures of such impairments.”

Exclusion: No benefit will be payable under this condition for any mental or nervous disorder without a demonstrable organic cause.
This is perhaps the lengthiest definition of all covered conditions.

I would like to point out that industry speculation is that no claim has ever been paid for Loss of Independence under a Canadian critical illness policy. I am unable to confirm or deny this speculation.

However, perhaps to address this potential concern, Manulife does not offer Loss of Independence coverage. Instead they have a similiar coverage called “LivingCare” which instead of paying a lump sum, pays a percentage of the coverage of the policy until the policy coverage is depleted. Manulife’s definition is 10 pages long and thus too long to post here, however they have a similiar definition in their standalong product here.

In addition, Manulife is one of the few companies that offers conversion to long term care. This means that under specific conditions, you may exchange your critical illness insurance policy for a long term care policy.

The loss of independence condition is certainly one that highlights the importance of reviewing different contracts from different companies. As part of your decision, you’ll need to weigh the benefits of policies that have loss of independence against Manulife’s policy that has their LifeCare benefit. We are happy to discuss specifics with you, feel welcome to contact us.

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