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CAA Life Insurance Glossary

Here are some of the more frequently used insurance terms. You can also find answers to many of the most commonly asked questions about insurance on our FAQs page.

To view a definition, click on the letter that the insurance term begins with:

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

A

Accident

Means an unintentional, sudden, fortuitous and unforeseeable event arising exclusively from an external cause, which inflicts, directly and independently of all other causes, bodily injury.

Accident Insurance

Provides benefits to the person insured in the event of an accident.

Anniversary Date

The first anniversary of the policy effective date and each anniversary of that date thereafter.

Aortic Surgery

The undergoing of surgery for disease of the aorta requiring excision and surgical replacement of the diseased aorta with a graft. Aorta refers to the thoracic and abdominal aorta, but not its branches. The surgery must be determined to be medically necessary by a specialist. Exclusion: No benefit will be payable under this condition for angioplasty, intra-arterial procedures, percutaneous trans-catheter procedures or non-surgical procedures.

Application

A signed document of personal and health-related information supplied by a person applying for insurance. An insurer uses the application to decide whether or not to provide coverage to that person.

Automobile

A motorized land vehicle which does not operate on rails or crawler treads and not including a two-wheeled vehicle, farm-type tractor or any equipment primarily designed for off-road use.

B

Beneficiary

The person, other than the insured or the insured's estate, to whom or for whose benefit, insurance money is made payable by contract or designation.

Benefits

The amounts paid to a claimant or beneficiary under the coverage of a policy.

C

Calendar Year

A calendar year refers to the period of 12 months that begins on January 1 and ends on December 31.

Cancellation

At the request of the insured or by the right of the insurer, the insurance policy is made void before its normal expiration date.

Cancer (Life Threatening)

For critical illness insurance, a definite diagnosis of a tumour characterized by the uncontrolled growth and spread of malignant cells and the invasion of tissue. The diagnosis of cancer must be made by a specialist.

Exclusions: No benefit will be payable under this condition for:

  • lesions described as benign, pre-malignant, uncertain, borderline, non-invasive, carcinoma in-situ (Tis), or tumours classified as Ta;
  • malignant melanoma skin cancer that is less than or equal to 1.0 mm in thickness, unless it is ulcerated or is accompanied by lymph node or distant metastasis;
  • any non-melanoma skin cancer, without lymph node or distant metastasis;
  • prostate cancer classified as T1a or T1b, without lymph node or distant metastasis;
  • papillary thyroid cancer or follicular thyroid cancer, or both, that is less than or equal to 2.0 cm in greatest diameter and classified as T1, without lymph node or distant metastasis;
  • chronic lymphocytic leukemia classified less than Rai stage 1; or
  • malignant gastrointestinal stromal tumours (GIST) and malignant carcinoid tumours, classified less than AJCC Stage 2.

Moratorium Period Exclusion

No benefit will be payable under this condition if within the first 90 days following the later of:

  • the effective date of the policy, or
  • the effective date of last reinstatement of the policy, if

the insured person has any of the following:

  • signs, symptoms or investigations, that lead to a diagnosis of cancer (covered or excluded under the policy), regardless of when the diagnosis is made,
  • a diagnosis of cancer (covered or excluded under the policy).

Medical information about the diagnosis and any signs, symptoms or investigations leading to the diagnosis must be reported to the insurer within 6 months of the date of the diagnosis. If this information is not provided, the Company has the right to deny any claim for cancer or, any critical illness caused by any cancer or its treatment.

The insured must survive for a period of 30 days following the date the condition is diagnosed in order for the benefit to be paid.

Certificate

A document issued to a person insured under a group insurance policy.

Claim

A request for benefit payment under the terms of an insurance policy.

Claimant

The person(s) making a request for payment of benefits under the terms of an insurance policy.

Coronary Bypass Surgery

For critical illness insurance, the undergoing of heart surgery to correct the narrowing or blockage of one or more coronary arteries with bypass graft(s). Exclusion: No benefit will be payable under this condition for angioplasty, intra-arterial procedures, percutaneous trans-catheter procedures or non-surgical procedures.

The surgery must be determined to be medically necessary by a specialist. The insured must survive for a period of 30 days following the date of the surgery in order for the benefit to be paid.

Coverage

Another term for the protection offered under an insurance policy. Coverage is used interchangeably with the terms insurance or protection.

Critical Illness Insurance

An insurance plan that pays benefits directly to the insured individual following diagnosis of a specified critical illness. Critical illness coverage is typically recommended as a means of preserving one's finances or lifestyle in the face of unforeseen medical costs not covered by other types of insurance.

D

Death Benefit

The amount of money paid to a beneficiary when a person insured under a life insurance policy dies.

Death Claim

A request for payment under the terms of a life insurance policy when an insured person dies.

E

Effective Date

The date when insurance coverage begins.

Evidence of Insurability

Any information that Manulife requires to decide if the person to be insured is insurable, and if so, on what terms. Evidence of Insurability means the insurance application and may include, but is not limited to, medical examinations, physician reports and blood and/or fluid tests.

Exclusions

Specific causes of death, circumstances and health-related conditions or any other losses for which an insurance policy does not provide benefits.

F

Face Amount

The amount of insurance shown on the first page of a policy. This amount is normally payable to a beneficiary when an insured person dies.

G

Grace Period

A period of time which acts as a cushion to ensure coverage is not cancelled if a payment is missed. If all payments due are not received within this period of time (or grace period) from the date a payment is missed, the insurance is cancelled.

Group Insurance

A single policy, which has been issued to a group or association, whereby members of the group can apply for coverage under the group policy.

Guaranteed Life

An insurance plan for mature Canadians that guarantees insurance coverage regardless of health. Rates are based on age at the time of application.

Guaranteed Renewable

Means the insurance company guarantees to renew the insurance at the end of a certain period, regardless of any changes in your health. Premiums may increase at renewal times.

H

Health Declaration

A health declaration is a type of declaration where an individual states that they have not suffered from a number of specified illnesses and conditions over a given period of time and are therefore eligible for coverage. If an individual declares eligibility, coverage is issued with no further requirements or underwriting assessment. If an individual has had any unusual signs or symptoms that have not yet been diagnosed by a physician or have been diagnosed with a condition named in the health declaration, they should not apply for CAA Critical Illness Insurance. If an individual is not sure whether they can declare good health we recommend they bring a copy of the health declaration and consult with their physician prior to submitting an application for CAA Critical Illness Insurance.

Heart Attack (Myocardial Infarction)

For critical illness insurance, the definite diagnosis of the death of heart muscle due to obstruction of blood flow, that results in a rise and fall of biochemical cardiac markers to levels considered diagnostic of myocardial infarction, with at least one of the following:

  • heart attack symptoms;
  • new electrocardiogram (ECG) changes consistent with a heart attack; or
  • development of new Q waves during or immediately following an intra-arterial cardiac procedure including, but not limited to, coronary angiography and coronary angioplasty.

The diagnosis of heart attack must be made by a specialist.

Exclusion: No benefit will be payable under this condition for:

  • elevated biochemical cardiac markers as a result of an intra-arterial cardiac procedure including, but not limited to, coronary angiography and coronary angioplasty, in the absence of new Q waves, or
  • ECG changes suggesting a prior myocardial infarction, which do not meet the Heart Attack definition as described above.

The insured must survive for a period of 30 days following the date the condition is diagnosed in order for the benefit to be paid.

I

Insured

A person covered under the terms of an insurance policy.

Insurer

The company providing the insurance coverage (e.g. Manulife).

L

Lump-sum

A single payment, paying a benefit in full.

N

Non-Smoker

An insured person who has not used any form of tobacco, including tobacco cessation products or marijuana, in the twelve (12) consecutive months preceding the date of application for insurance or non-smoker premiums, and who meets Manulife's health standards.

P

Policy

The legal document issued by an insurance company to a policyholder, which outlines the conditions and terms of the insurance.

Policy Anniversary

The first year immediately following the effective date, and every year thereafter.

Policy Effective Date

The policy effective date is shown on the policy summary page and is the date of underwriting approval. If the insurance is terminated and subsequently reinstated, the policy effective date remains the same. However, the contestability period will restart on the reinstatement effective date.

Policy Owner or Policyholder

The person who owns the insurance policy.

Pre-existing Condition

A pre-existing condition is an illness or condition for which, during the 24-month period prior to the effective date of the policy, the insured was diagnosed or was treated, hospitalized or attended to by a physician or was advised to seek treatment or consult a physician; was prescribed or took medication; showed indications, signs or symptoms or underwent tests or investigations.

Premium

The cost of insurance coverage. A premium can be paid monthly or annually.

Primary Insured

The person to whom the insurance was issued and with whom the Company has entered into a contract of insurance.

R

Rating Class

A population segment classified by actuaries as having similar insurance risks based on any of the following factors:

  • age;
  • benefit options; and
  • year of issue.
Rider

An optional benefit or coverage that is attached to, and dependent on, other coverage.

S

Stroke (Cerebrovascular Accident)

For critical illness insurance, a definite diagnosis of an acute cerebrovascular event caused by intra-cranial thrombosis or haemorrhage, or embolism from an extra-cranial source, with:

  • acute onset of new neurological symptoms; and
  • new objective neurological deficits on clinical examination, and persisting for more than 30 days following the date of diagnosis. These new symptoms and deficits must be corroborated by diagnostic imaging testing.

The diagnosis of stroke must be made by a specialist.

No benefit will be payable under this condition for:

  • transient ischemic attacks; or,
  • intracerebral vascular events due to trauma; or,
  • lacunar infarcts which do not meet the definition of stroke as described above.

The insured must survive until all of the criteria outlined under the description of stroke have been met in order for the benefit to be paid.

T

Term Life Insurance

A life insurance plan that provides coverage for a specified number of years. For instance, an insured can purchase a 20-year term life insurance plan and pay the same premium amount each year for the duration of the term. After 20 years, the coverage can be renewed at a higher price or cancelled. If the insured survives the stated period, the insurance expires without any value.

U

Underwriter

The person who decides the risk level of a potential insured applying for insurance protection. Also, the person or company that ensures money is available to pay for claims under the insurance policy. Manulife is the underwriter of the insurance plans described on this website.

Underwriting Requirements

The requirements used to assess whether an insured is eligible for i nsurance coverage. A person's age, the amount of coverage requested, medical records and physical examinations are generally used to decide if an insured will pass the underwriting requirements necessary for the insurance coverage and amount they have applied for.

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