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Ravi Soni

Critical illness

The cover people skip, and later wish they had.

A lump sum paid to you on diagnosis, while you are alive, to spend on whatever the diagnosis actually costs you.

What problem it solves

Life insurance handles the case where your income stops permanently. Disability insurance handles the case where it stops for a while. Critical illness handles a third case that neither covers well: you survive, and it is expensive.

Alberta Health pays for your treatment. It does not pay your mortgage during eight months of chemotherapy, or for the drug your oncologist wants that is not on the provincial formulary, or for your spouse to take unpaid leave to drive you to appointments, or for the flights to a specialist in Toronto. Those are ordinary consequences of a serious diagnosis and they land on a household at the exact moment its income has fallen.

How the money works

  • You are diagnosed with a covered condition, as the policy defines it.
  • You survive the survival period — usually 30 days.
  • The insurer pays you a tax-free lump sum. Not the hospital, not a creditor. You.
  • There are no conditions on what you spend it on.

That last point is the whole appeal. It buys time, and time is what a household in the middle of a diagnosis has least of.

Read these three clauses before anything else

  1. The definitions. “Cancer” in a contract usually means life-threatening cancer, with early-stage and non-invasive forms either excluded or paid at a reduced partial benefit. “Heart attack” requires specific diagnostic evidence. A contract covering four conditions generously can beat one covering twenty-five narrowly.
  2. The pre-existing condition and moratorium clauses. Most contracts exclude cancer diagnosed, or symptoms first appearing, within 90 days of coverage starting.
  3. Partial benefits. Better contracts pay a reduced benefit — often 10 to 15 per cent — for early-stage conditions such as ductal carcinoma in situ or stage A prostate cancer, without ending the policy. This is where good contracts separate from cheap ones.

How much, and for how long

A common starting point is one to two years of household income, or enough to cover fixed costs for eighteen months. Unlike life insurance, the goal is not to replace an income permanently — it is to remove financial pressure from a period of recovery.

On term length, most people are covering their working years. Coverage to age 65 or 70 is typical. Permanent critical illness exists and costs considerably more; the case for it is narrower than the case for permanent life insurance.

Who should look at this first

  • Self-employed people and contractors, who have no sick pay and no group benefits.
  • Single-income households, where one diagnosis removes all the income at once.
  • People with a family history — while it is still straightforward to underwrite. This is one product where waiting genuinely costs you.
  • Anyone with a mortgage and no savings buffer, which is a fair description of most first-time buyers in Edmonton.

Common questions

How is this different from disability insurance?
Critical illness pays a single lump sum on diagnosis of a covered condition, whether or not you stop working. Disability insurance pays a monthly benefit while you are unable to work, whatever the cause. They solve different problems and most people who need one need both — see disability and income protection.
What conditions are covered?
Almost every Canadian contract covers cancer, heart attack and stroke, and those three drive the large majority of claims. Broader contracts add 20 to 25 more, including multiple sclerosis, Parkinson's, major organ transplant, coronary bypass and loss of independent existence. The definitions matter more than the count — a policy listing 25 conditions with narrow definitions can be worse than one listing 4 with generous ones.
What is the survival period?
Most contracts pay 30 days after diagnosis, provided you survive that period. Some cancers have a longer waiting period, and most contracts exclude cancer diagnosed in the first 90 days of coverage. Read those two clauses before you sign.
What is a return of premium rider?
If you never claim, the insurer returns some or all of the premiums you paid, at a set point or on cancellation. It substantially increases the cost. It appeals to people who dislike the idea of paying for something they may never use — which is, in fairness, how all insurance works. Ask for both prices and decide with the numbers in front of you.
Does my province not cover cancer treatment?
Alberta Health covers treatment. It does not cover the mortgage while you are off work for eight months, a drug not on the provincial formulary, travel to a specialist in another province, childcare, or the income your spouse gives up to look after you. That gap is what the lump sum is for.

Worth pricing before you decide it is not for you.

Critical illness coverage is cheaper at 32 than at 42, and cheaper before a diagnosis than after one, when it stops being available at any price.