Cash. Comfort. Recovery.

Eligibility 

To be eligible, employees must:

• be working a minimum of 15 hours per week;
• reside in Canada; and
• be under age 70.

“Employee” means a person who is directly employed and compensated for services by a participating employer at its Canadian operations on a regular full-time basis.

Spouses

Spouses of eligible employees must also:

• reside in Canada; and
• be under age 70.

“Spouse” means the legal or common-law spouse of an employee. 

Dependent children

All dependent children of eligible employees must:

• reside in Canada; and
• be under age 22 (up to age 25 if they are enrolled full-time at a post-secondary school)

The employee must also be insured or in the process of applying for Victor's Optional Critical Illness Insurance.

“Dependent child” means any natural child, step-child or legally adopted child of an insured employee, who is under 22 years of age, unmarried and receives full parental support and maintenance, or who is 22 years of age or over but under 25 years of age, unmarried and receives full parental support and maintenance for reason of full-time attendance at a recognized school, college or university.

Provision regarding Quebec residents

To be eligible for and retain coverage under this proposed plan, applicants and insureds who reside in the province of Quebec and are under age 65 must be covered under a private drug plan (as required by the Quebec Act respecting prescription drug insurance).

Covered Condition Benefit

The Covered Condition Benefit amount in force* will be paid if the insured:

• is diagnosed with a Covered Condition while their Victor Optional Critical Illness Insurance is in force; and
• survives for the specified number of days following the date of diagnosis (see the Exclusions and Limitations section below for details).

In the event the insured, who has already received a benefit payment, receives a diagnosis for a separate and unrelated Covered Condition, then the Multiple Event Coverage Benefit can apply.

*Subject to the terms and conditions of the policy.

Multiple Event Coverage

Employees and spouses can claim multiple times provided the subsequent condition is in a different Multiple Event Coverage Grouping. See table below.

AdvanceCare Benefit

A one-time payment equivalent to 10% of the Benefit Amount will be paid if an insured:

• is diagnosed with an Early Stage Cancer; or
• requires a Coronary Angioplasty procedure.

The payment of the AdvanceCare Benefit will not affect the full benefit payment for a Covered Condition.

For full definitions of AdvanceCare Benefit Conditions, please click here.

Cancer Recurrence Benefit

An employee or spouse who is diagnosed with Cancer while insured under this plan and, after 60 consecutive months of being cancer-free is diagnosed with Cancer again, may claim the full benefit amount again. Subject to the terms and conditions of the policy.

Dependent children are not eligible for the Multiple Event Coverage, AdvanceCare and Cancer Recurrence Benefits nor Conversion.

Exclusions and limitations

• No benefit will be paid if a Covered Condition was diagnosed prior to the issue date of the insured’s Critical Illness Insurance.
• No benefit will be paid if a Covered Condition results directly or indirectly from: attempted suicide, alcohol or drug abuse, war or armed forces service, flying as a student pilot or flying as a privately licensed pilot, self-inflicted injury, taking poison or inhaling gas, or participation in a criminal act.
• No Cancer Recurrence Benefit will be paid if the first instance of cancer was diagnosed before the effective date of coverage under this policy.
• The insured must survive for 30 days (90 days for Paralysis, Loss of Independent Existence or Bacterial Meningitis, 180 days for Multiple Sclerosis or Loss of Speech) after first being diagnosed for a benefit payment to be made.
• If the insured employee or spouse is diagnosed with a Benign Brain Tumour, Cancer or Early Stage Cancer within the first 90 days of coverage, or with Multiple Sclerosis or Parkinson’s Disease within the first year of coverage, a Covered Condition Benefit will not be payable and the diagnosed condition will no longer be considered a Covered Condition for the insured.
• A diagnosis of Benign Brain Tumour, Multiple Sclerosis or Parkinson’s Disease within the applicable limitation period will also result in any condition under MEC Group 3 no longer being payable (see MEC Grouping details).
• If an insured dependent child is diagnosed with a Benign Brain Tumour or Cancer while in the womb or within 90 days of birth, or with Multiple Sclerosis while in the womb or within the first year of birth, then no benefit amount will be paid and Critical Illness Insurance for such child will be void.
• An insured dependent child, born in the 10-month period immediately following the effective date of Critical Illness Insurance coverage, will not be entitled to a Covered Condition Benefit if, within 30 days of birth they have any of the following:
  • a Diagnosis of a Covered Condition other than Benign Brain Tumour, Cancer or Multiple Sclerosis; or
  • the dependent child’s parent or physician notice or become aware of any sign, symptom, condition or medical problem that leads to a diagnosis of a Covered Condition at any time in the future.
• For Blindness, Coma, Deafness, Loss of Limbs, Severe Burns, Paralysis or Stroke, no benefit will be paid if the condition is a result of participating in hazardous sports or activities. 
• With respect to Guaranteed Acceptance Critical Illness Insurance as a result of a Special Offer, no benefit will be paid if a Covered Condition or AdvanceCare Benefit Condition results directly or indirectly from a Pre-existing Condition. A “Pre-existing Condition” means any symptom, condition, disorder, illness, pre-disease or disease, or any mental, nervous or psychiatric condition or disorder for which any one of medical advice, treatment, service, prescribed medication, diagnosis or consultation, including consultation to investigate and/or diagnose (where diagnosis has not yet been made) was received by the insured person or would have been received by a prudent individual within the 24 months immediately preceding the effective date of an insured person’s coverage. This exclusion applies for the 24 months following the effective date of such insured employee’s or insured spouse’s Guaranteed Acceptance Critical Illness Insurance.
• If you have already applied for the maximum guaranteed issue amount of Optional Critical Illness, you are not eligible to apply for additional guaranteed issue amounts. You may apply for higher amounts of coverage with evidence of good health. This also applies to your spouse and dependent children. 

Termination

Coverage for all insureds terminates on the earliest of the following dates:

• The date of death of the employee
• The date Victor receives written notice from the employee requesting cancellation of all or part of the insurance coverage
• The premium due date of unpaid premiums if not paid within the 31-day grace period

Employee coverage terminates on the earliest of the dates noted under “All Insureds” or below:

• The date the employee reaches age 75

Spouse coverage terminates on the earliest of the dates noted under “All Insureds” or below:

• The date the spouse is no longer eligible as a spouse
• The date of death of the insured spouse
• The date the spouse reaches age 75

Dependent child coverage terminates on the earliest of the dates noted under “All Insureds” or below:

• The date that the Covered Condition Benefit is paid with respect to that insured dependent child
• The date the child is no longer eligible as a dependent child
• The date the insured employee’s Optional Critical Illness Insurance terminates
• The date of death of the insured dependent child