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Critical Illness Insurance

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Presentation on theme: "Critical Illness Insurance"— Presentation transcript:

1 Critical Illness Insurance
[Company Name] 2013 What if you had a critical illness tomorrow? 1

2 Critical Illness Insurance
Let’s Face It Very few people are financially prepared to survive a critical illness. Without even looking at the statistics, you know that heart attacks, cancer and strokes happen to people every day. What Can Help? There’s a new way to plan for recovery and help protect your lifestyle. It’s Critical Illness insurance. Critical Illness insurance provides a substantial cash benefit upon the first diagnosis of a covered condition to help protect you from the associated costs. Your benefit can be used any way you and your family choose. And, your benefit is paid in full regardless of any other insurance you may have in force. Risks are real Financial risk • More than 50% of all personal bankruptcies in America are due to critical illness1 • Out-of-pocket medical expenses for Cancer average $35,0001 • How would a critical illness affect you financially? UNIVERSAL LIFE 1 Harvard Study, Illness and Injury as Contributors to Bankruptcy, February 2005

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First Diagnosis It is important you understand the meaning of first diagnosis. Most states define eligibility as first diagnosis. First diagnosis means the first time a physician identifies a covered condition from its signs or symptoms. If you’ve been diagnosed with a covered condition prior to having coverage, you may not be eligible for a benefit for that condition. Risks are real Health risk • One of every three Americans will contract cancer.3 • Every 29 seconds someone suffers a coronary event.4 • Every 53 seconds someone suffers a stroke.4 UNIVERSAL LIFE 3 American Cancer Society, American Heart Association, 2012 Update

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How can your Critical Illness insurance benefits be used? Your benefits provide security for many expenses not covered by medical insurance such as: • Rent or mortgage payment • Medical insurance copays and deductibles • Family income replacement during recuperation • College tuition • Experimental treatment or drugs • Childcare and housekeeping expenses

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Product Benefits

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Critical Illness with Cancer Covered conditions ALS (Lou Gehrig’s disease) Major organ transplant Paralysis of at least two Limbs Coronary artery by-pass surgery (25%)* Carcinoma in situ (25%)* Invasive cancer Heart attack Stroke Occupational HIV Renal (kidney) failure Blindness Remove Occupational HIV if not included on case *If the insured receives the 25% benefit for coronary artery by-pass surgery or carcinoma in situ, the remaining benefit will be available for a first diagnosis of another covered condition, or subsequent benefit if included. Most skin cancer is excluded. (Covered illnesses may vary by state.)

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Critical Illness only Covered conditions ALS (Lou Gehrig’s disease) Major organ transplant Paralysis of at least two Limbs Coronary artery by-pass surgery (25%)* Heart attack Stroke Occupational HIV Renal (kidney) failure Blindness Remove Occupational HIV if not included on case *If the insured receives the 25% benefit for coronary artery by-pass surgery, the remaining benefit will be available for a first diagnosis of another covered condition, or subsequent benefit if included. (Covered illnesses may vary by state.)

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Cancer only Covered conditions Invasive cancer Carcinoma in situ (25%)* *If the insured receives the 25% benefit for carcinoma in situ, the remaining 75% benefit will be available for a first diagnosis of another invasive cancer. Most skin cancer is excluded. (Covered conditions may vary by state.)

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Critical Illness with Cancer / New York Covered conditions -- NY ALS (Lou Gehrig’s disease) Major organ transplant Coronary artery obstruction (25%)* Carcinoma in situ (25%)* Invasive cancer Heart attack Stroke Occupational HIV Renal (kidney) failure Remove Occupational HIV if not included on case Special one-time $250 benefit for: Transient Ischemic Attack (TIA), Reversible Ischemic Neurologic Deficit (RIND), Skin Cancer *If the insured receives the 25% benefit for coronary artery obstruction, carcinoma in situ, or the skin cancer, RIND or TIA benefit, the remaining benefit will be available for diagnosis of another covered condition, or subsequent benefit if included.

10 Critical Illness Insurance
Critical Illness only - New York Covered conditions - NY ALS (Lou Gehrig’s disease) Major organ transplant Coronary artery obstruction (25%)* Heart attack Stroke Occupational HIV Renal (kidney) failure Remove Occupational HIV if not included on case Special one time $250 benefit for: Transient Ischemic Attack Benefit (TIA), Reversible Ischemic Neurologic Deficit Benefit (RIND) *If the insured receives the 25% benefit for coronary artery obstruction, or the RIND or TIA benefit, the remaining benefit will be available for diagnosis of another covered condition, or subsequent benefit if included.

11 Critical Illness Insurance
Cancer only – New York Covered conditions - NY Invasive cancer Carcinoma in situ (25%)* Special one time $250 benefit for: Skin Cancer Benefit *If the insured receives the 25% benefit for carcinoma in situ, or the skin cancer benefit, the remaining 75% benefit will be available for a first diagnosis of another invasive cancer.

12 Critical Illness Insurance
Double Benefit What happens if you experience a second covered condition? With Double Benefit, you can receive a second cash payment equal to the first. The second illness must be a different covered condition than the first and must occur at least six months later. UNIVERSAL LIFE Not Available On Cancer Only Plans (Not Approved in SD, Available on Combo Plans Only in GA)

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Subsequent condition benefit* Pays a lump-sum cash payment when you are diagnosed with any and every covered condition included in your policy. There are no limits to the number of payouts for each insured family member and no reduction in payouts for later-diagnosed conditions. (Coronary artery bypass surgery and carcinoma in situ are limited to one payout for each condition, which will not reduce any subsequent benefits.) How it adds up Example: $50,000 Critical Illness Policy Initial Benefit Heart attack diagnosis: $50,000 Subsequent Benefits Stroke diagnosis: $50,000 Major organ transplant: $50,000 Total Payout $150,000 UNIVERSAL LIFE *Separation periods between diagnoses may apply. Not available in all states. Except in NH, the Double Benefit rider will be offered in states where the Subsequent Condition Benefit riders are not available.

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Subsequent condition benefit with a recurring condition* Pays a lump-sum cash payment when you are diagnosed with any and every covered condition included in your policy. There are no limits to the number of payouts for each insured family member and no reduction in payouts for later-diagnosed conditions. Benefits are also payable for recurrence of the same covered condition previously paid under the contract, except for cancer, carcinoma in situ or coronary artery bypass. How it adds up Example: $50,000 Critical Illness Policy Initial Benefit Heart attack diagnosis: $50,000 Subsequent Benefit Stroke diagnosis: $50,000 Recurring Benefit Total Payout $150,000 UNIVERSAL LIFE *Separation periods between diagnoses may apply. Not available in all states. Except in NH, the Double Benefit rider will be offered in states where the Subsequent Condition Benefit riders are not available.

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Subsequent condition benefit with a recurring condition, including cancer* Pays a lump-sum cash payment when you are diagnosed with any and every covered condition included in your policy. There are no limits to the number of payouts for each insured family member and no reduction in payouts for later-diagnosed conditions. Benefits are also payable for recurrence of the same covered condition previously paid under the contract, except for carcinoma in situ or coronary artery bypass. How it adds up Example: $50,000 Critical Illness Policy Initial Benefit Invasive cancer diagnosis: $50,000 Subsequent Benefit Stroke diagnosis: $50,000 Recurring Benefit Total Payout $150,000 UNIVERSAL LIFE *Separation periods between diagnoses may apply. Not available in all states. Except in NH, the Double Benefit rider will be offered in states where the Subsequent Condition Benefit riders are not available.

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Health Screening Benefit Pays the cost of one screening test per calendar year ($50 or $100) for each insured. Some of the many screening tests covered include: Low dose mammography Stress test Pap smear (women over 18) Colonoscopy Serum cholesterol Bone marrow Prostate specific antigen Chest X-ray

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Waiver of Premium Waives your premiums if you are totally disabled. Waiting period and issue age limits apply. Not Approved in NY or GA

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EZ Value Option EZ Value – Raises your coverage automatically without additional underwriting. (Not available in CT, NH, NY or UT)

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Occupational HIV Benefit Rider Provides lump-sum cash payment in the event covered person contracts HIV at work. Benefit is the same as the base benefit amount HIV must be contracted by a needle stick, sharp injury or mucus membrane exposure at work. An initial test must be within five days of the accident. The infection must be found within 12 months of the accident. Not Approved in NY or GA

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This benefit empowers an insured who is critically ill by providing access to the right medical information and expertise. Comprehensive review of medical records and treatment recommendations by world-class experts and physicians Local and national referral to top specialized medical experts A personal advocate to assist with determining the best care provider for your medical needs as well as providing guidance to navigate the healthcare system Not Approved in NY or GA

21 Critical Illness Insurance
Built-in Features Guaranteed Renewable – Active coverage for life, as long as premiums are paid. Complete Portability – Take your policy with you. It’s yours to keep even if you change jobs or retire. Level Premiums – Rates do not increase as you age. Hospitalization or Treatment is Not Required – To receive benefit payment after diagnosis. Convenient Payroll Deduction – No bills to watch for and no checks to mail.

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Built-in Features Family Coverage Insure yourself, your spouse, your children and financially dependent grandchildren. Spouse and children same benefit as employee Spouse benefit 50% of employee’s benefit Spouse benefit 25% of employee’s benefit Children’s benefit 50% of employee’s benefit Children’s benefit 25% of employee’s benefit Children’s benefit 10% of employee’s benefit Use spouse/child benefits that match case

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Limitations and Exclusions Pre-existing Condition Limitation. In most states no benefit will be paid for any condition which begins in the first 12 months after the coverage effective date, if such condition is caused by or results from a pre-existing condition. A pre-existing condition is generally defined as a sickness or injury for which medical care, diagnosis or advice was received or recommended, or the existence of symptoms which would have caused an ordinarily prudent person to seek medical care, treatment, diagnosis or advice during the 12 months immediately prior to the coverage effective date. AK, AL, AR, AZ, CA, CO, DE, FL, IA, ID, KS, LA, MD, MI, MN, MO, MS, NC, ND, NE, NH, NJ, NV, OH, OK, RI, SD, TN, TX, VA, VT, WA, WI, WV, WY

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Limitations and Exclusions -- IL Pre-existing Condition Limitation. In IL there is no pre-existing condition for sickness or injury that applies to this plan. DC, GA, HI, IL, KY, MA, PA, SC

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Limitations and Exclusions -- NY Pre-existing Condition Limitation. In NY no benefit will be paid for any condition which begins in the first six months after the coverage effective date, if such condition is caused by or results from a pre-existing condition. A pre-existing condition is generally defined as a sickness or injury for which medical care, diagnosis or advice was received or recommended, or the existence of symptoms which would have caused an ordinarily prudent person to seek medical care, treatment, diagnosis or advice during the six months immediately prior to the coverage effective date. ME, NY, OR, UT

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Limitations and Exclusions -- IN Pre-existing Condition Limitation. In IN the Benefits or Partial Benefits provided to an eligible Covered Person may not be excluded, limited, or denied for more than nine months after the effective date because of a pre-existing condition of the Covered Person. For Late Enrollees, no Benefit Amount or Partial Benefit Amount will be paid for any condition caused by or resulting from a Pre-existing Condition for not more than 15 months from the date the Late Enrollee enrolls for coverage.

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Limitations and Exclusions -- MT Pre-existing Condition Limitation. In MT no benefit will be paid for any condition which begins in the first six months after the coverage effective date, if such condition is caused by or results from a pre-existing condition. A pre-existing condition is generally defined as a sickness or injury for which medical care, diagnosis or advice was received or recommended, or the existence of symptoms which would have caused an ordinarily prudent person to seek medical care, treatment, diagnosis or advice during the 12 months immediately prior to the coverage effective date.

28 Critical Illness Insurance
Limitations and Exclusions -- NM Pre-existing Condition Limitation. In NM no benefit will be paid for any condition which begins in the first 12 months after the coverage effective date, if such condition is caused by or results from a pre-existing condition. A pre-existing condition is generally defined as a sickness or injury for which medical care, diagnosis or advice was received or recommended, or the existence of symptoms which would have caused an ordinarily prudent person to seek medical care, treatment, diagnosis or advice during the six months immediately prior to the coverage effective date.

29 Critical Illness Insurance
For more details, contact your Trustmark representative today. This provides a brief description of your benefits and is not a contract. This is limited benefit coverage and should not replace existing basic medical coverage. Benefits, exclusions and limitations may vary by state. See Plan CACI and HS-12000/R for your state for exact terms and provisions.


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