Product Disclosure - Limitations, reductions, exclusions



Survival period

The survival period is generally 30 days, but may vary depending on the illness. This is the period of time the insured must survive after being diagnosed with a critical illness to be eligible for a benefit under his/her Protecta coverage. If the insured dies during the survival period and had purchased a Return of Premium option (on death, surrender or death/surrender), all premiums paid will be returned to the designated beneficiary, but no critical illness benefit payment will be made.


Claims

Before settling any claims, we will require evidence that is satisfactory to us. We will deduct any amount owed to us from the policy proceeds before settling any claims including any due and unpaid premiums during the grace period.


Confirmation of diagnosis

We reserve the right to request examination of the insured and confirmation of the diagnosis or surgery for an insured condition, by any doctor appointed by us. In the event of any elective surgery outside of Canada, such an examination will be required prior to the surgery.


Moratorium period exclusion for cancer

There is a 90-day exclusion period for cancer. That means no benefit will be payable if the diagnosis or the date of the signs and/or symptoms and/or medical consultation is within 90 days of the policy issue or reinstatement.


Contract validity

The validity of the contract is conditional upon the accurate representation of the facts needed by us to issue or reinstate the policy.

Misrepresentation of, or failure to disclose to us or to our medical examiners, in the application or any document which form part of the contract, any fact that is material to insurance applied for will allow us to contest the validity of the contract and/or coverage and deny the claim, and may render the contract and/or coverage void by us.


Misrepresentation of smoking habits

If a non-smoker class rate has been granted to an insured under this policy on the basis of incorrect or incomplete evidence, the coverages associated with the insured shall be void and terminated.


Misstatement of age or sex

Each coverage in this policy is issued using the age of the insured at the birthday nearest to the coverage issue date. If the age or sex of an insured is misstated on the application or the policy data page, the amount payable by Standard Life under any provision of this policy shall be adjusted to the amount payable had the age or sex been correctly stated. However, the true age will be used for determination of the termination of coverage.