There’s more than one way to get critical illness insurance coverage. Getting something called a critical illness rider is an option that often costs less money. But whether it’s better for you to get just a rider vs a full policy depends.

This article can help you take a look at the key features and differences of each, and help you decide which one is better for you to choose.

What is critical illness insurance?

Critical illness insurance is a form of insurance that pays you a lump sum if you are diagnosed with a serious illness. The critical illness benefit money can be used for anything you need, like covering costs for:

Most standalone CI policies will cover at least the major health conditions that are most common in Canada, like cancer, heart disease, multiple sclerosis, and more.

If you get a critical illness diagnosis and you have a standalone policy, you get a full lump-sum payment to use however you need to.

What are the pros and cons of a critical illness insurance policy?

The table below shows some of the major pros and cons of getting a standalone critical illness plan by itself.

Each insurance company offers distinct features for their critical illness plans that may suit your needs best, depending on the type of protection you require. This is why we’ve evaluated the top providers across various categories to present our compilation of the Top 14 Best Critical Insurance Companies in this article.

Head straight to the reviews.

What are the best critical illness insurance companies in Canada?

Our top choices for Canada’s best critical illness insurance policies are from BMO, Canada Life, iA Financial, and Desjardins.

PolicyAdvisor.com has painstakingly researched the insurance companies that offer the best critical illness insurance plans in Canada. Years of profiling and analyzing the industry’s top offerings gives us the unique opportunity to review the country’s best critical illness insurance companies and present you with a list of the top insurance offerings available in the category. The following reviews are a must-read for anyone thinking about purchasing critical illness insurance in 2024.

The 14 best critical illness insurance companies in 2024 are:

• Assumption Life: Best for simple coverage
• Beneva: Best for a mutual company
• BMO Insurance: Most affordable enhanced coverage
• Canada Life: Rolls Royce of coverage
• Desjardins: Best for extensive coverage
• Empire Life: Best for couples
• Equitable Life: Best for multi-product discount
• Foresters Financial: Best for built-in benefits
• Humania: Best for children
• iA Financial: Best for flexibility
• ivari: Best for bundling
• Manulife: Best for brand recognition
• RBC Insurance: Best for combination long-term care
• Sun Life: Best for comprehensive features

Every year in Canada, roughly 63,200 people are diagnosed with a heart attack for the first time (source: Government of Canada). With the heart attack mortality rate of about 12% (source: Healthline), that means that every year over 55,000 people live with varying degrees of heart damage, which can impact lifestyle, mobility, and the ability to work.

Critical illness insurance can play a vital role in supporting people’s heart attack recovery by providing financial protection should they undergo this life-threatening health event. Critical illness insurance is a living benefit that can be used at the insured’s discretion, whether it’s to pay for care, treatment, income replacement, or anything else they may need. Keep reading to learn more about who is eligible for heart attack insurance and how it can protect your financial future.

What is a heart attack?

A heart attack, also called myocardial infarction, is when the heart muscle suffers damage due to a lack of blood flow and, consequently, lack of oxygen. Just as a stroke is caused by loss of blood flow to the brain, a heart attack is caused by a lack of blood flow to the heart. The severity of heart attacks varies depending on how long the blood supply is cut off from the vital organ. In worst-case scenarios, it can lead to cardiac arrest and death.

There are several factors that can cause heart attacks. The most common cause is obstructed coronary arteries due to buildup of plaque, cholesterol plaque, or blood clots. Heart attacks can also be caused by a coronary artery spasm, which temporarily restricts the coronary artery, inhibiting blood flow. Symptoms of a heart attack include chest pain or discomfort, shortness of breath, and nausea, among others—though these manifest differently depending on the patient.

While heart attacks are often unexpected, there are certain factors that influence your risk of heart disease—some of which can be mitigated. For instance, smoking, stress, recreational drug use, obesity, high blood pressure, and high cholesterol can all increase your risk of this medical condition. Other uncontrollable factors—such as age, family medical history, and certain autoimmune conditions—can contribute to your risk of a heart attack.

What is critical illness insurance?

Critical illness insurance is a type of coverage offered by life insurance companies (typically as an add-on to a life insurance policy, but can also be purchased as a stand-alone policy) that pays out a tax-free lump sum should the insured be diagnosed with a life-threatening illness or suffer a serious health event while the policy is active. Unlike traditional life insurance, critical illness insurance issues a benefit while the insured is alive, providing them and their family with financial support as they manage the financial and health impact of a life-threatening illness. This money can be used to pay medical expenses, cover non-traditional treatment, travel expenses or any other expenses the family sees fit. It should be noted that the critical illness insurance benefit is only paid if the insured is diagnosed with a covered illness, as specified in the policy. The proceeds of the insurance can be used fully at the discretion of the insured.

Does critical illness insurance cover heart attack?

Yes, critical illness policies cover heart attacks. In fact, heart attacks are the second most claimed health event through critical illness coverage (representing 13%), following cancer (63%). If you’ve suffered from a heart attack, it is important to note what insurance companies consider when approving claims. First, a heart attack requires a medical specialist diagnosis, and the insured must have undergone symptoms as well as electrocardiogram (ECG) changes that are consistent with a heart attack.

There are certain exclusions that may apply. For instance, a claim may be denied if a policyholder has ECG changes that point to a pre-existing heart attack, displays other acute coronary syndromes, or has undergone a medical procedure or received another diagnosis that has caused elevated cardiac biomarkers.

How long do I have to wait to file a claim after having a heart attack?

In order to make a claim for heart attack insurance, policyholders must be diagnosed with a heart attack by a physician and wait 30 days after the diagnosis. This waiting period is called a survival period. Some insurance providers do offer shorter survival periods. Typically, the critical illness benefit will be paid within a month of the claim being submitted.

Can I start a critical illness insurance policy after I’ve had a heart attack?

While it is much easier to start a critical illness insurance policy before suffering any major health events, it is still possible to find coverage after a heart attack recovery. In other words, you have options, though you may not qualify for the most competitive rates or highest benefits.

The most common route for those who have recovered from a heart attack is guaranteed critical illness insurance. This type of policy, though inclusive, has some limitations. For example, guaranteed critical illness insurance typically includes a two-year pre-existing condition exclusion. This means that if you’ve suffered from a heart attack in the two-year period before the start of the policy, any heart attack or related health event in the next two years will not be covered.

Can I get critical illness insurance if my family has cardiovascular health concerns?

If your family has a history or signs of heart disease, it is prudent to think about investing in critical illness insurance. Though most life insurance companies take family medical histories into account when evaluating a critical illness insurance application, having an increased risk of heart disease will not necessarily exclude you from coverage. Your coverage limit and premium rates, however, may be impacted.

In cases where family history is a consideration, it is advisable to purchase critical illness insurance sooner rather than later. This will increase your chances of being able to place coverage and improve the premium rates you are offered.

To find out more about insurance for heart attacks and other critical health conditions, head to our critical illness insurance learning centre. To better understand how much critical illness insurance coverage you might need, consult our critical illness insurance calculator.

CLHIA heart attack definition

Heart Attack definition

Heart Attack means a 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
• 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 (acute myocardial infarction) must be made by a specialist.

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

• ECG changes suggestive of a prior myocardial infarction;
• Other acute coronary syndromes, including angina pectoris and unstable angina; or
• Elevated cardiac biomarkers and/or symptoms that are due to medical procedures or diagnoses other than heart attack.

Similarly, there may also be coverage for other cardiovascular conditions. To clarify what is usually covered, the CLHIA has defined the 26 conditions most commonly included in these insurance policies. 

Critical illness insurance policies are not discussed as much as other types of insurance like life insurance or disability insurance. However, a critical illness policy could be what stands between the insured and the possibility of financial hardship in the case of a big health emergency.

This could include many common ailments, such as a heart attack, stroke, or cancer. Even if you are covered by a group health insurance policy, the cost of treatment for these illnesses could go beyond the scale of the coverage you have.

You may think the chance of such health events happening to you is negligible and wonder if critical illness insurance is worth purchasing. But, unfortunately, nearly 50% of Canadians are prone to develop some form of cancer in their lifetime (source: Government of Canada statistics).

Is critical illness insurance worth it?

Yes, critical illness insurance coverage is worth it for all Canadians. It safeguards your financial future in the event that you are diagnosed with a critical illness. And the chances are, you will be within your lifetime.

Critical illness insurance pays you a one-time lump sum payment if you are diagnosed with a critical illness. You can use this money how ever you like in order to support your recovery.

Why is critical illness insurance coverage worth it?

Critical illness insurance is worth the cost of monthly premiums because it’s very likely that you will be payed out for your policy. In fact, over 80% of critical illness insurance policies are paid out, and that number is growing. Because this type of insurance coverage can include a variety of illnesses, chances are, you’ll have to make a claim. That means it’s worth your money.

Let’s take a look at some stats.

Critical illness insurance statistics

Advantages of critical illness insurance coverage

Critical illness insurance comes with many advantages as an insurance product beyond the high rate of payout.

• Flexibility in how benefit is used
• Premiums can be returned if there are no claims (return of premium rider)
• Ability to get coverage as a rider or separate policy
• Ability to convert to permanent coverage

Disadvantages of critical illness insurance coverage

While critical illness insurance is a great product, there are some aspects that some may find negative.

• More expensive than life insurance
• More stringent underwriting guidelines
• Strict claims process (you must have an official diagnosis, which may take time)

Do you need critical illness insurance cover?

Regardless of any disadvantages of the product, the rate at which you are likely to get paid out for this policy makes this policy worth it—it’s a very low-risk gamble compared to other insurance products. Critical illness insurance provides a different type of peace-of-mind than other insurance categories like term life or whole life insurance. If you worry about your quality of life after a health scare, how a sickness could affect your family’s financial well-being, or having to work through an illness thus delaying or hampering your recovery, then critical illness can definitely be considered worth it.

What others say about critical illness insurance 

At PolicyAdvisor, we believe that critical illness insurance is worth your money. But we understand you may want other opinions. Here’s what some are saying about critical illness insurance in Canada.

Is critical illness insurance worth it in Canada – Reddit 

Check out this take from a Reddit user.

Source: https://www.reddit.com/r/PersonalFinanceCanada/comments/mrt9ef/is_critical_illness_insurance_worth_it/?rdt=43691
The views expressed in these reviews/forums are from the respective posters and NOT the opinion of PolicyAdvisor.com.

Source: https://www.reddit.com/r/PersonalFinanceCanada/comments/txupfz/doing_the_math_on_critical_illness_insurance/
The views expressed in these reviews/forums are from the respective posters and NOT the opinion of PolicyAdvisor.com.

Which is better life insurance or critical illness?

Life insurance and critical illness insurance are completely different insurance products that serve different purposes.

Life insurance: pays out a death benefit to your beneficiaries when you pass away
Critical illness insurance: pays out a benefit to you (the policyholder) if you are diagnosed with a critical illness

In the context of permanent (or whole life) coverage, permanent life insurance is more of a guaranteed product than critical illness, because one day you will pass away, but you may not necessarily be diagnosed with a critical illness. But that doesn’t make it a better product than critical illness insurance.

Both policies are important to have when considering the financial future of your family. Critical illness insurance will financially support your family if you are recovering where as life insurance will take care of your family if you have passed away.

Do I need both income protection and critical illness cover?

Income protection and critical illness insurance cover are two different insurance products that have different purposes.

Income loss protection or job loss insurance: pays out a benefit if you lose your job
Critical illness insurance: pays out a benefit to you (the policyholder) if you are diagnosed with a critical illness
Disability insurance: replaces a portion of your income if you are sick or injured and cannot work for a short or long period of time (depending on the policy). This is different from job loss insurance as you are only temporarily off work.

Disability insurance will replace your income while you’re off work due to a critical illness, whereas critical illness insurance will pay you a one-time lump sum payment when you are diagnosed with that illness. We recommend both products to ensure your full financial security during your recovery period.

What to look for in a critical illness insurance policy

Every person has unique financial needs and goals. When selecting a critical illness policy and deciding if its worth it for your family, you should consider what your ideal financial outcomes are.

To give you a better idea of how to select the best critical illness insurance policy, here’s is a breakdown of policy benefits you should look for:

Several Canadian insurance providers offer different types of critical insurance policies. Each of these policies has its own merits and drawbacks. PolicyAdvisor has reviewed all the major critical illness insurance offerings in Canada. In doing so, we come up with a list of features, details, and options Canadians should look for when shopping for their own critical illness coverage.

It may be the case that every feature is available in one policy, but with the help of an experienced insurance broker, you can find the coverage that is best for you.

Is it worth paying for critical illness insurance?

Yes, in general, it is worth it to buy critical illness insurance. The coverage starts from as low as $20 per month, but it and may go up to as high as a few hundred dollars a month. If you’re worried about it not being worthwhile, you may consider purchasing a return of premium rider. This rider will return your premiums back to you if no claim was made during the policy term or at death if no claims were made during the policyholder’s life.

The bottomline is, if you can’t afford the monthly premium, it is not worth it. But if you can, then this insurance is well-worth the monthly premium. You already know the likelihood of being diagnosed with a critical illness in your lifetime (80%), so it is worth it to make sure you will at least be financially secure while you recover.

In Canada, the average life expectancy is 83 years. Healthcare is world-class. Apart from healthcare facilities, there are renowned lab and research facilities. Despite having all this, one can not deny the toll that lengthy treatment takes on one’s financial condition. Recovery from life-threatening diseases is also often about care and facilities being made available for a longer than normal period. Critical illness insurance is worth its money in cases like these where one does not need to put the concern about receding income as a hurdle on the way to recovery.

Find out if critical illness insurance is worth it for your family

Those seeking coverage should consider this carefully and choose the policy (or critical illness insurance rider) that suits them best, considering both their coverage requirements and their budget. Better yet, get in touch with one of our experienced advisors to help educate you on your options.

When your child is sick, the only thing that should be on your mind is their recovery. But unfortunately, when a child is diagnosed with a critical illness, there are wider repercussions that can affect more than just their health. Between taking time off work to attend to your child to paying for treatments or rehabilitation equipment, critical illnesses can create even more stress in a dire situation for the entire family.   

Getting critical illness insurance can bring you great peace of mind. Knowing you’ll have a financial safety net should your child fall seriously ill can allow for economic flexibility in your future plans and safeguard you and your family against the unexpected.

What is critical illness insurance?

Critical illness insurance is a type of coverage offered by life insurance companies that pays out a tax-free lump sum should the insured be diagnosed with a life-threatening illness or suffer a serious health event while the policy is active. Such critical illness coverages can be purchased as an add-on (a critical illness rider) to a life insurance policy, or as a stand-alone policy. Unlike traditional life insurance, critical illness insurance issues a benefit while the insured is alive, providing them and their family with financial support as they manage the financial and health impact of a life-threatening illness. It should be noted that the critical illness insurance benefit is only paid if the insured is diagnosed with a covered illness, as specified in the policy. The proceeds of the insurance can be used fully at the discretion of the insured (or the parent/guardian in the case of a children’s critical illness policy).

What is children’s critical illness insurance?

Critical illness insurance for children provides you with a lump sum tax-free payment if your child is diagnosed with one of the illnesses covered by the policy. The proceeds from the insurance coverage offer financial protection for the parents and the family as they focus on the child’s recovery if they fall seriously ill. The coverage offered under this policy is similar to adult critical illness, except there are a few extra conditions included in the list of what is covered. Children are covered for additional childhood illnesses that won’t appear on an adult’s policy.

What does children’s critical illness insurance cover?

Critical illness insurance generally covers 25 or 26 life-threatening conditions. The definitions for these critical illnesses are generally consistent across most insurance companies that offer critical illness insurance coverage. Children’s critical illness insurance covers a few additional coverages. 

The 26 conditions that most common carriers cover are:

Cancers and Tumours:

1. Benign Brain Tumour
2. Cancer (Life-Threatening)

Cardiovascular:

1. Aortic Surgery
2. Coronary Artery Bypass Surgery
3. Heart Attack
4. Heart Valve Replacement or Repair
5. Stroke (Cerebrovascular accident)

Neurological:

1. Bacterial Meningitis
2. Dementia, including Alzheimer’s Disease
3. Motor Neuron Disease
4. Multiple Sclerosis
5. Parkinson’s Disease and Specified Atypical Parkinsonian Disorders

Vital Organs:

1. Kidney Failure
2. Major Organ Failure on Waiting List
3. Major Organ Transplant

Accident and Functional Loss:

1. Acquired Brain Injury*
2. Blindness
3. Coma
4. Deafness
5. Loss of Independent Existence
6. Loss of Limbs
7. Loss of Speech
8. Paralysis
9. Severe Burns

Other

1. Aplastic Anemia
2. Occupational HIV Infection

You can read the full list of conditions covered, defined by the Canadian Life and Health Insurance Association (CLHIA) here. 

With children’s critical illness insurance, there are some conditions on this coverage list that children are commonly affected by. Some of these conditions include the following:

Additional childhood illnesses

• Autism spectrum disorder
• Cystic fibrosis
• Rett syndrome 
• Cerebral palsy
• Muscular dystrophy
• Type 1 diabetes mellitus

This is not an exhaustive list and the insurance company may have exclusions and stipulations around conditions and diagnosis. Some policies may have exclusions for pre-existing conditions. Always consult your policy wordings to see exactly what the policy covers or speak to an advisor who will walk you through your coverage options.

When can a child’s critical illness insurance policy be purchased?

A child’s critical illness insurance coverage can be purchased after the child is born and up to the age of 25 years for the child. Some companies may cover additional diseases before the child turns 17 years in age. While an application for the coverage can be issued as early as 1 day after the child is born, most companies will require that the contract be issued at least after the child has turned 1 month in age.

When can a child’s critical illness insurance policy be claimed?

You can submit a child’s critical illness claim if:

• the diagnosed critical illness meets the definition of a covered critical illness, as defined in the policy document
• the critical illness does not occur during the waiting period of the covered critical Illness;
• the diagnosis of the covered critical illness has been made by a specialist;
• the child has survived a period of thirty (30) days following the diagnosis of the condition

What are the benefits of children’s critical illness?

This critical illness policy lessens the financial impact on families, should the child be diagnosed with a serious illness. The lump-sum payment received after diagnosis can be flexibly used for anything you wish. Paid in a lump sum, this coverage helps you: 

• Compensate for lost income if you are required to take a leave of absence to care for your child
• Pay for additional expenses, including treatments and prescription drugs not covered by a provincial healthcare plan  
• Travel or hotel expenses if you have to travel to seek healthcare for your child. 
• Keep up contributions to RESPs, RRSPs or even mortgage payments, if you are not able to continue to work
• Any other special health care needs or personal care management your child or family might need. 

Other than coverage after being diagnosed with one of the 35 conditions, the premiums for these policies are low and generally guaranteed. This means that if the child continues the coverage into adulthood they will receive coverage at a lower rate than if they applied for critical illness as adults. With some children’s critical illness policies, premiums are only paid during childhood, but coverage can continue into adulthood.

What is limited pay children’s insurance?

Limited-pay policies represent a premium payment plan where you can pay for the policy for a for a set amount of time (sometimes 10 or 20 years). After this time is up, you no longer have to pay premiums, but the coverage will stay in force. Your policy is considered fully paid up after the limited pay period is over

With some children’s critical illness policies, limited pay options are available. This means that if you purchase a critical illness policy for newborn, you pay for the first 20 years of their life only. After that, the policy ownership can be transferred over to them and they get to keep the critical illness coverage for the rest of their life. 

Limited pay policies typically are the most expensive in premium payments since premiums are front-loaded.

What is ‘return of premiums’ on children’s policies?

Return of premiums is a feature that can be optionally added to the coverage allowing the parent or the child to seek a refund of premiums if there is no claim on the policy. Such return of premium options are typically offered after the 20 year limited pay period is over. This payout can be used for education costs, a downpayment on a house, or even business ventures.

Does my critical illness policy cover my child?

Generally, a parent’s critical illness insurance policy will only cover their diagnosis, not the diagnosis of a loved one. However, it is possible to add a rider to your critical illness policy to include your child, as well as those additional childhood illnesses. 

When adding this rider, your child’s coverage is tied to your policy—meaning that if you cancel your coverage or when your coverage expires, your child’s coverage will cancel or expire. Some companies may only allow the children’s rider if you have an enhanced critical illness policy yourself (compared to a basic policy). Additionally, riders may have restrictions to coverage amounts (limiting coverage to $20,000 or $50,000 depending on the company) compared to purchasing a stand-alone children’s critical illness policy which can be purchased for much higher amounts.

Which are the best insurance companies offering children’s critical illness?

While this product is more specialized, at PolicyAdvisor we work with many providers who offer children’s critical illness insurance. 

For stand-alone children’s policies, the following insurance companies offer options: 

• iA (Industrial Alliance) Financial Group
• Canada Life Insurance
• Desjardins Insurance
• Beneva Insurance
• Sun Life Insurance

 You can also add a children’s critical illness insurance rider to your policy through products purchased from the following insurance companies: 

• BMO
• Empire Life 
• Foresters 
• iA (Industrial Alliance) Financial Group
• Manulife 
• Beneva Insurance

When deciding which policy is best for your child, you may consider the amount of coverage offered, the conditions, and the premium cost. Insurance is there to provide financial protection for you when you are in a difficult time such as when a child is diagnosed with a critical illness. However, the premium cost should not bankrupt you. 

To determine you and your family’s need you can try out our critical illness insurance calculator. This tool will tell you how much coverage you may need to give you peace of mind, no matter what life throws at you.

What else can I do to protect my child?

In addition to children’s critical illness insurance, which can take care of financial needs if they fall ill, you can also purchase a children’s life insurance policy. These policies are purchased by a parent or guardian as either a rider on the parent’s policy or as a stand-alone policy for the child. Children term riders are generally the least expensive way to obtain coverage for your child. Stand-alone life insurance policies for children are normally issued as whole-life products. These stand-alone policies are guaranteed to remain in force for the covered child’s entire lifetime (including into adulthood) and generate dividends, creating an increasing pool of investment resource and coverage for the child.

Learn more

To find out how to best protect your child and their financial future, speak to one of our advisors. They can help you find the best children’s coverage for your family, whether it’s an add-on rider or a new policy for your child. Let critical illness insurance give you that peace of mind, so you can focus on more important matters like helping your child get better.

Try our free critical illness insurance calculator to figure out how much coverage you might require or speak to our friendly advisors.

When you are diagnosed with a sudden, critical illness, your first concern should be your health and getting better, of course… but what about money? If you can’t work, how will you pay your bills?

Between taking time off work and losing income, travel costs to get special medical treatments, and the possibility of expensive home care, you could bleed your savings dry.

Find out when to buy critical illness insurance to cover these bills, so you can recover free from financial stress!

When should I buy critical illness insurance?

If you don’t have it already, NOW is the cheapest time and the right time for you to purchase. You should buy critical illness insurance as soon as you can fit the monthly premiums into your budget.

Like life insurance, there are advantages to getting critical illness insurance earlier in life. Critical illness insurance will get more expensive as you age as you are at a higher risk of sudden illness such as heart attack, stroke, or cancer as you get older. The younger and healthier the lifestyle you have, the cheaper this coverage can be.

How long does critical illness insurance coverage last?

Critical illness insurance comes in terms, similar to term life insurance, or it can cover you up to the age of 75. When you purchase a policy, you lock in your rate for the rest of your term, no matter your age or lifestyle changes.

How much critical illness insurance cover do I need?

Many Canadians purchase $50,000 – $100,000 in critical illness coverage. The maximum amount of coverage available with most Canadian critical illness insurance companies is $3 million.

To determine how much insurance you may need, take a look at your current expenses—your mortgage payments, car payments, potential out-of-pocket medical expenses, travel costs, etc. If you can afford to cover that in the short term, then critical illness insurance may not be worth it for you. However, most Canadians have not saved enough to cover these costs without steady employment—and most critical illnesses will force you to stop work.

Why critical illness insurance is important

Critical illnesses are incredibly common. In fact, according to the Canadian Cancer Society, “Nearly 1 in 2 Canadians (45% of men and 43% of women) is expected to develop cancer during their lifetime.” We’re not telling you this to freak you out—but you should be aware that critical illness may have an impact on your physical and financial health.

Critical Illness insurance can be your lifeline during these difficult times while the paperwork for your other insurance is being processed. With critical illness insurance, you know how much you’ll get paid out and the process is a lot faster. You can file critical illness insurance right away, with a diagnosis report from your doctor.

Here are a few situations where critical illness insurance can play a crucial role in saving your financial life:

• Your spouse needs to take time off work and does not have allowances for paid extended leaves of absences; the critical illness insurance can be used to replace all or part of their income (depending on how much coverage you purchase)
• You are self-employed and do not qualify for disability insurance, critical illness insurance can be used to replace your income.
• Your medical expenses are not covered by your extended medical or universal health care. This might include adapting your home for any new physical disability you may have or physio appointments.

Critical Illness insurance is especially important if you do not have any other type of medical or disability insurance in place. It covers specific sudden critical illnesses that can include:

Read the full list of what critical illness insurance policies cover.

What age should you get critical illness insurance coverage?

You should get critical illness insurance coverage at the youngest age possible. That way, you’ll lock in the lowest possible prices for critical illness insurance. Many Canadians wait until they are in their 30s or 40s to purchase coverage, but we recommend to protect yourself as soon as you can afford the monthly premiums.

It is true that when you’re younger you are less likely to be diagnosed with a critical illness, and you may have less financial responsibility than later in life as you earn more in your career and take on more financial risk.

But ask yourself:

• Even if you have disability insurance or other insurance to replace your income, can you wait that 1-3 months before that insurance kicks in?
• Have you saved enough to pay for any specialized or out-of-country treatment?
• Can you pay to retrofit your home if your needs change?
• If you got diagnosed with a terminal illness and wanted to use your time to take a trip or spend as much time with family as possible, could you afford it?

If you said no, or are unsure, then critical illness insurance may be great protection for you, so you can stop worrying about your bank account balance and focus on your health.

When can you buy critical illness insurance for your child?

A child’s critical illness insurance coverage can be purchased after the child is born and up to the age of 25 years for the child. Some companies may cover additional diseases before the child turns 17 years in age. While an application for the coverage can be issued as early as 1 day after the child is born, most companies will require that the contract be issued at least after the child has turned 1 month in age.

When can I get a quote for critical illness insurance?

You can get a quote for critical illness insurance coverage instantly! PolicyAdvisor works with over 20 of Canada’s top insurance providers to make sure you get coverage that is best for YOU.

Not all policies are created with the same definitions of illnesses and coverage. If you have questions about critical illness insurance or critical illness riders and want to see if it’s worth it for you, speak to one of our advisors today!

Wouldn’t it be nice to pay nothing for your insurance coverage if you don’t end up using it? While some types of insurance – like car insurance – can decrease in cost as you prove you have little need for it, most forms of your personal insurance protection cost more as you age.

However, in Canada, some forms of living benefit insurance, such as critical illness insurance and disability insurance, allow you a partial or full refund on your premiums paid. This is offered through a life insurance rider called return of premium (ROP).

How does a return of premium work?

As mentioned, return of premium is available only on critical illness insurance and disability insurance policies. It is usually available as an add-on rider. A policy with a return of premium rider works just like a regular policy: you pay the monthly premiums and the policy coverage continues. If there is a critical illness or disability claim, the policy pays out.

When return of premium rider is added, an insurance provider pays back a portion or all of the premiums paid by the policyholder under certain circumstances.

There are generally three ROP variants:

Upon death or Return of Premium on Death (ROPD)

ROPD refunds all returnable premiums paid if the policyholder passes away while the policy is in force. The premiums returned are paid to the beneficiary appointed by the insured, upon the passing away of the insured individual.

Different providers have their own individual definitions of what constitutes a returnable premium but generally will remove any advanced payments made for long-term care or child policies if they were part of the original coverage.

At the end of the contract or Return of Premium on Expiry

In this case, the insurance provider refunds premiums paid if the policy term expires without any claim being made.

When the contract is cancelled or Return of Premium on Cancellation/Surrender

In the case of Return of Premium on Cancellation or Surrender, most insurance companies will allow a partial or full return of premiums at predefined ages or depending on how long the policy has been in force.

For instance, a policyholder may have 50% of the premiums returned back to them 20 years after your coverage has begun. That percentage will increase with the insured’s age, with full return of premiums at the age of 65 or 75.

Providers have different rules and guidelines on how returnable premiums are defined, including when you can claim them. Schedule a call with our experienced life insurance advisors so we can help you select the return of premium option that works best for your needs.

Can I get return of premium on term life insurance?

Unlike in other jurisdictions like the United States, Canadian insurance companies do not offer return of premium for term life insurance policies.

For those Canadian life insurance seekers also looking to get back some or all of the premiums they pay for their coverage, there are permanent insurance options available with accessible cash value to explore.

What are the benefits of return of premium riders?

The number one benefit of a return of premium rider is the refund of the premium that you or your beneficiary could receive. While insurance is something you buy and hope you never need, such a feature can be a helpful push for those on the fence about getting more specialized coverages like critical illness and disability.

For the risk-averse, ROP can also act as a guaranteed savings account that simultaneously provides you with income protection. Should you decide you don’t need or cannot afford the policy, you can cancel or surrender your policy and access those funds.

What are the drawbacks of return of premium (ROP) riders?

Cost: Nothing in life is free, adding a ROP rider to your policy can increase your monthly premium. You could decide that cash is better used elsewhere, like adding more coverage to your policy or taking out another kind of coverage that you may also require.

Opportunity cost of capital: As mentioned above, some ROP riders can only be exercised at certain ages.

And, while you do have the guarantee that you or your beneficiaries will get your premiums back, there are alternatives for saving and investing your money that would offer a better return than parking your money in a ROP rider.

Availability of providers: Lastly, insisting on ROP at expiry or cancellation option may limit who you can choose as an insurance provider, as not all companies offer the full suite of ROP variations. ROP options may also vary based on your chosen term; for instance, Return of Premium on Surrender options are typically only available on longer-term policies. The provider that offers ROP on expiry, cancellation, or surrender may not have other insurance features you seek or charge a higher premium than another provider.

Which critical illness insurance providers offer return of premium riders?

Many Canadian insurance providers offer riders for return of premium. Below is a list of some of the companies offering Return of Premium on Death (ROPD), Return of Premium on Expiry (ROPX), Return of Premium on Cancellation (ROPC), and Return of Premium on Surrender (ROPS).

How do I get return of premium coverage?

PolicyAdvisor’s team of licensed brokers have decades of experience helping Canadians navigate living-benefit insurance and ROP riders. Reach out today to speak to an advisor, get instant quotes, and find the right coverage for your budget and needs.

It’s incredibly likely you know someone who has or will be diagnosed with cancer. In fact, nearly half of all Canadians will battle the disease in their lifetime. Perhaps more shocking is that one in four people will die from cancer, making it the most common cause of death in Canada. 

Of all critical illness insurance payouts, over 60% are made to those diagnosed with cancer. While critical illness insurance can’t cure cancer, it can offer peace of mind and financial support to those diagnosed as well as their loved ones.  

Below we’ll give you a brief overview of critical illness insurance and coverage for cancer. 

What is cancer?

Cancer is a type of disease which is classified by the uncontrolled spread of mutated or damaged cells (cancer cells). These cancerous cells disrupt the normal function of organs and systems within the body by destroying healthy cells. Cancer can appear in the body as a solid tumor or as tissue lesions. However exceptions to this general rule include cancers in the blood or bone marrow which do not have a “mass”. 

Cancers are curable if the diagnosis is early (early stage cancers). When cancers are caught early, they tend to be smaller and can be either removed surgically or be shrunk through therapy.

Cancers that have spread to different parts of the body (metastasized cancers) may not always be curable but are generally treatable. Increasingly therapies and treatments are becoming available that may extend a person’s life or ability to deal with the chronic illness.

Read more about how cancer affects life insurance. 

What is critical illness insurance?

Critical illness insurance provides you with a one-time tax-free lump sum payment if you are diagnosed with a critical life-threatening disease or condition. This type of insurance is different from disability insurance, which only replaces part of your income when you cannot work. Critical illness insurance pays out in the event of a diagnosis of an illness specified in the contract, even if there was no disruption to employment earnings.

Does critical illness insurance cover cancer?

In short, yes cancer is one of the main conditions that critical illness insurance covers! But, there are some exceptions depending on the type and stage of cancer diagnosis, both of which determine whether or not the coverage will be paid and the amount of coverage that may be claimed. 

Cancer is a general term that is used to describe a wide variety of cell mutations, some less serious than others, including those that are not critical. Critical illness insurance covers life-threatening cancer as one of the main conditions that can trigger a full payout of the critical illness insurance policy. 

Most Canadian insurers will follow the definition provided by The Canadian Life and Health and Life Insurance Association (CLHIA) for various covered conditions including cancer. The CLHIA defines life-threatening cancer as “a definite diagnosis of a tumour characterized by the uncontrolled growth and spread of malignant cells and the invasion of tissue.” Additionally, the CLHIA requires that the diagnosis be made by a specialist such as an oncologist (cancer doctor) and be confirmed by a pathology report. 

The CLHIA has fully defined all the 26 commonly covered illnesses. 

Are all forms of cancer covered for critical illness insurance?

Non-life-threatening cancers are typically excluded (see exclusions below) from the list of covered illnesses for most critical illness insurance policies. However, if one of these excluded cancers is not cured and becomes metastasized and life-threatening, then critical illness insurance benefits may become payable provided the policy remains in force. Certain less serious forms of cancer such as early stage skin cancer, early stage prostate cancer, or early stage breast cancer may be eligible for a partial benefit payout.

Read the full CLHIA definition of cancer here. 

What is cancer insurance and is it good enough?

Cancer insurance refers to a type of policy which only provides a lump-sum payment for cancer as the only covered condition. Cancer insurance can be great to cover things like chemotherapy treatments or alternative medications or lifestyle changes not covered by standard medical coverage, but critical illness insurance is better. Critical illness insurance is more comprehensive and can offer some comfort knowing that regardless of if you suffer a stroke or heart attack or are diagnosed with MS or cancer, some of the financial burden is taken care of. 

Can I submit a claim on a critical illness policy upon diagnosis of cancer?

Yes — submitting a claim upon diagnosis of an illness like cancer is what your critical illness insurance policy is for. 

Most companies will require that medical information about the diagnosis and any signs, symptoms or investigations leading to the diagnosis must be reported to the company within six months of the date of diagnosis. If this information is not provided within the six month period, the insurance companies have the right to deny any claim for cancer or any critical illness caused by any cancer or its treatment.

Additionally, as mentioned previously, coverage and future claims will depend on your specific cancer diagnosis. It’s important to note that most policies have a 30 day survival period after your diagnosis before a claim can be made. 

Another important note is that as with many types of insurance, there is the waiting period. Some companies may require you to have the policy for 90 days before you can make a claim for certain conditions, particularly cancer. As always, reach out to one of our insurance experts if you need help understanding the specifics of your policy. 

Can I start a critical illness insurance policy after my diagnosis?

There are some circumstances where you can start a critical illness insurance policy after a cancer diagnosis. Some policies offer guaranteed coverage, regardless of when you signed up for the policy and received your diagnosis. However, such policies will have exclusions for pre-existing conditions for a specified period of time and the premium cost for guaranteed coverage will be high. If you already have a cancer diagnosis, cancer would be considered a pre-existing condition for the period specified in the policy. In situations like these, it’s always best to consult an advisor to understand the specifics of the coverage that may be available to you.  

Can I get critical illness insurance if I am in remission?

Remission means that you no longer have detectable active cancer cells and are no longer receiving treatment such as chemo or radiation. Depending on the provider, you may be able to get critical illness insurance once you are in remission. However, the type of coverage available and the cost for it will depend on how long you have been in remission and your original diagnosis and prognosis. 

Can I get critical illness insurance if I have a family history of cancer?

As with life or health policies, an insurance company will look at your family history to determine risk, eligibility, coverage, and cost of critical illness insurance. If you have a family history of cancer (or any other critical illness), you may receive an insurance rating  (i.e. a higher insurance price or an exclusion (i.e. certain conditions may not be covered for claims). It’s best to chat with an advisor to determine how your family’s health history may impact your critical illness insurance coverage. 

If you know you are at a high risk of cancer through either genetic testing or through family history, you should absolutely get critical illness insurance. But the bottomline is, given the increasing incidence of cancer, critical illness insurance is an essential component of financial protection for every individual.

Definition of cancer according to CLHIA

Cancer (Life-Threatening) means the definite diagnosis of a malignant tumour. This tumour must be characterized by the uncontrolled growth and spread of malignant cells and the invasion of tissue. Types of cancer include carcinoma, melanoma, leukemia, lymphoma, and sarcoma.

The diagnosis of cancer must be made by a specialist and must be confirmed by a pathology report.

For purposes of the policy:

• T1a or T1b prostate cancer means a clinically inapparent tumour that was not palpable on digital rectal examination and was incidentally found in resected prostatic tissue.
• The term gastrointestinal stromal tumours (GIST) classified as AJCC Stage 1 means:
• Gastric and omental GISTs that are less than or equal to 10 cm in greatest dimension with five or fewer mitoses per 5 mm2, or 50 per HPF; or
• Small intestinal, esophageal, colorectal, mesenteric and peritoneal GISTs that are less than or equal to 5 cm in greatest dimension with 5 or fewer mitoses per 5 mm2, or 50 per HPF;
• The terms Tis, Ta, T1a, T1b, T1 and AJCC Stage 1 are as defined in the American Joint Committee on Cancer (AJCC) cancer staging manual, 8th Edition, 2018.
• The term Rai stage 0 is as defined in KR Rai, A Sawitsky, EP Cronkite, AD Chanana, RN Levy and BS Pasternack: Clinical staging of chronic lymphocytic leukemia. Blood 46:219,1975.

Exclusions: No benefit will be payable under this Covered Condition for the following:

• Lesions described as benign, non-invasive, pre-malignant, of low and/or uncertain malignant potential, borderline, carcinoma in situ, or tumors classified as Tis or Ta;
• Malignant melanoma of skin that is less than or equal to 1.0mm 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. This includes but is not limited to, cutaneous T cell lymphoma, basal cell carcinoma, squamous cell carcinoma or Merkel cell carcinoma;
• 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 2.0cm in greatest dimension and classified as T1, without lymph node or distant metastasis;
• Chronic lymphocytic leukemia classified as Rai stage 0 without enlargement of lymph nodes, spleen or liver and with normal red blood cell and platelet counts;
• Gastro-intestinal stromal tumours classified as AJCC Stage 1;
• Grade 1 neuroendocrine tumours (carcinoid) confined to the affected organ, treated with surgery alone and requiring no additional treatment, other than perioperative medication to oppose effects from hormonal oversecretion by the tumour; or
• Thymomas (stage 1) confined to the thymus, without evidence of invasion into the capsule or spread beyond the thymus.

90-Day Exclusion: No benefit will be payable under this covered condition if, within the first 90 days following the later of the issue date of an insured person’s coverage, or the last reinstatement date of an insured person’s coverage, the insured person has any of the following:

• Signs, symptoms or investigations leading directly or indirectly to a diagnosis of any cancer (covered or not covered under the policy), regardless of when the diagnosis is made; or
• A diagnosis of any cancer (covered or not covered under the policy).

Want to learn more?

Critical illness insurance is a great option for those who are concerned about future diagnoses and the costs associated. Cancer is an unpredictable disease that impacts those diagnosed emotionally, physically, and financially. With critical illness insurance, some of that financial burden and worry can be alleviated. For more info, reach out to one of our advisors to chat about which options and policies are best for you.

Ultimately, only you can make the decision for what kind of protection you think you need, but due to the unexpected nature of illness, trying to figure out your ‘needs’ can leave you scratching your head. If you’re concerned, it’s best to err on the side of caution.

Try our free critical illness insurance calculator to figure out how much coverage you might require or speak to our friendly advisors.