Does Critical Illness Insurance Cover Stroke? - PolicyAdvisor
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Does critical illness insurance cover stroke?

SUMMARY

Critical illness insurance policies may cover up to 26 diseases or illnesses. This insurance provides a lump-sum payment if you should be diagnosed with one of these illnesses. Stroke is commonly covered under most critical illness insurance plans.

By Jiten Puri
CEO & Founder, Insurance Advisor, LLQP
8 min read
IN THIS ARTICLE

Every year over 50,000 Canadians will experience a stroke, making it the leading cause of adult disability in the country. Symptoms vary, but the short and long-term effects of a stroke can be debilitating and even life-threatening. Strokes are also the third leading cause of death in Canada.

While insurance can’t protect against the medical risk of stroke, it can provide a financial safety net should you or a loved one be diagnosed with this critical illness. Critical illness insurance can help pay for treatment, care, or general support. In Canada, strokes represent the third most common diagnosis claimed through critical illness insurance. 

Keep reading to find out more about how critical illness insurance can benefit you if you or a loved one is at risk for stroke.

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What is a stroke?

A stroke, also known as a cerebrovascular accident, occurs when the brain suffers from blood flow loss due to a hemorrhage, embolism, or thrombosis. The loss of blood damages brain cells, which, in turn, causes stroke and associated symptoms. Early symptoms of a stroke include numbness, confusion, headaches, and loss of balance, while long-term effects can manifest as speech impairments, memory problems, and permanent loss of function.

There are three main types of stroke:  ischemic stroke, hemorrhagic stroke, and transient ischemic attack (TIA). 

  • Ischemic strokes (the most common type of stroke) are caused when a blood vessel in the brain becomes blocked by a clot or build-up of plaque. 
  • A hemorrhagic stroke occurs when a blood vessel in the brain ruptures. This type of stroke has links to high blood pressure.
  • A TIA, also known as a mini-stroke, is caused by a temporary blockage of an artery in the brain. This type of stroke typically has minor, short-term symptoms, but is often indicative that another stroke is imminent

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. 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 stroke?

Yes! Strokes fall into the category of covered health conditions in most critical illness insurance policies. Strokes along with cancer and heart attack are the most common types of claims for this type of insurance. Strokes are one of the main conditions covered both in basic critical illness policies (that cover 3 or 4 conditions) or enhanced critical illness insurance policies (that cover 25 or 26 conditions). 

Depending on the type or severity of strokes, however, there may be exclusions. For example, TIAs or mini-strokes may not qualify as a critical illness. Strokes caused by trauma may also not be covered depending on the life insurance provider.

Most Canadian insurers will follow the definition provided by The Canadian Life and Health Insurance Association (CLHIA) for various covered conditions including stroke. For critical illness insurance purposes, a stroke is defined as an acute cerebrovascular event that results in acute neurological symptoms and new neurological deficits that persist for more than 30 days after the initial diagnosis. The CLHIA has fully defined all the 26 commonly covered illnesses.

Read the full CLHIA definition of stroke below.

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

Most critical illness insurance policies include a survival period clause. In short, this means that an insured person must survive for at least 30 days after a stroke diagnosis before filing a claim. It is only after this period that the benefit will be paid. 

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. 

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

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

Generally, it is advisable to purchase critical illness insurance before you have been diagnosed with any serious health condition or illness. However, it is still possible to buy critical illness coverage after you’ve had a stroke. 

If you’ve already had a stroke or other critical illness diagnosis, one option is guaranteed critical illness insurance. This type of coverage does not require a medical evaluation but is usually accompanied by a two-year pre-existing condition exclusion. In other words, if you had a stroke in the two-year period before applying for coverage, the policy will not issue payment if another stroke happens within the first two years of coverage. The two-year exclusion may also apply if a different critical illness condition occurs that is directly attributable to the stroke. 

Depending on the severity of the stroke and the time period (typically several years since the stroke) that has elapsed, it may be possible to get traditional, fully underwritten insurance. 

As always, reach out to one of our insurance experts if you need help understanding the potential options for coverage. 

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

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 stroke (or any other critical illness), the insurance company will assess your health risks closely. If the predisposition to stroke (or any other critical illness insurance) may seem elevated, then 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 stroke through either genetic testing or through family history, you should absolutely get critical illness insurance. While you may not have control over some aspects of your familial health history, you have control over your financial health. Critical illness insurance is an essential component of financial protection for every individual.

Full definition of stroke according to CLHIA

Stroke (Cerebrovascular Accident) means a definite diagnosis of an acute cerebrovascular event caused by intracranial thrombosis or hemorrhage, or embolism from an extracranial source, with:

  • acute onset of new neurological symptoms, and
  • new objective neurological deficits on clinical examination,
  • persisting for more than 30 days following the date of diagnosis. These new symptoms and deficits must be corroborated by diagnostic imaging testing. The diagnosis of stroke must be made by a specialist.

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

  • Transient Ischemic Attacks (TIA); or
  • Intracerebral vascular events due to trauma; or
  • Lacunar infarcts, which do not meet the definition of stroke as described above.
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Want to learn more?

Critical illness insurance is a great option for those who are concerned about future diagnoses and the costs associated. 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. 


The information provided herein is for general informational purposes only. It is not intended and should not be construed to constitute legal aid, financial advice, or diagnostic purposes.

KEY TAKEAWAYS

  • Stroke affects more than 50,000 Canadians every year, that can leave life-threatening damage
  • Stroke is commonly covered under critical illness insurance policies
  • Stroke is the third most common diagnosis claimed through critical illness
  • Critical illness insurance can help you cope with the financial and medical impact of a stroke and other life-threatening conditions

By Jiten Puri
CEO & Founder, Insurance Advisor, LLQP
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