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The secure site and tools will be temporarily unavailable starting Friday April 19 @ 9pm until 9pm on Saturday April 20 ET for system maintenance. Thank you for your understanding.
There's good reason to consider Sun Critical Illness Insurance (Sun CII). Medical advances are helping more people survive critical illnesses like cancer, stroke and heart disease. But recovery can come with a significant financial cost that impacts Clients and their families.
Sun CII offers financial help for the costs associated with life-altering illnesses. Clients can use their coverage to help with things like:
Why choose Sun CII?
1. Comprehensive coverage that includes:
2. Wide ranging benefit amounts on adult and child plans:
3. Simple and easy to understand return of premium options. Including graded Return of premium on cancellation or expiry on adult plans.
Sun CII provides a lump sum benefit that helps the clients respond to a critical illness in their own way.
Sun Life offers the following standalone plan designs for single lives:
For all plans above, coverage will end when a claim is paid for a full payout illness, or when the insured person dies or when the policy is cancelled.
Adult: 18 - 65
Child: 30 days - 17
Issue ages are based on the insured person's insurance age, or their age at their nearest birthday. For example, if your client is 48 years and 7 months, their insurance age will be 49.
Adult: $25,000 - $3,000,000 1
Child: $25,000 - $1,000,000 2
Band 1 | Band 2 | Band 3 | Band 4 | Band 5 | |
---|---|---|---|---|---|
Child plans | $25,000 - $49,999 |
$50,000 - $99,999 |
$100,000 - $250,000 |
n/a |
n/a |
Adult plans | $25,000 - $49,999 |
$50,000 - $99,999 |
$100,000 - $249,999 |
$250,000 - $499,999 |
$500,000 and over |
The annual policy fee for Sun CII is $45.00. All premiums must be paid in Canadian funds and drawn from an account at a Canadian financial institution.
Definition: Non-Smoker
No use of tobacco or product containing nicotine for the past 12 months.
Note: we may offer non-smoker rates for a new application where the proposed insured is an occasional large cigar smoker and had a negative cotinine test (when testing is required).
Adult plans | Child plans |
---|---|
The base plan and the optional Total disability waiver benefit can be rated. The minimum rating is +25 (125%) The maximum rating is +150 (250%) Ratings do not apply to any premium paid for a return of premium benefit. The Long-term care conversion option is not available on rated or modified plans and therefore can only be issued standard. The Owner waiver benefit cannot be rated. |
Children will only be accepted if they qualify as a standard risk, otherwise they will be declined. Plans with a +25 rating will be considered a standard risk and will not be declined. |
Depending on the premium frequency chosen by the client, payments can be made on a monthly basis through our pre-authorized chequing (PAC) process or annually by cheque.
If PAC is chosen, monthly payments are deducted automatically from the payor's account. Monthly premiums are calculated by multiplying the annual premium (including a $45 policy fee) by 0.09 (the modal factor).
The annual premium for this policy is $1,729 If the client chooses to pay monthly, the monthly premium would be $155.61 (annual premium* 0.09). Over a 1 year period, the client would pay $221 less in premiums if they decide to pay annually instead of monthly.
If the client chooses to pay annually by cheque, payments can be remitted to our head office before the policy anniversary date. An annual statement is sent to the owner approximately three weeks before the policy anniversary, reminding them that their annual premium is due.
Limited premium payment periods are available on both Sun CII T75 and T100 plans, providing the client with the opportunity to fully pay for their policy premiums in a shorter period of time instead of having to pay for the life of the policy. The options are:
Limited premium payment periods may be suited for:
While most features of our regular pay Sun CII plans remain the same when a limited premium payment option is selected, there are 4 exceptions you should be aware of.
In some CII policies, the premiums paid may exceed the critical illness insurance benefit amount of the policy. Here are some factors that may result in a client paying more in premium than the face amount of the plan:
The below scenarios show what will be paid out for Sun CII policies sold after September 17, 2012
Scenario | Claims for full benefit payout | At cancellation | At death |
---|---|---|---|
CII without any ROP benefit |
CII benefit amount |
$0 | $0 |
CII with ROPD |
CII benefit amount |
$0 | Total returnable premium amount, even if this exceeds the CII benefit amount |
CII with ROPC/E (before maturity date)1 |
Total Returnable premium amount or the CII benefit amount, whichever is higher |
$0 |
$0 |
CII with ROPC/E (after maturity date)1 |
Total returnable premium amount or the CII benefit amount, whichever is higher |
Total returnable premium amount, even if this exceeds the CII benefit amount |
$0 |
CII with both ROPD and ROPC/E (before maturity date)1 |
Total Returnable premium amount or the CII benefit amount, whichever is higher |
$0 |
Total returnable premium amount, even if this exceeds the CII benefit amount |
CII with both ROPD and ROPC/E (after maturity date)1 |
Total returnable premium amount or CII benefit amount, whichever is higher |
Total returnable premium amount, even if this exceeds the CII benefit amount |
Total returnable premium amount, even if this exceeds the CII benefit amount
|
1 Maturity dates will vary depending on the type of ROPC/E selected.
printable copy: Guide to critical illness definitions
This guide to critical illness definitions will help you understand the illnesses and procedures covered by the critical illness insurance policy. This is for your reference only, and does not replace the policy. Please review the policy carefully.
If the insured is diagnosed with one of these 26 critical illnesses and meets the survival period, the client will receive a lump sum payment of their coverage amount and the policy will end. We refer to this list of illnesses as Group 1.
Sun CII includes coverage for 5 additional illnesses when the insured is between ages 0 and 17 years. If the child is diagnosed with and survives one of these critical illnesses, the client will receive a lump sum payment of their coverage amount and the policy will end. Coverage for these conditions ends on the child's 24th bithday.
If the insured person is diagnosed with and survives one of these 5 illnesses, the client will receive a partial lump sum benefit. We refer to this list of illnesses as Group 2. The partial lump sum payment will be equal to 15% of the critical illness insurance benefit amount to a maximum of $50,000 per condition. The client can make one claim per partial payout illness, to a maximum of four partial payments. The policy will not end, and the client must continue to pay premiums for coverage to continue. The critical illness benefit amount will not be reduced and the coverage will be available for any future claims.
* If an insured child is diagnosed with LOIE before the policy anniversary nearest their 18th birthday, a claim may be submitted at the policy anniversary nearest their 18th birthday and no later than the policy anniversary nearest their 19th birthday.
The following table shows all illnesses that have an eligibility qualifying period and/or a survival period.
ILLNESS | ELIGIBILITY QUALIFYING PERIOD | SURVIVAL PERIOD |
---|---|---|
Acquired brain injury due to external trauma |
180 days | n/a |
Aortic surgery |
n/a | 30 days following the date of surgery |
Bacterial meningitis |
90 days | n/a |
Coma |
96 hours | n/a |
Congenital heart disease (childhood illness) |
n/a | 30 days following the date of diagnosis. If surgery is performed, 30 days following the date of the surgery. |
Coronary angioplasty (illness eligible for partial benefit payout) |
n/a | 30 days following the date of the procedure |
Coronary artery bypass surgery | n/a | 30 days following the date of surgery |
Dementia, including Alzheimer’s disease | 6 months | n/a |
Heart attack |
n/a | 30 days following the date of diagnosis |
Heart valve replacement or repair |
n/a | 30 days following the date of surgery |
Loss of independent existence |
90 days | n/a |
Loss of speech |
180 days | n/a |
Multiple sclerosis |
Refer to full definition | n/a |
Occupational HIV infection |
Refer to full definition | n/a |
Paralysis |
90 days | n/a |
Parkinson’s disease and specified atypical parkinsonian disorders |
1 year | n/a |
Stroke | 30 days | 30 days following the date of diagnosis |
Type 1 diabetes mellitus (childhood illness) |
3 months | n/a |
Issue ages (age nearest)
T10 T75 T100 |
|||||
---|---|---|---|---|---|
ADULT | Long-term care conversion option1 | 18 - 50 |
x | x | x |
Total disability waiver | 18 - 55 |
x | x | x | |
Owner waiver disability benefit | Owner is 18 - 55 |
x | x | x | |
Owner waiver death benefit | Owner is 18 - 60 |
x | x | x | |
Owner waiver death and disability benefit | Owner is 18 - 55 |
x | x | x | |
ROPD | 18 - 65 |
x | x | x | |
ROPC/E - 15 years | 18 - 60 |
x | x | ||
ROPC/E - age 652 | 18 - 50 |
x | x | x | |
ROPC/E - age 752 | 18 - 60 |
x | x | x | |
CHILD | Long-term care conversion option1 | May apply to add at policy anniversary nearest the insured's 18th birthday |
x | x | x |
Total disability waiver2 |
0 - 17 |
x | x | x | |
Owner waiver disability benefit |
Owner is 18-55 |
x | x | x | |
Owner waiver death benefit |
Owner is 18-60 |
x | x | x | |
Owner waiver death and disability benefit |
Owner is 18-55 |
x | x | x | |
ROPD |
0 - 17 |
x | x | x | |
Advanced ROPC/E2 |
0 - 17 |
x | x | x | |
ROPC/E - age 353 |
0 - 17 |
x | x |
1 Not available on limited pay plans. Available for standard risks only.
2 Not available on plans with a '10 years' or '15 years' payment period.
3 Only available on plans with a '10 years' or '15 years' payment period.
Adult plans: Optional benefit for issue ages 18 - 50
Child plans: The owner may apply for this option between the policy anniversary nearest the insured person's 18th birthday and the policy anniversary nearest their 19th birthday, with evidence of insurability.
This option is available only if the insured person is a standard risk. It is not available on plans with limited premium payments (10, 15 years).
If this option is included in the policy, the owner may apply once to convert a portion or the entire critical illness insurance benefit to a long-term care insurance (LTCI) policy on the insured person without evidence of insurability.
The application to convert to long term care insurance may be made during the 5 policy years that start on the policy anniversary nearest the insured person's 60th birthday.
For example: | $150,000 (CII benefit amount) 200 |
= $750 (weekly LTCI benefit amount) |
NOTE: If a policy includes the Long-term care conversion option (LTCCO) and the Return of premium on cancellation or expiry - age 75 (ROPC/E - age 75), the use of these benefit will be limited. The client can choose to:
This optional benefit maintains coverage if the insured person becomes totally disabled and is unable to earn an income. With Total disability waiver the premiums will be waived if the insured person becomes disabled.
Issue ages |
|
Availability |
|
Coverage period for this benefit |
|
Length of time premiums will be waived for |
|
Waiting period |
|
Maximum amount Sun Life will waive under this benefit |
|
Exclusions | Premiums won't be waived if the total disability:
Please refer to the policy for other exclusions. |
Making a claim |
For clients to make a claim:
|
Definition of total disability – An insured person must be completely unable, as a result of injury or disease, during the first two years following the date of their disability, to carry on with the essential duties of their own occupation, and thereafter to carry on any occupation. The total disability must be continuous.
This is an optional benefit that maintains coverage if the owner of the policy becomes totally disabled between the policy anniversary nearest their 18th and 60th birthdays. Premiums for the insurance amount and any optional benefits in the policy, along with the policy fee, are waived if the owner insured under this benefit becomes disabled.
Issue ages |
|
Availability |
|
Coverage period for this benefit |
|
Length of time premiums will be waived for |
|
Waiting period |
|
Maximum amount Sun Life will waive under this benefit |
|
Exclusions |
Premiums won't be waived if the total disability:
Please refer to the policy for other exclusions. |
Making a claim |
For clients to make a claim:
|
If ownership of this policy is transferred, the benefits under this option aren't transferrable and therefore the new owner won't qualify for the Owner waiver on death benefit.
If there are multiple owners on one policy, the Owner waiver benefit cannot be transferred between owners.
This is an optional benefit that combines the coverages provided by the Owner waiver death and Owner waiver disability benefits. When both benefits are purchased, a discount is applied to the benefit premium.
The issue age for this combined benefit is 18 to 55. All other features and provisions for the separate Owner waiver death and Owner waiver disability benefits remain the same.
Issue ages: 30 days - 65 years
We will pay the returnable premiums (described below) to the ROPD beneficiary if the insured person dies while the policy is in effect and a critical illness benefit is not payable.
Definition: Returnable premium amount
This definition applies to all return of premium benefits - ROPD, ROPC/E and Advanced ROPC/E.
The returnable premium amount is the sum of all premiums paid, including rated premiums, minus:
The returnable premium amount is not reduced by any payments made for partial payout illnesses and may be greater than the CII benefit amount. We will pay either a return of premium benefit or a CII benefit, but not both.
Summary
Sun CII Adult Plans |
Sun CII Child Plans | ||||
---|---|---|---|---|---|
ROPC/E - age 15 years | aROPC/E - age 65 | ROPC/E - age 75 | Advanced ROPC/E | ROPC/E - age 35 | |
T10 | x | x | x | ||
T75 (lifetime pay plans) |
x | x | x | x | |
T75 (10-pay or 15-pay plans) |
x | x | |||
T100 (lifetime pay plans) |
x | x | x | x | |
T100 (10-pay or 15-pay plans) |
x | x |
Issue ages: 18 - 60
Plan types: T75 or T100. It is also available on plans with limited premium payment periods. It is not available on T10 plans
We will pay a percentage of the returnable premium amount to the owner if the policy is cancelled on or after the 3rd policy anniversary, if the CII benefit is not payable. The benefit has no value if the policy is cancelled before this date. The percentage amount starts at 10% of the returnable premium amount and increases by 7.5% per year to a maximum of 100%.
Policy anniversary | Percentage |
---|---|
3 | 10.0% |
4 | 17.5% |
5 | 25.0% |
6 | 32.5% |
7 | 40.0% |
8 | 47.5% |
9 | 55.0% |
10 | 62.5% |
11 | 70.0% |
12 | 77.5% |
13 | 85.0% |
14 | 92.5% |
15 | 100.0%
|
If the policy expires at age 75 and no claim for a full-payout covered illness has been made, you can receive 100% of the returnable premiums. We will also pay the policy owner any amount in the withdrawable premium fund on the policy end date.
Issue ages: 18 - 50
Plan types: T10, T75 or T100. It is not available on plans with limited premium payment periods.
We will pay a percentage of the returnable premium amount to the owner if the policy is cancelled on or after the policy anniversary nearest the insured person’s 53rd birthday, if the CII benefit is not payable. The benefit has no value if the policy is cancelled before this date. The percentage amount starts at 10% of the returnable premium amount and increases by 7.5% per year to a maximum of 100%.
Age nearest policy anniversary |
Percentage |
---|---|
53 | 10.0% |
54 | 17.5% |
55 | 25.0% |
56 | 32.5% |
57 |
40.0% |
58 |
47.5% |
59 | 55.0% |
60 |
62.5% |
61 |
70.0% |
62 | 77.5% |
63 | 85.0% |
64 | 92.5% |
65+ |
100% |
If the policy expires at age 75 and no claim for a full-payout covered illness has been made, you can receive 100% of the returnable premiums. We will also pay the policy owner any amount in the withdrawable premium fund on the policy end date.
Issue ages: 18 - 60
Plan types: T10, T75 or T100. It is not available on plans with limited premium payment periods.
We will pay a percentage of the returnable premium amount to the owner if the policy is cancelled on or after the policy anniversary nearest the insured person’s 63rd birthday, if the CII benefit is not payable. The benefit has no value if the policy is cancelled before this date. The percentage amount starts at 10% of the returnable premium amount and increases by 7.5% per year to a maximum of 100%.
Age nearest policy anniversary |
Percentage |
---|---|
63 | 10.0% |
64 | 17.5% |
65 | 25.0% |
66 | 32.5% |
67 | 40.0% |
68 | 47.5% |
69 | 55.0% |
70 | 62.5% |
71 | 70.0% |
72 | 77.5% |
73 | 85.0% |
74 | 92.5% |
75 | 100.0%
|
If the policy expires at age 75 and no claim for a full-payout covered illness has been made, you can receive 100% of the returnable premiums. We will also pay the policy owner any amount in the withdrawable premium fund on the policy end date.
Advanced return of premium on cancellation or expiry - Advanced ROPC/E
Issue ages: 30 days - 17 years
Plan types: T10, T75 or T100. It is not available on plans with limited premium payment periods.
If a CII benefit is not payable, we will automatically pay the owner 75% of the returnable premiums (described below) on the 15th policy anniversary or the policy anniversary nearest the insured person's 25th birthday, whichever is later, and coverage continues.
If a CII benefit is not payable, we will pay the owner the remainder of the returnable premiums if they cancel the policy on or after the 30th policy anniversary or the policy anniversary nearest the insured person's 40th birthday, whichever is later. This benefit has no value prior to these maturity dates.
For T10 and T75 plans, we will pay the returnable premiums (described below) to the owner if the policy has not been cancelled and therefore expires (ends) and a CII benefit is not payable. These policies expire on the policy anniversary nearest the insured person's 75th birthday.
Return of premium on cancellation or expiry - ROPC/E - age 35
Issue ages: 30 days - 17 years
Plan types: T75 or T100 plans with limited premium payment payment periods.
If a CII benefit is not payable, we will pay the owner the returnable premiums (described below) if they cancel the policy on or after the policy anniversary nearest the insured person's 35th birthday.
For T75 plans with a 15-year limited payment period, we will pay the returnable premiums (described below) to the owner if the policy has not been cancelled and therefore expires (ends) and a CII benefit is not payable. These policies expire on the policy anniversary nearest the insured person's 75th birthday.
This benefit has no value prior to its maturity at age 35.
Note: ROPD and ROPC/E cannot be added after issue except in certain cases of internal replacement.
Definition: Returnable premium amount
This definition applies to all return of premium benefits - ROPD, ROPC/E and Advanced ROPC/E.
The returnable premium amount is the sum of all premiums paid, including rated premiums, minus:
The returnable premium amount is not reduced by any payments made for partial payout illnesses and may be greater than the CII benefit amount. We will pay either a return of premium benefit or a CII benefit, but not both.
The benefit from critical illness insurance when a child is seriously ill can help a family cope financially at a very stressful time. But more than that, choosing to put critical illness insurance in place when a child is young can mean affordable, guaranteed coverage for life. Sun CII has unique benefits designed just for kids that can contribute financially to their futures even if they don't suffer an illness in childhood. A Sun CII policy can be a great gift for parents or grandparents to give a child or young adult.
Key features
A smart plan that grows with the child that can be converted to LTCI coverage later.
The optional Advanced return of premium on cancellation or expiry benefit gives the client the opportunity to get 75% of premiums back and keep their coverage.
The optional Owner waiver benefits provide an additional coverage for parents, ensuring that premiums are waived if the owner dies or becomes disabled.
The child gets their own policy and does not need to re-apply as an adult.
There are no specific tax laws governing critical illness insurance (CII) policies.
Based on these general tax laws and guidance, we expect that:
If the policy is owned by a corporation, different tax laws may apply to some circumstances:
This is only a general summary. A tax professional should be consulted for more information.
The following policy wording is provided solely for your convenience and reference. It is incomplete and reflects only some of the general provisions that may be found in some of our insurance policies. We periodically make changes to policy wording and therefore this incomplete sample may not duplicate the wording of any actual issued policy. It is not to be construed or interpreted in any manner as a contract or an offer to contract. The actual policy issued to any given client will govern that relationship.
Critical illness insurance can be owned by an individual or a corporation. In most cases, the owner, the insured, and the payee will be the same person.
But there are some special circumstances where the owner, insured, or payee differ.
The following forms must be completed:
What is a Plan change?
A plan change is a non-contractual administrative process. It allows the policyowner to modify a policy with coverage options that were available at issue. We don’t require medical evidence for these changes and the original policy remains otherwise intact.
Plan changes allowed for CII policies
A) Changing from a smoker to a non-smoker
If the insured person was a juvenile at the time of issue:
If the insured person was not a juvenile at the time of issue:
If we approve the request, we’ll classify the insured person as a non-smoker. We’ll base the premiums on the non-smoker rates in effect for the insured person’s sex and age on the policy date.
B) Decreasing the benefit amount - use Application for change to an existing critical illness policy - E328
Policyowners can decrease the policy’s benefit amount down to the minimum issue limit for their specific CII product. This can be different from the minimum issue limit of $25K offered now for Sun CII.
If the policy includes Additional Group 1 covered critical illnesses, those benefits will also decrease. Additional Group 1 illnesses offered on Sun CII plans include:
If the policy includes a long-term care insurance (LTCI) conversion option, we’ll also decrease the LTCI conversion option. We’ll calculate the new weekly LTCI benefit amount by:
Minimums may apply depending on the LTCI product that is available for conversion. For example: $150,000 (CII benefit amount) / 200 = $750 (weekly LTCI benefit amount)
If the policy includes Return of premium (ROP) options:
If the policy includes the Return of Premium on Cancellation/Expiry (ROPC/E) benefit, a partial return of premium may be available. Reducing the CII benefit amount won’t reduce any accumulated ROP balance. The return of premium amount will continue to accumulate based on the new premium.
C) Decreasing the automatic increase benefit (AIB) from 50% to 25% (Sun CII series prior to 2009) - use Application for change to an existing critical illness policy - E328
D) Terminating an optional benefit - use Application for change to an existing critical illness policy - E328
If the Client terminates the Additional Group 1 covered critical illnesses benefit, we’ll also terminate any long-term care insurance conversion option on the policy.
E) Adding the long-term care insurance conversion option on child plans only - use Policy change, reinstatement and/or reconsideration of rating application requiring evidence - E245
What is a conversion?
Certain CII Term policies allow the policyowner to change the renewable term coverage to a level premium plan. They won’t have to give proof of insurability if they apply within the timeframe set out in the contract. We determine which types of plans are available for conversion and the terms and conditions of the new policy. We can limit the amount of coverage and which optional benefits are available for the conversion.
We won’t require evidence if converting to a plan with the same number of illnesses. Conversions are subject to minimums except where the full benefit amount is converted.
We’ll issue the new policy on the same basis as the original policy (i.e., smoker or special class basis).
If policyowners add benefits or features on the new policy that weren’t on the original, we usually require evidence.
We’ll date the new policy from the date the Client applied for conversion unless they backdate to retain age. We can backdate a CII policy up to a maximum of 6 months. Rates will be current and at the Client's current age or backdated age.
Partial conversions of CII are not contractually guaranteed. We may allow partial conversions when the original and new policy’s benefit amounts meet the minimum amount requirements. Clients can partially convert their policy and keep the existing amount in force if:
Which existing CII plans can Clients convert?
Clients can convert:
There is no conversion from Sun Life Assist, Basic CII, Sponsored CII, Prudential, and Met Life plans.
If the original plan is Sun T10, Clients can convert:
See Sun T10 conversion rules at a Glance (810-5139)
If the original plan is Clarica CII or SunSpectrum CII Term, Clients can convert:
See Clarica or SSP conversion rules at a Glance (810-5138)
If the original plan is CII Term Insurance Benefit on Universal Life, Clients can convert:
Things to know about applying for a conversion
If the Client is in Quebec, we require disclosure statements for conversions or partial conversions Notice of Replacement of Insurance of Persons contract .
We don’t require evidence of insurability for conversions and partial conversions if:
The policy must be in force for the Client to convert it. This means the policy cannot be in a lapsed position with premiums outstanding for no more than 40 days.
Important things to remember:
CII Conversions at age nearest 66
Submit a Special Issue application if the Client has a contractual right to convert a CII plan and:
Obtain a special quote and provide it to the Client before you submit the application. Special Instructions in the application should state the following:
Sun CII Conversion FAQ
1. What happens if the Client converts a child policy when the child is 18 or older?
When converting a child policy after age 18, the new policy will be an adult policy.
2. Can a Client partially convert the original policy? How does that affect any Return of Premium on Death (ROPD) or Return of Premium on Cancellation/Expiry (ROPC/E) benefit?
We allow partial conversions, subject to the minimum face amounts for the original policy and the new policy.
If the policy included an ROPC/E or ROPD benefit and the Client adds either of these to the new policy, we’ll transfer the prorated accumulated returnable premium amount to the new policy.
3. How do we know which optional benefits the Client can add to the new policy?
Clients can add or carry over optional benefits from the original policy if they qualify for the benefits based on their attained age when they convert.
For example, if the Client had an ROPC/E at age 65 on the original policy and converts:
4. Do we ever request evidence of insurability on conversion?
Conversions and partial conversions need evidence of insurability if:
5. What happens if the original policy has ROPC/E that has met the maturity date?
When the original policy includes ROPC/E, the conversion never triggers a return of premium.
If ROPC/E is not available on the new policy due to issue age limitations, the Client forfeits the accumulated returnable premium amount.
6. What happens when a Client converts an older Sun CII plan with ROPC/E to a new Sun CII plan with graded ROPC/E?
There are no changes to our conversion rules because of the new graded ROPC/E.
The new graded ROPC/E will apply for newly issued plans. This means access to a portion of the returnable amount may be available according to the following tables:
Policy Anniversary | Percentage |
---|---|
3 | 10.0% |
4 | 17.5% |
5 | 25.0% |
6 | 32.5% |
7 | 40.0% |
8 | 47.5% |
9 | 55.0% |
10 | 62.5% |
11 | 70.0% |
12 | 77.5% |
13 | 85.0% |
14 | 92.5% |
15+ | 100.0% |
Policy Anniversary Age Nearest | Percentage |
---|---|
53 | 10.0% |
54 | 17.5% |
55 | 25.0% |
56 | 32.5% |
57 | 40.0% |
58 | 47.5% |
59 | 55.0% |
60 | 62.5% |
61 | 70.0% |
62 | 77.5% |
63 | 85.0% |
64 | 92.5% |
65+ | 100.0% |
Policy Anniversary Age Nearest | Percentage |
---|---|
63 | 10.0% |
64 | 17.5% |
65 | 25.0% |
66 | 32.5% |
67 | 40.0% |
68 | 47.5% |
69 | 55.0% |
70 | 62.5% |
71 | 70.0% |
72 | 77.5% |
73 | 85.0% |
74 | 92.5% |
75+ | 100.0% |
What is an internal replacement?
An internal replacement allows for a plan change outside of the contractual right. Clients must always submit evidence for internal replacements. A benefit of the internal replacement is that we may pay out the accumulated ROPC/E benefit cancellation values.
Note: Clients can only surrender Clarica Basic CII (sold up until April 24, 2008). They can’t replace these policies. Complete a surrender form and proceed as new business.
The new policy will use the date the Client applied for the internal replacement unless they backdate the policy. We can backdate a policy up to 6 months to retain age. Rates will be current and at the Client’s current age or backdated age.
The same backdating rules apply to new business, internal replacements, and conversions.
How is a replacement different from a surrender or cancellation?
An internal replacement doesn't require a surrender form, and we don’t immediately cancel the original policy. Instead, we terminate the original policy once we issue the new replacing policy. If we decline the replacement application, we won’t terminate the original policy.
Why is evidence required?
Clients must submit evidence for internal replacements because the new policy is a new risk. We need evidence to assess this risk.
What happens to the ROPC/E value on an internal replacement?
If the original policy has an accumulated ROPC/E value, we’ll pay the return of premium amount to the owner. If the original plan is a SunSpectrum CII permanent policy, we’ll pay any accumulated cancellation value when we cancel the original policy.
General rules to keep in mind for CII internal replacements
A) When the original policy is a Clarica or SunSpectrum CII
B) When the original policy is a Sun CII plan
Determining if plan is eligible for a conversion or an internal replacement
From Existing Policy: Plan Name |
To New: Sun CII Term 10 |
To New: Sun CII Term 75 |
To New: Sun CII Lifetime |
---|---|---|---|
Sun Critical Illness Term 10 (pre-2009) | Internal replacement | Conversion | Internal replacement |
Sun Critical Illness Term 10 (series 2009) | Internal replacement | Conversion | Conversion |
Sun Critical Illness Term 75 | Internal replacement | Internal replacement | Internal replacement |
Sun Critical Illness Lifetime | Internal replacement | Internal replacement | Internal replacement |
Sun Life Assist | Internal replacement | Internal replacement | Internal replacement |
Clarica/SunSpectrum CII Term | Internal replacement | Conversion | Conversion |
Clarica/SunSpectrum CII Perm | Internal replacement | Internal replacement | Internal replacement |
Clarica Ulife 2000 CII Term Rider | Internal replacement | Conversion | Conversion |
SunSpectrum Basic CII (available as of April 25, 2008) | Internal replacement | Internal replacement | Internal replacement |
Met Assist | Internal replacement | Internal replacement | Internal replacement |
Clarica Universal Life CII Term Rider | Internal replacement | Conversion | Conversion |
SunSpectrum Universal Life CII Term Rider (clone of Sun CII Term 10) | Internal replacement | Conversion | Internal replacement |
Notes:
What is the long-term care conversion (LTCCO) on Sun CII?
The LTCCO allows the owner to apply once to convert their Sun CII benefit to a long-term care insurance (LTCI) policy. Coverage is for the insured person. Clients can convert some or all of their CII benefit without evidence of insurability.
When Clients become eligible to exercise this option, we send them a letter. We send a letter every year they're eligible to convert. As always, you will receive a copy of this letter in your activity center.
There are various factors to consider about converting from CII to LTCI.
When should the Client consider converting?
For all Sun CII policies with a Long-term care conversion option
For series 2009 only: If we're waiving premiums under the disability waiver benefit, the Client must wait until the final conversion date to convert.
For CII policies with a Return of premium on cancellation or expiry (ROPC/E) benefit
If the Client's CII policy includes ROPC/E - age 65, the Client may want to receive the return of premium before converting. This means they’ll need to wait until age 65 before conversion.
Three scenarios for the Client to consider with ROPC/E - age 65.
Important: This also applies if a policy includes the ROPC/E - 15 years benefit and the ROP amount becomes payable between ages 60-65.
How much can the Client convert?
Assessing Client needs
Use the cost of care reports to help Clients understand how much long-term care costs in their province today.
Remember the effect of inflation while determining an appropriate benefit amount.
What happens to optional benefits on conversion?
Sun CII policy | LTCI policy |
---|---|
ROPD included | Converting to Sun Retirement Health Assist (Sun RHA): The returnable premium amount is transferred to Sun RHA |
ROPD is not included | Optional ROPD can be added to Sun RHA |
ROPC/E is included | ROPC/E is not available on Sun RHA If the Sun CII policy is converted before the returnable premium amount is payable, the Client forfeits ROPC/E benefit. |
Additional things to note about partial conversions
If ROPD is included on the CII policy
If the CII policy includes ROPD and ROPC/E, and the Client converts before the ROPC/E benefit is available:
If the CII policy includes ROPD and ROPC/E, and the Client converts after the ROPC/E benefit is available:
If the CII policy includes ROPC/E and the Client converts before the ROPC/E benefit is payable:
If the CII policy includes ROPC/E and the Client converts after the ROPC/E benefit is payable:
How to apply for the LTCI conversion?
To apply, please complete and submit Application for Sun Retirement Health Assist (4535).
You will not need to complete Sections 8 as evidence information is not required.
In Section 10: Special instructions please indicate “This is a conversion application for policy LI-XXXX,XXX-X”.
The required premiums for the CII policy must be paid by the due date. If premiums aren’t paid when due, we’ll withdraw the unpaid premium from the withdrawable premium fund if it has enough funds.
If premiums aren’t received within 30 days after they’re due and there are insufficient funds in the withdrawable premium fund, the policy will end. If the policy ends this way, it’s called a lapse.
The Client will have until day 61 to reinstate without providing evidence of insurability.
If the policy ended because it lapsed, the owner can apply to have it put back into effect (or reinstated) if:
To reinstate the CII policy, the owner must:
Critical illness insurance reinstatement rules:
Number of days from the premium due date | Amount of insurance | Evidence requirements | Payment requirements |
---|---|---|---|
Less than 62 | Any | None | The total of all back payments to the current date, without interest. |
62 - 180 | Any | Application for reinstatement of life or critical illness insurance (form E67). | |
Greater than 180 | Any | Option 1: Regular evidence for age and amount Option 2: Policy change, reinstatement and/or reconsideration of rating application requiring evidence (form E245) |
When an insured person has an eligible illness as defined in the critical illness policy, a claim should be submitted immediately1. A claim must be sent to us while the policy is in effect and within 1 year of the date the insured person has a covered critical illness.
Please contact the Individual Claims Services department directly for the appropriate critical illness claim forms. You can call Individual Claims Services toll free by dialing 1 800-800-4SUN (1 800 800-4786).
The person making the claim must complete the form and give us the information we need to assess the claim.
The form and information must be sent to this address:
Individual Claims Services
Sun Life Assurance Company of Canada
227 King St S, PO BOX 1601 Stn Waterloo
Waterloo ON N2J 4C5
Physicians may charge a fee to complete certain forms. The person making the claim is responsible for any fees for this information.
1Child plans: The first date a claim for Loss of independent existence may be made is the policy anniversary nearest the insured person's 18th birthday. If the insured person would have qualified for a Loss of independent existence before this date, you may still make a claim. However, you must submit the claim to us no later than the policy anniversary nearest the insured person's 19th birthday.
Note: No benefit is payable if the illness is cancer or benign brain tumour where signs or symptoms began in the first 90 days following the later of:
If this is the case, the client still has a responsibility to report the cancer or benign brain tumor. Form Responsibility to report cancer or benign brain tumour - E277
will need to be completed. You can print the form here or call the underwriting department toll free by dialing 1 800-800-4SUN (1 800 800-4786) for a copy of this form.
If this information is not provided within 6 months of the date of diagnosis, we have the right to deny any claim for cancer or benign brain tumor or any critical illness caused by any cancer or benign brain tumor or their treatment.
This form E277 will need to be forwarded to:
Note: No benefit will be payable for Parkinson's disease or specified atypical parkinsonian disorders if, within 1 year following the later of:
the insured person has any of the following:
If this is the case, the client still has a responsibility to notify us about Parkinson's disease or specified atypical parkinsonian disorders. Form Responsibility to report Parkinson's Disease and Specified Atypical Parkinsonian Disorders will need to be completed. You can print the form here or call the underwriting department toll free by dialing 1 800-800-4SUN (1 800 800-4786) for a copy of this form.
This form 4860-E will need to be forwarded to:
Once we receive the forms, we will assess the insured person's eligibility for benefits. Written requests for additional medical information may be sent directly to the physician by Individual Claims Services as we may require additional medical information to assess the claim. If the policy was issued within the last five years, be sure to advise the client that these additional reports will be requested by Individual Claims Services to complete the assessment of the claim.
Once we receive all information we require, Individual Claims Services assesses the information and makes its decision. We communicate the decision to the advisor. We send payment cheques to the advisor for delivery. If we deny a claim, we send a letter explaining the decision to the owner. If the owner and insured person are not the same person, we send two decline letters. We send one letter to the insured person fully explaining our decision. We send a separate letter to the owner confirming our denial of the claim but no medical information is given to the owner for privacy reasons.
To contact the Individual Claims Services department, you have the following options:
The person making a claim for a covered critical illness that occurs or is diagnosed in Canada must give us all information we need to assess the claim, including:
The written diagnosis must:
A specialist is a licensed medical practitioner who has been trained in the specific area of medicine relevant to the critical illness for which a benefit is being claimed, and who has been certified by a specialty examining board. In the absence or unavailability of a specialist, a condition may be diagnosed by another qualified medical practitioner as approved by us.
Please refer to the sample policy pages for more details.
A claim can be made for a critical illness insurance benefit if a covered critical illness develops or is diagnosed while outside of Canada. The person making the claim will be required to provide us with all of the information described above. If the medical records of the insured person are not in French or English, the original records must be provided along with a translation2 of the records in either French or English. The person making the claim is responsible for any cost associated with providing the translation.
2The translator may not be the owner, any person insured under this policy, anyone entitled to make a claim under this policy, or any relative or business associate of these people.
Based on the medical records we require, we must be satisfied that the same diagnosis would have been made if the illness developed in Canada.
Ensure the person making the claim completes all the information and fields on the claims forms and signs and dates the form.
The most common missing information is:
If the claim is approved, the CII benefit is issued once the eligibility period has been satisfied subject to the definition outlined in the policy.
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