Products

	Eligibility
	Benefit Amounts
	Premium Rates
	Product Features
	Additional Benefits
	General Information
	Definitions of Covered Conditions
	Definitions of AdvanceCare Benefit Conditions

Eligibility

Members and their spouses are eligible to apply for Critical Illness Insurance. Members do not have to be insured in order for a spouse to apply for coverage.

All applicants must be resident in Canada and less than 65 years of age.

Member, as defined under the plan, means a graduate of the University of Victoria or an alumni member as defined by the Alumni Association.

Spouse means the legal or common-law spouse of an eligible Member. Legal spouse means a person who is legally married and cohabiting with the Member and with whom there is no formal or informal agreement of separation. Common-law spouse means a person who has been cohabiting in a marriage-like relationship with the Member for at least 12 consecutive months.

 

Benefit Amounts

Members and Spouses can each apply for coverage in units of $25,000 up to a maximum of $300,000. That is a combined maximum of $600,000 protection for you and your Spouse.

Premium Rates

Premiums are calculated each year based on the insured’s age at October 1^st, and will increase as the insured reaches a higher age band.

Critical Illness Insurance Monthly Premium Rates per $25,000 Unit
	Male		Female
Attained Age at October 1st	Non- Smoker*	Smoker	Non- Smoker*	Smoker
24 or less	$3.60	$4.90	$3.75	$4.75
25 - 29	4.80	8.15	4.95	8.40
30 - 34	6.10	11.00	6.30	11.25
35 - 39	7.35	13.45	7.65	13.80
40 - 44	10.10	21.90	10.50	19.70
45 - 49	15.85	36.90	16.00	31.05
50 - 54	22.60	59.25	22.70	50.25
55 - 59	30.20	80.55	29.95	68.35
60 - 64	50.60	134.55	49.80	101.60
65 - 69 **	74.35	202.25	73.95	157.60
70 - 74 **	161.30	371.20	114.55	242.65

*Non-Smoker rates apply to individuals who, at the time of application, have not used any tobacco, marijuana or nicotine products within the last 12 months and who have provided satisfactory evidence of insurability.

**The premiums shown for ages 65 to 74 are for renewal of existing coverage only.

Product Features

Payment of Benefit
If you are faced with one of the twenty-five covered medical conditions before the age of 75, and survive for 30 days (90 days for Paralysis, Loss of Independent Existence or Bacterial Meningitis, 180 days for Multiple Sclerosis or Loss of Speech) after first being diagnosed, you can receive a tax-free lump sum benefit. Full recovery may be made and the benefit is not dependent on your ability or inability to work.

Covered conditions include:

AdvanceCare Benefit
With the AdvanceCare Benefit you are covered not just for 25 critical illnesses, but also for several non life-threatening conditions. The AdvanceCare Benefit will pay 10% of the total benefit amount for Coronary Angioplasty and several Early Stage Cancers.

Additional Benefits

Access to OneWorld Medicare’s Treatment Management Service
Coverage under IAP’s Critical Illness Insurance also provides access to OneWorld Medicare’s Treatment Management service. If you decide to find private treatment for a diagnosed condition, OneWorld Medicare can help.

OneWorld Medicare…

• works with you and your physician to help find the best treatment for you
• links you with physicians in medical centres of excellence who are best suited to treat your condition
• books transportation and arranges accommodations for you and your travelling companions
• books your surgery and pre- and post-operative visits
• co-ordinates any other details connected to your medical procedure and period of recovery
• ensures that your money goes considerably further than if you arrange treatment yourself

General Information

Fully Portable Coverage
If you are an alumni member, coverage goes with you regardless of a change in your profession, job status, place of employment or residence – 24 hours a day, anywhere in the world – as long as you continue to pay your premiums.

Money Back Guarantee
Once your application is received and approved, you will be sent a Certificate of Insurance. You will have 60 days to review it to ensure that it meets your needs. Should you choose not to accept the insurance you can cancel your coverage and return the Certificate within 60 days of the effective date. You will receive a full refund of any premiums already paid.

Beneficiary
The Critical Illness Benefit is payable directly to the insured person; that is, the Member is the beneficiary of Member coverage, and the Spouse is the beneficiary of Spousal coverage.

Termination of Coverage
Your coverage terminates on the earliest of the following dates:

• the end of the month in which your written request to cancel your insurance is received by IAP;
• the date the Critical Illness Benefit is paid;
• the end of month in which you are no longer eligible;
• the due date of any unpaid premiums;
• the date the Group Master Policy between your Alumni Association and IAP terminates;
• the end of the policy year following the date you reach age 75;
• with regard to your Spouse's Critical Illness Insurance, the earliest of the above or the end of the policy year following the date they reach age 75, or the end of the month in which they no longer qualify as a "Spouse".

Limitations

1. Covered Condition Benefit
   An Insured Person will not be entitled to a Covered Condition Benefit for Benign Brain Tumour or Cancer (Life-Threatening) and coverage will be void, if, within the first 90 days following the effective date of his Voluntary Group Critical Illness Insurance coverage, such Insured Person has any of the following:
   1. A Diagnosis of Benign Brain Tumour or any signs, symptoms or investigations that lead to a Diagnosis of Benign Brain Tumour, regardless of when the Diagnosis is actually made.
   2. A Diagnosis of Cancer (Life-Threatening) or any signs, symptoms or investigations that lead to a Diagnosis of Cancer (Life-Threatening), regardless of when the diagnosis is actually made.
2. AdvanceCare Benefit
   An Insured Person’s Voluntary Group Critical Illness Insurance will be void and the Company’s liability will be limited to the return of any premiums paid if, within the first 90 days following the Issue Date of his Voluntary Group Critical Illness Insurance, such Insured Person has a Diagnosis of Early Stage Cancer or any signs, symptoms or investigations that lead to a diagnosis of Early Stage Cancer, regardless of when the diagnosis is actually made. However, in the event an Insured Person, who was insured under the Previous Plan, is diagnosed with Early Stage Cancer within 90 days following 01 October 2010, the Voluntary Group Critical Illness Insurance will remain in force but Early Stage Cancer will no longer be considered an AdvanceCare Benefit Condition for such Insured Person.

Exclusions
In addition to the exclusions included within the definition of certain Covered Conditions, the following exclusions also apply.

No benefit will be paid if a Covered Condition or AdvanceCare Benefit Condition results directly or indirectly from any one or more of the following:

1. any Covered Condition or AdvanceCare Benefit Condition diagnosed prior to the effective date of an Insured Person’s Voluntary Group Critical Illness Insurance;
2. attempted suicide
3. taking poison or inhaling gas, whether voluntarily or involuntarily, not connected with the employment of the Insured Person;
4. taking any drug other than as prescribed by a licensed physician;
5. war or full-time active service in the armed forces of any country;
6. flying as a student pilot or flying as a privately licensed pilot for less than 25 hours or more than 400 hours per year;
7. participation in a criminal act or any attempt to commit a criminal offense, including but not limited to operating a motor vehicle while the concentration of alcohol in 100 millilitres of the Insured Person’s blood exceeds 80 milligrams; or
8. intentionally self-inflicted injury, while sane or insane.

In addition, no benefit will be paid if the Insured Person suffers Paralysis, Blindness, Deafness, Severe Burns, Stroke, Coma, or Loss of Limbs as a result, directly or indirectly, from amateur or professional boxing, bungee jumping, B.A.S.E. jumping, cliff diving, mountain climbing, motor vehicle racing or speed competition on land and/or water, parachuting or underwater activities, including scuba diving and snuba diving.

Definitions of Covered Conditions

Alzheimer’s Disease means a definite diagnosis of a progressive degenerative disease of the brain. The insured person must exhibit the loss of intellectual capacity involving impairment of memory and judgement, which results in a significant reduction in mental and social functioning, and requires a minimum of 8 hours of daily supervision. The diagnosis of Alzheimer’s Disease must be made by a specialist.

Exclusion: No benefit will be payable under this condition for all other dementing organic brain disorders and psychiatric illnesses.

Aortic Surgery means the undergoing of surgery for disease of the aorta requiring excision and surgical replacement of the diseased aorta with a graft. Aorta refers to the thoracic and abdominal aorta but not its branches. The surgery must be determined to be medically necessary by a specialist.

Aplastic Anemia means a definite diagnosis of a chronic persistent bone marrow failure, confirmed by biopsy, which results in anemia, neutropenia and thrombocytopenia requiring blood product transfusion, and treatment with at least one of the following: marrow stimulating agents; immunosuppressive agents; bone marrow transplantation. The diagnosis of Aplastic Anemia must be made by a specialist.

Bacterial Meningitis means a definite diagnosis of meningitis, confirmed by cerebrospinal fluid showing growth of pathogenic bacteria in culture, resulting in neurological deficit documented for at least 90 days from the date of diagnosis. The diagnosis of Bacterial Meningitis must be made by a specialist.

Exclusion: No benefit will be payable under this condition for viral meningitis.

Benign Brain Tumour means a definite diagnosis of a non-malignant tumour located in the cranial vault and limited to the brain, meninges, cranial nerves or pituitary gland. The tumour must require surgical or radiation treatment or cause irreversible objective neurological deficit(s). The diagnosis of Benign Brain Tumour must be made by a specialist.

Exclusion: No benefit will be payable under this condition for pituitary adenomas less than 10 mm.

Blindness means a definite diagnosis of the total and irreversible loss of vision in both eyes, evidenced by:

• the corrected visual acuity being 20/200 or less in both eyes; or,
• the field of vision being less than 20 degrees in both eyes.

The diagnosis of Blindness must be made by a specialist.

Cancer (Life-Threatening) means a definite diagnosis of a tumour characterized by the uncontrolled growth and spread of malignant cells and the invasion of tissue. The diagnosis of Cancer must be made by a specialist.

• carcinoma in situ, or
• Stage 1A malignant melanoma (melanoma less than or equal to 1.0 mm in thickness, not ulcerated and without Clark level IV or level V invasion), or
• any non-melanoma skin cancer that has not metastasized, or
• Stage A (T1a or T1b) prostate cancer.

Coma means a definite diagnosis of a state of unconsciousness with no reaction to external stimuli or response to internal needs for a continuous period of at least 96 hours and for which period the Glasgow coma score must be 4 or less. The diagnosis of Coma must be made by a specialist.

• a medically induced coma; or,
• a coma which results directly from alcohol or drug use; or,
• a diagnosis of brain death.

Coronary Artery Bypass Surgery means the undergoing of heart surgery to correct narrowing or blockage of one or more coronary arteries with bypass graft(s), excluding any non-surgical or trans-catheter techniques such as balloon angioplasty or laser relief of an obstruction. The surgery must be determined to be medically necessary by a specialist.

Deafness means a definite diagnosis of the total and irreversible loss of hearing in both ears, with an auditory threshold of 90 decibels or greater within the speech threshold of 500 to 3,000 hertz. The diagnosis of Deafness must be made by a specialist.

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 must be made by a specialist.

• elevated biochemical cardiac markers as a result of an intra-arterial cardiac procedure including, but not limited to, coronary angiography and coronary angioplasty, in the absence of new Q waves, or
• ECG changes suggesting a prior myocardial infarction, which do not meet the Heart Attack definition as described above.

Heart Valve Replacement means the undergoing of surgery to replace any heart valve with either a natural or mechanical valve. The surgery must be determined to be medically necessary by a specialist.

Exclusion: No benefit will be payable under this condition for heart valve repair.

Kidney Failure means a definite diagnosis of chronic irreversible failure of both kidneys to function, as a result of which regular haemodialysis, peritoneal dialysis or renal transplantation is initiated. The diagnosis of Kidney Failure must be made by a specialist.

Loss of Independent Existence means a definite diagnosis of:

• a total inability to perform, by oneself, at least 2 of the following 6 Activities of Daily Living, or
• Cognitive Impairment as defined below,

for a continuous period of at least 90 days with no reasonable chance of recovery. The diagnosis of Loss of Independent Existence must be made by a specialist.

• Bathing – the ability to wash oneself in a bathtub, shower or by sponge bath, with or without the aid of equipment.
• Dressing – the ability to put on and remove necessary clothing including braces, artificial limbs or other surgical appliances.
• Toileting – the ability to get on and off the toilet and maintain personal hygiene.
• Bladder and Bowel Continence – the ability to manage bowel and bladder function with or without protective undergarments or surgical appliances so that a reasonable level of hygiene is maintained.
• Transferring – the ability to move in and out of a bed, chair or wheelchair, with or without the use of equipment.
• Feeding – the ability to consume food or drink that already has been prepared and made available, with or without the use of adaptive utensils.

Cognitive Impairment means mental deterioration and loss of intellectual ability, evidenced by deterioration in memory, orientation and reasoning, which are measurable and result from demonstrable organic cause as diagnosed by a specialist. The degree of cognitive impairment must be sufficiently severe as to require a minimum of 8 hours of daily supervision. Determination of a Cognitive Impairment will be made on the basis of clinical data and valid standardized measures of such impairments.

Exclusion: No benefit will be payable under this condition for any mental or nervous disorder without a demonstrable organic cause.

Loss of Limbs means a definite diagnosis of the complete severance of two or more limbs at or above the wrist or ankle joint as the result of an accident or medically required amputation. The diagnosis of Loss of Limbs must be made by a specialist.

Loss of Speech means a definite diagnosis of the total and irreversible loss of the ability to speak as a result of physical injury or disease, for a period of at least 180 days. The diagnosis of Loss of Speech must be made by a specialist.

Exclusion: No benefit will be payable under this condition for all psychiatric related causes.

Major Organ Failure on Waiting List means a definite diagnosis of the irreversible failure of the heart, both lungs, liver, both kidneys or bone marrow, and transplantation must be medically necessary. To qualify under Major Organ Failure on Waiting List, the insured person must become enrolled as the recipient in a recognized transplant center in Canada or the United States of America that performs the required form of transplant surgery. The date that the insured person is enrolled in the transplant centre will be deemed the Date of Diagnosis for this Covered Condition. The diagnosis of the major organ failure must be made by a specialist.

Major Organ Transplant means a definite diagnosis of the irreversible failure of the heart, both lungs, liver, both kidneys or bone marrow and transplantation must be medically necessary. To qualify under Major Organ Transplant, the insured person must undergo a transplantation procedure as the recipient of a heart, lung, liver, kidney or bone marrow, and limited to these entities. The diagnosis of the major organ failure must be made by a specialist.

Motor Neuron Disease means a definite diagnosis of one of the following: amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), primary lateral sclerosis, progressive spinal muscular atrophy, progressive bulbar palsy, or pseudo bulbar palsy, and limited to these conditions. The diagnosis of Motor Neuron Disease must be made by a specialist.

Multiple Sclerosis means a definite diagnosis of at least one of the following:

• two or more separate clinical attacks, confirmed by a magnetic resonance imaging (MRI) of the nervous system, showing multiple lesions of demyelination; or
• well-defined neurological abnormalities lasting more than 6 months, confirmed by MRI imaging of the nervous system, showing multiple lesions of demyelination; or
• a single attack, confirmed by repeated MRI imaging of the nervous system, which shows multiple lesions of demyelination which have developed at intervals at least one month apart.

The diagnosis of Multiple Sclerosis must be made by a specialist.

Occupational HIV Infection means a definite diagnosis of infection with Human Immunodeficiency Virus (HIV) resulting from accidental injury during the course of the insured person’s normal occupation, which exposed the person to HIV contaminated body fluids. The accidental injury leading to the infection must have occurred after the effective date of such insured person’s insurance coverage.

• The accidental injury must be reported to IAP within 14 days of the accidental injury;
• A serum HIV test must be taken within 14 days of the accidental injury and the result must be negative;
• A serum HIV test must be taken between 90 days and 180 days after the accidental injury and the result must be positive;
• All HIV tests must be performed by a duly licensed laboratory in Canada or the United States of America;
• The accidental injury must have been reported, investigated and documented in accordance with current Canadian or United States of America workplace guidelines.

The diagnosis of Occupational HIV Infection must be made by a specialist.

Paralysis means a definite diagnosis of the total loss of muscle function of two or more limbs as a result of injury or disease to the nerve supply of those limbs, for a period of at least 90 days following the precipitating event. The diagnosis of Paralysis must be made by a specialist.

Parkinson’s Disease means a definite diagnosis of primary idiopathic Parkinson’s Disease which is characterized by a minimum of two or more of the following clinical manifestations: muscle rigidity, tremor, or bradykinesis (abnormal slowness of movement, sluggishness of physical and mental responses). The insured person must require substantial physical assistance from another adult to perform at least 2 of the following 6 Activities of Daily Living. The diagnosis of Parkinson’s Disease must be made by a specialist.

Activities of Daily Living are:

• Bathing – the ability to wash oneself in a bathtub, shower or by sponge bath, with or without the aid of equipment.
• Dressing – the ability to put on and remove necessary clothing including braces, artificial limbs or other surgical appliances.
• Toileting – the ability to get on and off the toilet and maintain personal hygiene.
• Bladder and Bowel Continence – the ability to manage bowel and bladder function with or without protective undergarments or surgical appliances so that a reasonable level of hygiene is maintained.
• Transferring – the ability to move in and out of a bed, chair or wheelchair, with or without the use of equipment.
• Feeding – the ability to consume food or drink that already has been prepared and made available, with or without the use of adaptive utensils.

Exclusion: No benefit will be payable under this condition for all other types of Parkinsonism.

Severe Burns means a definite diagnosis of third-degree burns over at least 20% of the body surface. The diagnosis of Severe Burns must be made by a specialist.

Stroke (Cerebrovascular Accident) means a definite diagnosis of an acute cerebrovascular event caused by intra-cranial thrombosis or haemorrhage, or embolism from an extra-cranial 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.

Definitions of AdvanceCare Benefit Conditions

Coronary Angioplasty means the undergoing of an interventional procedure to unblock or widen a coronary artery that supplies blood to the heart to allow an uninterrupted flow of blood. The procedure must be determined to be medically necessary by a specialist.

Early Stage Cancer refers to one of the following conditions:

• Malignant Melanoma means an invasive malignant melanoma into the dermis equal to or lower than a depth of 1.0mm;
• Stage A Prostate Cancer (T1a or T1b)
• Ductal Carcinoma in situ of the Breast

The diagnosis of an Early Stage Cancer must be made by a specialist.