Sun Critical Illness Insurance

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:

• Reducing debt and other financial concerns while they cope with their illness
• Replacing any reduced or lost income for them or their spouse
• Bringing in extra help at home from for their family or themselves
• Pay for medical treatments, medications or other care related costs not covered by private or government health insurance plans

Why choose Sun CII?

1. Comprehensive coverage that includes:

• 26 critical illnesses for full payout (including acquired brain injury due to external trauma and loss of independent existence)
• 8 minor illnesses for partial payout
• 5 additional illnesses for child plans

2. Wide ranging benefit amounts on adult and child plans:

• Adult plans available in amounts of $25,000 to $3,000,000
• Child plans available in amounts of $25,000 to $1,000,000

3. Simple and easy to understand return of premium options. Including graded Return of premium on cancellation or expiry on adult plans.

Overview

Product details

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:

• Term 10 (T10) - Guaranteed renewable premiums every 10 years until the policy ends at the policy anniversary nearest the insured person's 75th birthday.
• Term 75 (T75) - Guaranteed level premiums until the policy anniversary nearest the insured person's 75th birthday, at which time the policy ends.
• Term 75 (T75) Payable for 15 years - Guaranteed level premiums for 15 policy years at which time the policy is paid up and coverage continues until the policy ends at the policy anniversary nearest the insured person's 75th birthday.
• Lifetime (T100) - Guaranteed level premiums until the policy anniversary nearest the insured person's 100th birthday at which time the policy is paid up and coverage continues.
• Lifetime (T100) Payable for 10 years - Guaranteed level premiums for 10 policy years at which time the policy is paid up and coverage continues.
• Lifetime (T100) Payable for 15 years - Guaranteed level premiums for 15 policy years at which time the policy is paid up and coverage continues.

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.

Base plan issue ages

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.

Issue limits

Adult: $25,000 - $3,000,000 1
Child: $25,000 - $1,000,000 2

Premium details

Premium rate bands for all plan types:

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.

Risk classes

• Male non-smoker
• Male smoker
• Female non-smoker
• Female smoker

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).

Ratings

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.

Premium frequency - monthly or annually

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.

Premium payment periods

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:

• Sun CII T75: 15 year limited premium payment option, for issue ages 30 days to 59 years
• Sun CII T100: choose either 10 year or 15 year premium payment options

Limited premium payment periods may be suited for:

• clients who don't want the expense of paying premiums during retirement years
• parents/guardians who want to avoid paying premiums while financing their children's post secondary education
• clients who want to potentially pay less total premiums for their coverage over their lifetime
• employers who want to protect their key person while limiting premium payments

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.

• Return of premium on cancellation or expiry - ROPC/E - age 65 and the Return of premium on cancellation or expiry - ROPC/E - age 75 are not available.
• The Advanced return of premium on cancellation or expiry - Advanced ROPC/E for child plans is not available. Instead, child plans with a limited premium payment option may select the Return of premium on cancellation or expiry - ROPC/E age 35 for T75 and T100 plans.
• The Long-term care conversion option is not available.
• The Total disability waiver for child plans is not available.

When premiums exceed the critical illness insurance benefit amount

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:

• Rated policies
• An older insured at the time of issue
• Limited pay policy
• Smoker status
• ROPC/E added to the policy

The below scenarios show what will be paid out for Sun CII policies sold after September 17, 2012

CII without any ROP benefit

CII benefit amount

CII with ROPD

CII benefit amount

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

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

Total Returnable premium amount or the CII benefit amount, whichever is higher

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.

Covered illnesses

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.

Illnesses eligible for full benefit payout

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.

• Acquired brain injury due to external trauma
• Aortic surgery
• Aplastic anemia
• Bacterial meningitis
• Benign brain tumour
• Blindness
• Cancer
• Coma
• Coronary artery bypass surgery
• Deafness
• Dementia, including Alzheimer's disease
• Heart attack
• Heart valve replacement or repair
• Kidney failure
• Loss of independent existence (LOIE)*
• Loss of limbs
• Loss of speech
• Major organ failure on waiting list
• Major organ transplant
• Motor neuron disease
• Multiple sclerosis
• Occupational HIV infection
• Paralysis
• Parkinson's disease and specified atypical parkinsonian disorders
• Severe burns
• Stroke

Childhood illnesses eligible for full benefit payout

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.

• Cerebral palsy
• Congenital heart disease
• Cystic fibrosis
• Muscular dystrophy
• Type 1 diabetes mellitus

Illnesses eligible for partial benefit payout

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.

• Cancer – chronic lymphocytic leukemia (CLL) Rai stage 0
• Cancer – ductal carcinoma in situ of the breast
• Cancer - gastrointestinal stromal tumours classified as AJCC Stage 1
• Cancer - grade 1 neuroendocrine tunours (carcinoid)
• Cancer – papillary thyroid cancer or follicular thyroid cancer stage T1
• Cancer – stage 1A malignant melanoma
• Cancer – stage A (T1a or T1b) prostate cancer
• Coronary angioplasty

* 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.

Eligibility qualifying periods and survival periods

The following table shows all illnesses that have an eligibility qualifying period and/or a survival period.

Acquired brain injury due to external trauma

Aortic surgery

30 days following the date of surgery

Bacterial meningitis

Coma

30 days following the date of diagnosis. If surgery is performed, 30 days following the date of the surgery.

30 days following the date of the procedure

30 days following the date of surgery

Heart attack

30 days following the date of diagnosis

Heart valve replacement or repair

30 days following the date of surgery

Loss of independent existence

Loss of speech

Multiple sclerosis

Occupational HIV infection

Paralysis

Parkinson’s disease and specified atypical parkinsonian disorders

30 days following the date of diagnosis

Optional benefits

Optional benefits - Availability at a glance

Issue ages (age nearest)

Owner is 18 - 55

Owner is 18 - 60

Owner is 18 - 55

May apply to add at policy anniversary nearest the insured's 18th birthday

Total disability waiver 2

Owner waiver disability benefit

Owner waiver death benefit

Owner waiver death and disability benefit

Advanced ROPC/E 2

ROPC/E - age 35 3

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.

Long-term care conversion option

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.

• We determine the type of LTCI available for conversion.
• The weekly benefit amount will be calculated by dividing the critical illness insurance amount being converted by 200 and rounded to the nearest dollar. Minimums may apply depending on the LTCI product that is available for conversion.

• The maximum critical illness insurance amount that may be converted is $250,000 per insured person for a weekly LTCI benefit amount of $1,250.
• Premiums for the new LTCI policy will be the attained age rates we charge for the new insurance at the time the application for the new policy is signed.
• If a return of premium on cancellation or expiry (ROPC/E) benefit is included in the CII policy and the policy has been in effect long enough for the owner to receive the returnable premium amount if they cancelled the policy, then on conversion to LTCI, we transfer the returnable premium amount to the LTCI withdrawable premium fund.
• If ROPD was included on the CII policy the Return of premium amount will be carried over to the Sun RHA.

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:

• convert the total CII benefit to long-term care insurance between ages 60 and 65;
  • If converting between 60 and 62 the policy will end and no return of premium benefit will be payable.
  • If converting between 63 and 65 the policy will end and the return of premium benefit percent available at the given age will be payable
  • if they convert between the ages of 60 and 62 they won't receive a returnable amount. For ages 63 to 65 a portion of the returnable premium amount will be returned, based on the converted benefit amount and the chart in the ROPC/E - age 75 section below,

  Total disability waiver

  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

  • Ages 0 - 55
  • For issue ages 0 - 17, premiums and coverage for this benefit begin at age 18.
  • Not available after issue.
  • Not available if the insured is between 0-17 years and the payment period is '10 years' or '15 years'.

  Coverage period for this benefit

  • Until the policy anniversary nearest the insured person's 60th birthday.

  Length of time premiums will be waived for

  • For the duration of disability of the insured person, even if disability extends past age 60, provided that the disability began before age 60.

  Waiting period

  Maximum amount Sun Life will waive under this benefit

  Premiums won't be waived if the total disability:

  • continues for less than six months,
  • is the result of self-inflicted injuries, or
  • is the result of committing a criminal offence

  Please refer to the policy for other exclusions.

  Making a claim

  For clients to make a claim:

  • notice must be given to Sun Life during total disability and before the policy anniversary nearest the insured person's 60th birthday.
  • proof of disability must be provided within six months of notice, and then periodically as required.
  • payments under this benefit won't be made for any period earlier than one year before notice of total disability is received.

  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.

  • Disabled while a student – If the insured person becomes disabled while they are a student, Sun Life considers them to be disabled if they are completely unable to attend or participate as a student in an education program or perform the duties of any occupation within their education, training or experience.
  • Disabled while unemployed – If the insured person becomes disabled while unemployed, and isn't profiting from any occupation, Sun Life considers them to be disabled if they're completely unable to perform the duties of any occupation within their education, training or experience.

  Owner waiver disability benefit

  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

  • Owner is 18 - 55
  • Only one owner can be covered per policy.
  • The owner must be different than the insured.
  • Not available when the policy is owned by a corporation.
  • Not available on rated policies.

  Coverage period for this benefit

  • Insured ages 18 - 55: Policy anniversary nearest the owner's 60th birthday.
  • Insured ages 0 - 17: Earlier of the policy anniversary nearest the insured's 25th birthday or the policy anniversary nearest the owner's 60th birthday.

  Length of time premiums will be waived for

  • For the duration of disability of the owner insured under this benefit.

  Waiting period

  Maximum amount Sun Life will waive under this benefit

  Exclusions

  Premiums won't be waived if the total disability:

  • continues for less than six months,
  • is the result of self-inflicted injuries, or
  • is the result of committing a criminal offence.

  Please refer to the policy for other exclusions.

  Making a claim

  For clients to make a claim:

  • notice must be given to Sun Life during total disability and before the policy anniversary nearest the insured person's 60th birthday.
  • proof of disability must be provided within six months of notice, and then periodically as required, and
  • payments under this benefit won't be made for any period earlier than one year before notice of total disability is received.

  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.

  Owner waiver death and disability benefit

  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.

  Return of premium on death (ROPD) - All plans

  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:

  • Any advanced return of premium amount we have paid,
  • Any premiums paid for the Long-term care conversion option, if included in the policy, and
  • Any unpaid premiums plus interest.

  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.

  Return of premium on cancellation or expiry (ROPC/E)

  Summary

  Sun CII Adult Plans

  T75 (lifetime pay plans)

  T75 (10-pay or 15-pay plans)

  T100 (lifetime pay plans)

  T100 (10-pay or 15-pay plans)

  Adult options:

  Return of premium on cancellation or expiry (ROPC/E) – 15 years

  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%.

  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.

  Return of premium on cancellation or expiry (ROPC/E) – age 65

  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%.

  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.

  Return of premium on cancellation or expiry (ROPC/E) – age 75

  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%.

  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.

  Child options:

  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:

  • Any advanced return of premium amount we have paid,
  • Any premiums paid for the Long-term care conversion option, if included in the policy,
  • Any unpaid premiums plus interest.

  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.