Disability Insurance

The lifestyle protection plan is a non-cancellable personal disability insurance policy which can provide a monthly disability benefit during a total disability. The premium is level to age 65 (with the exception of the health care profession rider and graded premium rider). The policy is conditionally renewable on a modified basis after age 65, while the insured continues to work full-time. The lifestyle protection plan is available to all occupation classes – 4A, 3A, 2A, A and B. Non-cancellable to age 65 Once issued, the lifestyle protection plan policy cannot be cancelled or modified and the premium cannot be raised by Canada Life prior to age 65 (with the exception of the health care profession rider and graded premium rider), as long as premium is paid when due. This period is known as the non-cancellable period. Conditionally renewable after age 65 After age 65, modified coverage may be continued on an annually renewable basis as long as the insured is not disabled and continues to work full-time*.

No evidence of medical insurability will be required.

All optional benefit riders will terminate on the policy anniversary nearest the insured’s 65th birthday. The benefit period will be 24 months if the insured becomes totally disabled before his or her 75th birthday and 12 months if the insured becomes totally disabled after his or her 75th birthday.

The premium will be based on rates in effect at time of renewal.

Availability Occupation classes 4A, 3A, 2A, A and B Waiting periods 30, 60, 90, 120, 180, 365 and 730 days Benefit periods 24, 60, 120 months and to age 65 Issue ages 18 – 60: 24 months and to age 65 benefit periods 18 – 55: 60 and 120 months benefit periods Graded premium issue ages 18 – 45 Issue limits Minimum monthly disability benefit The minimum monthly disability benefit available is $500.

Maximum monthly disability benefit The maximum monthly disability benefit available varies by occupation class and issue age as shown in the table below. Maximum monthly disability benefit Occupation class Issue ages 18 – 55 Issue ages 56 – 60 4A $25,000 $12,000 3A $15,000 $8,000 2A $8,000 $5,000 A $6,000 $4,000 B $4,000 $3,000 Important basic policy definitions Total disability means the insured, due directly to injury or sickness, is unable:

• During the first 24 months, to perform the substantial duties of his or her regular occupation and is not engaged in any other gainful occupation; and
• Thereafter, to work in any gainful occupation. Injury means accidental bodily injury which occurs on or after the policy effective date and while the policy is in force. The signs and symptoms of the injury must be assessed and documented by a doctor and supported by objective medical evidence. Sickness means disease or illness which is first manifested on or after the policy effective date and while the policy is in force.

The signs and symptoms of the sickness must be assessed and documented by a doctor and supported by objective medical evidence. Regular occupation means the occupation(s) in which the insured is regularly engaged at the time he or she becomes disabled, except, if the insured regularly engages in any other gainful occupation between successive periods of disability, that gainful occupation will be considered the insured’s regular occupation. Gainful occupation means any occupation for which the insured is reasonably fitted by reason of his or her education, training or experience. Basic policy benefits Presumptive disability benefits Presumptive disability means the total and irreversible loss of any of the following due directly to injury or sickness:

• Speech;
• The hearing of both ears;
• The sight of both eyes;
• The use of both hands or both feet; or
• The use of one hand and one foot. If the insured is presumptively disabled, he or she will be considered totally disabled even if he or she engages in any occupation. If the insured becomes presumptively disabled before the monthly disability benefit becomes payable (i.e. he or she is not already on claim):
• The waiting period will not have to be satisfied;
• Premium will be waived from the date he or she becomes totally disabled; and
• The monthly disability benefit will be payable to the end of the benefit period. If the insured becomes presumptively disabled while the monthly disability benefit is payable (i.e. he or she is already on claim):
• Premium will be waived from the date he or she becomes presumptively disabled (if it has not already been waived under the waiver-of-premium provision); and
• The monthly disability benefit will be payable for the remainder of the benefit period. For occupation classes 3A and 4A only — the monthly disability benefit will be increased by 25 per cent and Canada Life will pay a lump-sum benefit equal to the lesser of three times the increased monthly disability benefit and $15,000. If the monthly disability benefit under the basic policy steps up or down, the monthly disability benefit used to calculate the lump sum benefit will be the higher amount. The maximum lump sum benefit we will pay is $15,000

The insured will not be considered totally disabled under this provision if he or she has already been deemed to be catastrophically disabled. Catastrophic disability benefits (for occupation classes 3A and 4A only) Catastrophic disability means the insured satisfies the definition of loss of independent existence (see definition below).

If the insured is catastrophically disabled, he or she will be considered totally disabled, even if he or she engages in any occupation. The insured will not be considered totally disabled under this provision if he or she has already been deemed to be presumptively disabled If the insured becomes catastrophically disabled before the monthly disability benefit becomes payable (i.e. he or she is not already on claim):

• The waiting period will not have to be satisfied;
• Premium will be waived from the date he or she becomes totally disabled; • The monthly disability benefit will be increased by 25 per cent and will be payable to the end of the benefit period; and
• A lump-sum benefit will be payable equal to the lesser of three times the increased monthly disability benefit and $15,000. If the insured becomes catastrophically disabled while the monthly disability benefit is payable (i.e. he or she is already on claim):
• Premium will be waived from the date he or she becomes catastrophically disabled (if it has not already been waived under the waiver-of-premium provision);
• The monthly disability benefit will be increased by 25 per cent and will be payable for the remainder of the benefit period; and
• A lump-sum benefit will be payable equal to the lesser of three times the increased monthly disability benefit and $15,000. If the monthly disability benefit under the basic policy steps up or down, the monthly disability benefit used to calculate the lump sum benefit will be the higher amount. The maximum lump sum benefit we will pay is $15,000, regardless of the number of disability insurance policies with Canada Life insuring the same life. Definition of loss of independent existence — loss of independent existence means a condition that qualifies under the definition of physical impairment or cognitive impairment below and there is no reasonable chance of recovery based on the then current medical practice.

Physical impairment means the insured is unable to perform, by himself or herself, whether with or without the use of any equipment, at least two of the following six activities of daily living.

1. Bathing – the ability to wash oneself in a bathtub, shower or by sponge bath;
2. Dressing – the ability to put on, remove, fasten and unfasten all necessary clothing, braces, artificial limbs or other surgical appliances;
3. Toileting – the ability to get to and from the toilet and complete related personal hygiene;
4. Bladder and bowel continence – the ability to manage bowel and bladder functions, with or without any protective undergarments or surgical appliances, so that a reasonable level of hygiene is maintained;
5. Transferring – the ability to move into and out of a bed, chair or wheelchair; and
6. Eating – the ability to consume food that has already been prepared and made available.

The diagnosis for the insured’s condition must be made by a doctor and accompanied by a current physical assessment from an occupational therapist other than the insured. Cognitive impairment means mental deterioration and loss of intellectual ability, evidenced by deterioration in memory, orientation and reasoning, which is measurable by neuro-psychometric methods and results from demonstrable organic cause, and where the severity is such that the insured is incapable of independent living and requires a minimum of eight hours of daily supervision. For further clarification, any mental or nervous disorder without a demonstrable organic cause, including but not limited to anxiety disorders, mood disorders, sleep disorders, pain disorders, personality disorders and psychotic disorders, does not satisfy the definition of cognitive impairment. Survivorship benefit If the insured dies while receiving disability benefits, a lump-sum death benefit of three times the monthly disability benefit will be paid to the insured’s estate.

Vocational training program Vocational Training Program means a government sponsored or other professionally planned vocational program Canada Life has approved in writing in advance of the insured’s participation in the program. In considering whether to approve a vocational training program, Canada Life will assess such factors as the expected duration of the total disability and the level of activity required to facilitate the earliest possible return to work. The disability benefit will be payable while the insured is totally disabled and participates in a vocational training program. Canada Life may pay the cost of a program provided in connection with the vocational training program, as long as:

a) The program will assist the insured in working in a gainful occupation;

b) The program is not covered by any other program or plan;

c) The program has been approved in advance; and

d) Canada Life receives satisfactory evidence of the cost of the program.

Reasonable expenses associated with the program may be paid by Canada Life. If approved, payment will be made to the supplier of the program or to the insured if Canada Life receives satisfactory proof that the supplier has been paid. Accumulation of days to satisfy the waiting period To satisfy the waiting period, non-consecutive days of disability, which result from the same or a related cause, may be accumulated, provided they are separated by:

• 24 months or less — for occupation classes 3A and 4A.
• 6 months or less — for occupation classes B, A and 2A. March 2020 Page 9 This material is not intended for use with clients. Recurrent disability If the insured becomes disabled again within 12 months (for occupation classes 3A and 4A) or 6 months (for occupation classes B, A and 2A) from the same or a related cause as a prior disability (for which benefits have been payable), the disability will be considered a continuation of the prior disability. Such an extension only applies if the insured has worked continuously in a full-time* occupation away from his or her home for less than:
• 12 months following the earlier period of disability — for occupation classes 3A and 4A.
• 6 months following the earlier period of disability — for occupation classes B, A and 2A In the case of a recurrent disability, a new waiting period will not need to be satisfied and the original benefit period will be continued. *Full-time means the insured is working at least 30 hours per week on a year-round basis. Payment of disability benefit Disability benefits are payable only while the insured is receiving medical care from a doctor that is of an appropriate nature and frequency for the disability. The doctor must be a licensed medical doctor other than the insured. Disability benefits will be paid at the end of the month after the waiting period has been satisfied while the insured is disabled until the earliest of:
  • The date the insured is no longer disabled;
  • The end of the benefit period;
  • The date of the insured’s death; and

The date the claim is terminated by us for failure to comply with requirements outlined in the policy. The payment of any benefits will be subject to receiving any information that we may request for the adjudication, investigation and verification of a claim. Recovery benefit A recovery benefit will be payable for two months after the insured returns to full-time work in his or her regular occupation. The waiting period must have been satisfied and the disability must have lasted at least three months. The benefit will be 50 per cent of the monthly disability benefit for the first month and 25 per cent of the monthly disability benefit for the second month. The recovery benefit will not be paid if the insured:

• Is receiving any other benefits under the policy;
• Has already received disability benefits for the entire benefit period;
• Is over age 65; or
• Has already received this benefit for this period of disability.

Transplant surgery benefit If the policy has been in force for at least six months and the insured becomes disabled as a result of surgery to transplant an organ or other part of the insured’s body to the body of another person, Canada Life will consider the insured to be disabled due to sickness. Extension of benefits If the insured is disabled on the date the policy expires and 24 months of disability benefits have not been paid, Canada Life will continue to pay disability benefits for the remaining balance of the 24 months while the insured’s disability continues. March 2020 Page 10 This material is not intended for use with clients.