Long Term Care Guarantee Standard Issue Plan
This overview is prepared to help you understand your Long Term Care Guarantee Standard Issue plan. It is not a contract or an offer to provide insurance. If and when your policy is issued, complete insurance coverage details will be made available in your policy, and the terms and conditions of your policy will take precedence over any information in this document.
Some exclusions and limitations may apply to the insured’s coverage. You may request a sample policy from us through your employer before the policy is issued. You will have ten (10) days from the day you receive your policy to examine its provisions. If you are not satisfied, you can return it to RBC Life Insurance Company and any premium paid will be refunded. You may also cancel your policy at any time after that ten (10) day period.
Your long term care insurance coverage
Long term care insurance provides a way to maintain your lifestyle and protect your financial security if one day medical problems prevent you from performing certain activities of daily living. Long term care insurance provides you with the resources to remain independent should you require the services of a long term care facility or professional services at home.
Long term care insurance pays a daily benefit if you:
|To lose the ability to care for yourself, due to cognitive impairment or a condition that results in the inability to perform two (2) or more activities of daily living; and
|On the certification of a physician, requires the services of a long term care facility or professional assistance at home.
The Activities of Daily Living are:
This coverage provides you with the resources to offset the cost associated with confinement in a long term care facility. The daily benefit is payable when health or personal care services are required in a long term care facility at the recommendation of a physician and the elimination period of 90 days has been satisfied. The daily benefit is paid directly to the insured and in addition to any government benefits that the insured may be receiving. If long term care services are being rendered in a facility outside of Canada, you are eligible to receive the daily benefit after satisfying the elimination period and the insured’s complete medical records are supplied to us and the insured has undergone an independent examination by a physician appointed by us, if we make such a request.
Waiver of Premium
While you are receiving benefits under the policy, RBC Life Insurance Company will waive the monthly premiums for the full coverage as they become due. Monthly premiums will continue to be waived for as long as you’re receiving benefits under the terms of the policy.
Reduced Paid Benefit for Facility Care
If premiums continue to be fully paid beyond the end of the tenth (10th) policy year and then cease, the policy will not terminate but become a fully paid-up policy, providing a reduced daily benefit amount for facility care benefits. Please refer to the policy for the table of Reduced Paid-Up Benefits.
Your premium amount will be set once your coverage is underwritten. The amount of your initial premium will be specified in your policy when it is issued. Your premium paying period is the longer of 20 years or when you attain age 65.
While you remain employed with your current employer, premiums are payable monthly. If you leave your current employment and continue your coverage under this policy, you will then have the option of paying your premiums monthly or annually. The monthly premium will be calculated by multiplying the annual premium by 0.09.
Renewal premiums for this policy are guaranteed not to increase for the first 5 policy years. After this time, we can, at our discretion, change future renewal premiums required under this policy. However, we only can do this when we change the premium for all policies issued under this series to persons of the same classification living in your province of residence.
If you wish to change from Smoker rates to Non-smoker rates after your policy is issued, or if you wish to reinstate your coverage after it terminates due to non-payment of premium, we reserve the right to request evidence of insurability satisfactory to us. A service fee may apply.
Exclusions and Limitations
Benefits under this policy will not be payable for any loss that results directly or indirectly from:
|Suicide or attempted suicide, or intentionally self-inflicted injury, while mentally competent or incompetent, use or intake of any drug, intoxicant, or poisonous substance except as prescribed and administered by a physician. Drug, intoxicant, or poisonous substance will not include cigars, cigarettes or incidental use of alcohol.
|Committing, attempting or provoking a criminal offence.
|Rest cures, nervous or mental disorders without demonstrable organic cause (does not exclude Alzheimer’s Disease or Senile Dementia).
|Operating a motor vehicle while the concentration of alcohol in 100 millilitres of blood exceeds 80 milligrams.
|Participation in war or hostile action of the armed forces of any country, whether such war is declared or undeclared. This exclusion will not apply if the insured is a victim of a war or hostile action (including terrorism).
Pre-Existing Conditions Limitation
Benefits are not payable under this policy for any period of the inability to perform 2 or more activities of daily living or cognitive impairment at any time during the 24 months immediately before the later of the date this policy came into force and the date it was reinstated after a lapse. However, this limitation does not apply to a period of the inability to perform 2 or more activities of daily living or cognitive impairment that is diagnosed more than 24 months after coverage goes into effect.