Your Quantum Disability Income Protection Standard Issue Plan
This overview is intended to help you understand your Quantum Disability Income Protection Standard Issue Plan. It is not a contract or an offer to provide insurance. This overview is written in plain language and does not include all terms and conditions included in your policy. In the event of a discrepancy between the language of this overview and your policy, the language your policy as issued will prevail. You may request a sample policy from us through your employer before the policy is issued.
If a policy is issued, you will have ten 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 (without refund) at any time after that 10-day period.
Your Disability Insurance Coverage
Personal income contributes to our quality of life in a variety of ways. It makes it possible to buy products and services that we need and value, and affords us the pride and self-esteem that comes from working to earn an income. It makes sense that people will seek out ways to protect their income.
In general, there are three ways a person risks loss of income that have a practical insurance solution.
| Three Ways Income Could End: |
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Income Ending Event |
Financial Solution |
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Person Dies During Working Years |
Life Insurance |
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Person Retires and Out Lives Resources |
Retirement Savings and Annuities |
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Person Becomes Disabled |
Disability Insurance |
Quantum provides quality income protection with an affordable, easily-understood policy that meets the basic needs for income replacement while disabled. Focusing on ability rather than disability, Quantum provides both income replacement and return-to-work benefits. The focus of the policy clearly places the emphasis on providing incentives to help you return to work.
Your Quantum plan is guaranteed renewable to age 65. Contract provisions are fully guaranteed to age 65 while premiums may be subject to change. Your policy alone may not be singled out for premium change. An adjustment to premiums will be made for an entire group of policy owners who share common characteristic(s). After age 65, your coverage continues with a reduced benefit period while you remain actively and regularly employed full-time.
Income Replacement Benefits
Disability
You are considered disabled if, as a result of an injury or sickness,
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You have a reduced ability to work |
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You have a loss of earnings of at least 20%; and |
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You are under appropriate physician’s care. We may waive the physician’s care requirement if we receive acceptable written proof indicating that further physician’s care would not be of benefit to you. |
While you are disabled, your monthly benefit is based on your loss of earnings. This benefit is payable each month after you have satisfied the elimination period.
Your loss of earnings is determined based on your prior earnings at time of disability.
In order for benefits to continue, you are required to work in a reasonable occupation to the capacity you are able. If you are working in a reasonable occupation, and provided you continue to meet the requirements of the definition of disability, the amount of disability benefit that is payable will be based on your loss of earnings, subject to the integration of benefits provision. A reasonable occupation includes any gainful work for which you are reasonably suited based on your education, training and experience, and which could be expected to generate at least 60% of prior earnings.
Commencement Date
continuous period of disability, 90-720 days, as set out in your policy. Periods of disability from the same or related causes, separated by 12 months or less, will be accumulated and deemed to be continuous in order to determine the Commencement Date
Prior earnings
We offer two definitions of prior earnings from which we calculate your disability benefit. We use the definition which results in the greater of the following:
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Your average monthly earnings for the fiscal year with the greater earnings during the last two fiscal years ending immediately prior to the date of disability. The two fiscal years must occur after the date of issue of your policy; or |
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Your average monthly earnings from the 12 consecutive calendar months immediately before your disability began. |
Inflation protection
After each year of disability, an inflation adjustment based on the change in the Consumer Price Index is made to your prior earnings to help ensure your disability benefits are not eroded by inflation. We guarantee that this cumulative adjustment is not less than 2% compounded per year since the start of disability. The cumulative maximum is 10% compounded per year since the start of disability.
Successive disabilities
If you recover from a disability and then become disabled again from the same or related cause within 12 months, we consider it a continuation of the previous disability and waive the elimination period.
Cosmetic or transplant surgery benefits
If you are disabled as a result of cosmetic or transplant surgery, we consider you to have a sickness. Disability benefits are payable while you continue to satisfy the definition of disability.
Waiver of Premium
We realize the strain on your finances during a disability. In order to assist you after you have been disabled for 90 days, we pay your premiums while you remain disabled and refund those premiums paid during the first 90 days.
Focus On Ability vs. Disability
Return-to-work assistance benefit
Starting from the first day of injury or sickness, we may provide some assistance in returning you to work or enhancing your ability to work.
Our assistance may include such services as:
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Co-ordination of physical rehabilitation services; |
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Financial and business planning; |
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Vocational evaluation; |
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Education; and |
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Job placement for a new occupation. |
In addition, we may provide work site modification which could include such things as:
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Ergonomic furniture and/or equipment; |
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Mobility enhancing equipment; and |
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Visual and/or audio devices. |
If we approve the services prior to the costs being incurred, we may pay some or all of the costs of these services or approved item(s) provided you are not entitled to payment of the costs from any other sources.
Additional protection upon recovery from disability
After you have recovered from your disability, you will receive a portion of your monthly benefit based on your loss of earnings for up to 12 months while you meet the following criteria:
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You have been continuously disabled for the longer of 90 days or the waiting period; and |
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You return to work in a reasonable occupation; and |
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You have a loss of earnings of at least 20 percent. |
You are not required to be under physician's care to receive this benefit. In order for benefits to continue, you are required to work in a reasonable occupation to the capacity you are able.
Your Premiums
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.
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.
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.
A grace period of thirty-one-days will be allowed for late payment of any premium.
When Coverage Takes Effect
The Policy becomes effective when all of the following events have occurred:
| 1. |
The Policy has been delivered to the Owner; |
| 2. |
All conditions for delivery to the Owner have been completely satisfied; and |
| 3. |
There has been no change in insurability since the application was signed. |
Limitations and Exclusions
Integration of benefits
To ensure benefits are coordinated with other sources of income received during disability, an integration of benefits provision has been included in this policy. Benefits for disability will be reduced by any amount that the sum of the benefits for disability, current earnings, and other income or disability benefits, exceeds 85% of your pre-disability income.
Other income benefits include:
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Disability benefits from provincial or federal government plans such as: CPP/QPP and the Workers' Compensation board or similar plan; |
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Automobile insurance; |
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Any employer sick pay, formal wage or salary continuation plans; and |
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Group and association long-term and short-term disability or weekly indemnity insurance or plans. |
Exclusions
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For disability due to an act or accident of war, whether declared or undeclared; or |
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For normal pregnancy or childbirth, but we will cover disabling complications of pregnancy or childbirth; or |
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During any period that you are incarcerated. |
Pre-Existing Condition Limitation
A pre-policy period is a period just prior to policy issue and a post-policy period is a period just after policy issue. Pre-policy and post-policy periods are determined as part of the plan design and are usually 24 months or less. We will not pay any Income Benefits, for any portion of any period of Disability which results, directly or indirectly, from any injury or sickness, or any medical condition or symptom(s) in respect of which, at any time during the pre-policy period:
| 1. |
You have incurred any health-related expenses on the advice of a physician or any other health care practitioner; |
| 2. |
You have taken any prescribed medication; |
| 3. |
You have consulted a physician or any other health care practitioner; |
| 4. |
You have received any health-related care, advice or treatment from a physician or any other health care practitioner; or |
| 5. |
A reasonable prudent person with such injury, sickness or medical condition or symptom(s) would have consulted a physician or any other health care practitioner. |
However, this limitation does not apply to disabilities commencing after the post-policy period.
Riders Which May Be Available On Your Plan
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