Critical Illness Insurance for Pre Existing Conditions Made Easy

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Critical illness insurance can be a lifesaver, but what if you have a pre-existing condition? Fortunately, there are options available. Some insurers offer pre-existing condition waivers, allowing you to apply for coverage even with a pre-existing condition.

You'll need to disclose your condition upfront, and the insurer may ask for medical records to assess the risk. This can be a bit of a process, but it's worth it to get the coverage you need.

According to the article, some insurers offer special plans for people with pre-existing conditions, which can be more affordable than traditional plans. These plans often have higher deductibles and co-pays, but they can be a good option for those who need coverage.

It's also worth noting that some policies have a "look-back" period, during which the insurer will review your medical history to determine if your condition is stable or not.

What Are the Types?

Critical illness insurance policies can be provided by an employer as a voluntary benefit. This means employees have the option to purchase the coverage, but it's not mandatory.

Critical illness insurance can also be purchased as an individual plan. This allows people to buy coverage directly from an insurance provider, rather than through an employer.

Policy and Coverage

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Critical illness insurance policies can be complex, but understanding the basics can help you make an informed decision. It's essential to look for policies that clearly define the conditions needed to receive a critical illness payment.

A lower price may seem appealing, but be sure to do your research. Monthly costs can range from as low as $10 to as high as $200 depending on your age, sex, and chosen benefits.

If you're predisposed to certain conditions, look for a plan that offers better coverage for those specific illnesses. For example, if you're at risk for cancer, make sure the policy covers cancer.

The total exposure and coverage limits are also crucial to consider. Are these sufficient to meet your needs? The policy should clearly outline the coverage limits so you can make an informed decision.

Pre-existing conditions are typically not covered by critical illness insurance. This means that if you have a pre-existing condition, you may not be eligible for coverage or the condition may be excluded from the policy.

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There are waiting periods to consider as well. While there may be no waiting period before coverage begins, there are often limitations surrounding pre-existing conditions.

Here are some key things to consider when evaluating critical illness insurance policies:

  • Is the policy clear about the conditions covered?
  • Are there any exclusions or limitations?
  • What are the total exposure and coverage limits?
  • Are there any optional riders, such as built-in inflation protection?
  • Are there waiting periods or pre-existing condition limitations?

Filing a Claim and Policy Application

Filing a claim for critical illness insurance can take 4-6 weeks, depending on how quickly the carrier receives the medical evidence required.

The claims process typically begins once a physician has diagnosed you with an illness covered by your critical insurance plan.

You can file a claim directly with the carrier, and they will have a dedicated customer service department or claims service department to assist you with any questions.

Insurance companies now accept claim forms electronically due to the emergence of COVID-19.

The policy owner works directly with the carrier to submit a claim form, following the required steps.

Finding the Best Policy and Broker

Finding the right critical illness insurance policy and broker can be a daunting task, especially if your client has pre-existing conditions. Research is key, so don't just go for the cheapest option - make sure to look for policies that clearly define the conditions needed to receive a critical illness payment.

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Consider your client's specific needs, such as if they're at risk for cancer, and look for a plan that covers those conditions. You should also ask about waiting periods, total exposure, and coverage limits to ensure the policy meets their needs.

Here are some key questions to ask when searching for a broker:

  • Responsiveness and attentiveness: Are they knowledgeable of the products and solutions available to serve you and your clients’ needs?
  • Back-office support: What happens after an application is submitted?
  • A good team instead of just a good salesperson: make sure that the service is as good as the pitch.
  • Do the owners invest back into the agency or focus on paying themselves?

Some reputable insurance companies, such as Industrial Alliance and Canada Protection Plan, offer no-medical products and guaranteed issue products that can provide faster access to insurance coverage.

Finding the Best Policy for a Client

A lower price may seem more appealing, but it's essential to do your research and look for policies that clearly define the conditions needed to receive a critical illness payment.

Monthly costs for critical illness insurance range from as low as $10 to as high as $200, depending on your client's age, sex, and chosen benefits.

Consider your client's predispositions and look for a plan that offers better coverage for specific illnesses if they are at risk.

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For example, if your client is at risk for cancer, make sure your policy covers cancer.

The specific conditions covered by a policy are crucial, and you should also check how it will affect coverage if the illness occurs a second time.

Total exposure and coverage limits are also essential to consider, and you should ask if these are sufficient to meet your client's needs.

Optional riders, such as built-in inflation protection, can also be a valuable addition to a policy.

Be aware of any waiting periods, but in most cases, there is no waiting period before coverage begins.

However, there may be limitations surrounding pre-existing conditions.

Working with an insurance brokerage agency can help you and your client navigate these details and find the best policy.

A broker can shop a wide range of products and carriers on your behalf, potentially saving you time and money.

Some insurance companies are more accommodating and have a superior risk tolerance, especially when it comes to pre-existing health conditions.

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Non-medical providers, such as Industrial Alliance and Canada Protection Plan, offer products with faster access to insurance coverage.

Here are some key questions to ask when evaluating critical illness insurance policies:

  • Is my client predisposed to any conditions?
  • What are the specific conditions covered?
  • How much can my client afford?
  • What are the total exposure and coverage limits?
  • Are there optional riders?
  • Are there waiting periods?

Finding the Best Broker

Referrals from trusted sources in your network can be a great resource for finding high-quality critical illness insurance brokers.

You can also connect with NAILBA, a leading insurance industry organization promoting consumer choice.

Prospecting several insurance brokerages in your area is another way to do your research. Look for these qualities in a broker:

  • Responsiveness and attentiveness
  • Back-office support
  • A good team instead of just a good salesperson
  • Whether the owners invest back into the agency or focus on paying themselves

Calling the brokerage and asking pertinent questions can also help you learn more about them. Some questions to ask include:

  • How long have you sold critical illness insurance?
  • Have you had any complaints with the state?
  • Who are your primary carriers?
  • What are the carrier ratings?
  • What types of products are the affiliate carriers selling?

Availing a Cover

You can get a critical illness cover in a few ways.

One way is to add it as a rider to your term life or Mediclaim insurance cover. This option is available for those who already have a basic life insurance policy.

You can also buy a separate critical illness cover. This way, you can have a dedicated policy that covers only critical illnesses.

To buy a term insurance or critical illness cover, you'll need some documents.

Impact of Pre-Existing Conditions

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Having a pre-existing condition can significantly impact your ability to get critical illness insurance. If you try to beat around the bush and provide wrong information, you could run into problems while making a claim, or your agency might deem the claim invalid.

Some common pre-existing conditions include HIV/AIDS, morbid obesity, diabetes, high blood pressure, stroke, Alzheimer's disease, cancer, transplant, kidney disease, Parkinson's disease, anorexia nervosa/bulimia, anxiety, depression, or mood disorder, congestive heart failure, coronary artery disease, and liver disease, cirrhosis.

These conditions can affect the pricing for your application and may require you to undergo a full medical examination. The information collected about you is used to assess whether coverage can be offered to you at standard risk, better than standard risk, or substandard risk.

Critical illness cover exclusions can be a major concern, as no policy covers every single type of illness. A cheaper policy might cover 10 main illnesses, a more expensive one could cover around 40, and some might even cover up to 100. It’s essential to read the small print and be aware of just what is and is not covered under a critical illness cover policy.

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The insurer might decline your application to avail of critical illness insurance altogether if the insurer feels that your previous diagnosis and current health condition are too severe and will always make you a 'too high' risk individual for insurance. Alternatively, you might be approved for the policy, but with a rating applied, meaning you would pay a higher premium for the same coverage than someone who did not have the condition.

Here are the five possible outcomes when applying for life insurance with a pre-existing condition:

  1. The insurance company outright declines your life insurance application.
  2. You are approved for the policy, and a rating is applied.
  3. You are approved for a policy with an exclusion.
  4. Your policy is fully approved.
  5. Your policy application approval is postponed.

Frequently Asked Questions

Can you still be denied insurance for pre-existing conditions?

No, insurance plans cannot deny coverage or charge more for pre-existing conditions. Once enrolled, you're protected from rate increases or denial of benefits based on your health history

Caroline Cruickshank

Senior Writer

Caroline Cruickshank is a skilled writer with a diverse portfolio of articles across various categories. Her expertise spans topics such as living individuals, business leaders, and notable figures in the venture capital industry. With a keen eye for detail and a passion for storytelling, Caroline crafts engaging and informative content that captivates her readers.

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