Dread Disease Policy Coverage and What It Includes

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Dread disease policy coverage is a type of insurance that provides financial protection against serious illnesses.

Dread diseases are typically defined as conditions that are life-threatening or debilitating, such as cancer, heart disease, and stroke. These conditions often require expensive medical treatment and can have a significant impact on a person's quality of life.

A standard dread disease policy typically covers 11 major diseases, including cancer, heart disease, and stroke.

The policy can provide a lump sum payment to the policyholder upon diagnosis, which can be used to cover medical expenses, lost income, and other related costs.

Coverage and Benefits

Critical illness insurance can provide a financial safety net in the event of a serious medical condition, such as a heart attack or stroke. Benefits typically range from $10,000 to $30,000 and are payable in $10,000 increments.

Some common conditions covered under critical illness insurance policies include heart attack, stroke, cancer, and coronary artery-bypass surgery. Additionally, some policies may cover more specific conditions, such as blindness, deafness, or major organ failure.

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The benefits of critical illness insurance can be used to cover various expenses, including medical treatment, recuperation aids, and lost income due to a decrease in ability to earn. It can also be used to fund a change in lifestyle.

A lump sum benefit may be paid out for a covered illness, depending on the specific policy. For example, some policies may pay out a benefit for permanent paralysis due to a covered accident, while others may pay out for end-stage renal failure.

Some policies may also offer additional benefits, such as a health screening benefit, which pays a lump sum for annual health screening tests. The Recurrent Diagnosis Benefit is another feature that pays an additional benefit equal to 50% of the benefit amount purchased if a covered person receives a recurrent diagnosis or second occurrence date for a covered critical illness.

Here are some examples of critical illness insurance benefits:

Policy Details

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Dread disease policy benefits can range from $10,000 to $30,000, paid in $10,000 increments. This means you can choose a benefit amount that suits your needs.

A Schedule of Benefits is a document that details specific plan benefits, which you can view in your policy document through your online account. This is a useful tool to understand what's covered and what's not.

Benefit amounts can be paid for various conditions, including heart attack, stroke, major organ failure, and end stage renal failure. For example, a heart attack benefit will be paid following a heart attack due to coronary artery disease resulting in death of a portion of the heart muscle.

Here are some of the specific benefits and their definitions:

  • Heart Attack Benefit: A benefit will be paid following a heart attack (Acute Myocardial Infarction) due to coronary artery disease resulting in death of a portion of the heart muscle.
  • Stroke Benefit: A benefit will be paid for permanent damage due to a stroke. A stroke is defined as permanent neurological damage to the brain which results from an acute or sub-acute interruption of blood flow to brain tissue.
  • Major Organ Failure Benefit: A benefit will be paid for failure of major organ function diagnosed by a physician that results in placement on the United Network for Organ Sharing (UNOS) list for transplant of the heart, liver, lungs or entire pancreas.
  • End Stage Renal Failure Benefit: A benefit will be paid for irreversible failure of both kidneys to function and requires regular dialysis or renal transplantation.

First Product

The first product of its kind, critical illness insurance, was launched on October 6, 1983, in South Africa by Crusader Life Assurance company under the name dread disease insurance.

The original product covered four primary human health conditions: cancer, stroke, heart attack, and coronary bypass surgery.

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Manuel Sardinha, a marketing general manager at Crusader Life Assurance, played a key role in introducing this innovative concept to the world.

He was also the designer of the first automated life underwriting system in 1972.

This pioneering product has since been accepted into many insurance markets around the world.

Other names for this type of insurance include trauma insurance, serious illness insurance, and living assurance.

Here are the four primary human health conditions originally covered by the first critical illness product:

  • Cancer
  • Stroke
  • Heart attack
  • Coronary bypass surgery

Health Screening Benefit

The Health Screening Benefit is a valuable feature of your policy. This benefit pays a lump sum when a covered person receives a health screening test. You can receive this benefit once per calendar year for annual health screening tests. Qualified tests include those that are payable under the Health Screening Benefit, which are not specified in detail.

The maximum number of covered tests per calendar year is one. This means you can only receive a health screening benefit once per year. If you have any questions about what tests are covered, you can refer to your Schedule of Benefits in your policy document through your online account.

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To give you a better idea of what tests are included, here are some examples of qualified tests:

  • Annual health screening tests
  • Other tests that are payable under the Health Screening Benefit (not specified in detail)

Keep in mind that only one covered test per calendar year is eligible for the Health Screening Benefit. Be sure to review your Schedule of Benefits for more information.

What Doesn’t Cover

Critical illness insurance is designed to provide financial protection in the event of a serious health condition. It's essential to understand what isn't covered by this type of insurance.

Some conditions, like cancer, are major health events, but there are special insurance policies designed to support you through your journey, separate from critical illness insurance.

Critical illness insurance typically doesn't cover conditions like congestive heart failure, atherosclerotic heart disease, angina, cardiac arrest, or any other dysfunction of the cardiovascular system.

Here are some examples of conditions that may not be covered by critical illness insurance:

  • Congestive heart failure
  • Atherosclerotic heart disease
  • Angina
  • Cardiac arrest
  • Transient Ischemic Attacks (TIA)

It's also worth noting that some policies may have exclusions or limitations, so it's crucial to review the policy document carefully to understand what's covered and what's not.

Eligibility and Claims

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You can continue your critical illness insurance coverage after losing eligibility as an employee, but you need to have been continuously covered for 12 consecutive months prior to the date your coverage ends.

To continue coverage, submit a request to American Fidelity within 30 days of losing eligibility.

Claims can be filed through your online account or the AFmobile app, which is available for download from the App Store or Google Play.

The fastest way to file a claim is online or through AFmobile, and you can check the status of your claim through the same platform.

Claims are generally processed within seven business days after all required documentation is submitted, but you can receive payment in as little as one day if you're enrolled in direct deposit and submit your claim online or through AFmobile.

Who Needs?

If you're wondering who needs critical illness insurance, the answer lies in understanding your personal risk factors and financial situation. Individuals with a family history of critical illnesses are at a higher risk, so it's essential to consider this when evaluating your eligibility.

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People with a genetic predisposition to certain critical illnesses, such as a heart attack or stroke, are more likely to develop these conditions. This is especially true for those with a family history.

Sole income earners, who are the primary source of income for their families, may need this supplemental plan to ensure their family's financial stability is maintained in case of a critical illness.

Having young children can also make you a good candidate for critical illness insurance. Parents with dependents may need this insurance to ensure they can continue to provide for their children's needs, such as education and daily expenses, if they are diagnosed with a critical illness.

Older adults, especially those approaching retirement, might need critical illness insurance to help cover medical expenses and support their lifestyle in case of serious health issues.

Here are some specific groups that may benefit from critical illness insurance:

  • People with a family history of critical illnesses
  • Sole income earners
  • Parents with young children
  • Older adults approaching retirement

Eligibility

Eligibility is a key factor in determining your coverage. You can continue this coverage after you're no longer an eligible employee.

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If you've been continuously covered for 12 consecutive months prior to the date your coverage ends, you can submit a request to American Fidelity within 30 days of losing eligibility.

You can find more information about keeping your coverage on the American Fidelity website or by contacting the Policy Continuation team online or by calling 800-943-2231.

Claims

Filing a critical illness insurance claim is a straightforward process, and you can do it quickly through your online account or our mobile app, AFmobile. This is the fastest way to get your claim processed.

You'll need to provide some documentation to support your claim, which includes medical records and other relevant information. We may also need additional documents, but we'll let you know what's required.

If you're filing a claim for an infectious disease, the process is similar, and you can do it through your online account or AFmobile. You'll need to provide the required documentation, which may include test results and medical records.

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You can download and print a paper claim form if you prefer, but this is not the fastest option. If you want to get your money faster, file a claim online or through AFmobile.

Claims are typically processed within seven business days after we receive all the required documentation. However, if you're enrolled in direct deposit and you file your claim online or through AFmobile, you may be able to get paid in as little as one day. This is part of our AFQuickClaims program.

There are some circumstances where benefits may not be paid, such as if the critical illness is caused by an excluded condition. You can log in to your account to view your policy details and see what exclusions apply to your policy.

If you want to check the status of your claim, you can do it quickly through your online account or AFmobile. This is the fastest way to get an update on your claim.

Frequently Asked Questions

What is an example of a dread disease?

Examples of dread diseases include heart attacks and cancer, which require serious treatment and have significant costs. These conditions are often life-altering and can be costly to treat.

What is the purpose of dread disease policy?

A dread disease policy helps cover additional medical expenses and lifestyle adjustments, allowing you to focus on recovery. It provides financial support during a critical illness, reducing the burden of medical bills.

Is the dread disease policy illegal?

No, dread disease policies are not illegal. However, it's crucial to carefully review the policy terms to ensure it meets your needs.

Kristin Ward

Writer

Kristin Ward is a versatile writer with a keen eye for detail and a passion for storytelling. With a background in research and analysis, she brings a unique perspective to her writing, making complex topics accessible to a wide range of readers. Kristin's writing portfolio showcases her ability to tackle a variety of subjects, from personal finance to lifestyle and beyond.

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