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Discussion Starter #1
Quick background: I'm in my late 30s, healthy (no significant conditions), covered under provincial healthcare but no supplementary health.

Currently I do not have either kind of insurance. I left my job and will likely work independently for a while, as a self-employed professional, picking up contracts. I may also work for an employer again, but almost definitely not lifelong. I am able to earn a reasonably strong income as long as I'm in good health.

I'm trying to make sense of disability insurance (DI) vs critical illness (CI). Some questions:

1. DI appears to only pay out as long as you are unable to work. What if you get injured -- e.g. cancer or heart attack -- then recover somewhat, but remain at a diminished capacity. Does the insurance stop paying out? It seems to me that you'd be back in the workforce, earning less income (not able to work 100%) and also have no insurance assistance any more.

2. Critical illness insurance doesn't use the words "injury" in their descriptions, and I'm trying to find out what happens in case of illnesses that result from injury. For example, a car accident or sport accident (I'm a cyclist) leading to brain injury. If the brain injury is a recognized illness, for example in Sun Life Critical Illness, would that cover the situation in which a bike or car accident caused the injury?

3. As I'm self-employed, I believe that CI is really my only option at the moment. What do you think about someone in my situation getting CI, to be able to afford extra care or income replacement for being unable to work, in situations like: very serious car/bike accidents or major illness?
 

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I guess as a 30 something year old, you are not used to talking to people rather than texting as you are doing here. If I wanted to know about medical insurance, I would PHONE an insurance provider and TALK to someone who is an expert in that subject, not post in a forum of non-experts.

https://www.huffpost.com/entry/when-did-texting-replace-_b_5105265?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAJRryvARPcIcNQ7BTcQpIuyZHObSOhfmtUzIZDyoddzcT4v73jJu3Osf8HqHkFohSi0gkcEAFpHfB5QC2jWwTE6OgN0orj20jd0KcRT-9NZTF_dqmJHIGF5L8Cn0S-zbku4yH5sF7E69NslzxFc2cFbVQJY2XJiflO73QMtDNyQ-

https://www.inc.com/wanda-thibodeaux/why-people-dont-make-phone-calls-anymore-according-to-psychology.html

If I wanted an answer to your question james4beach, I would simply phone an insurer and ask someone the question, 'which one suits my situation better and why?'
 

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Quick background: I'm in my late 30s, healthy (no significant conditions), covered under provincial healthcare but no supplementary health.

Currently I do not have either kind of insurance. I left my job and will likely work independently for a while, as a self-employed professional, picking up contracts. I may also work for an employer again, but almost definitely not lifelong. I am able to earn a reasonably strong income as long as I'm in good health.

I'm trying to make sense of disability insurance (DI) vs critical illness (CI). Some questions:

1. DI appears to only pay out as long as you are unable to work. What if you get injured -- e.g. cancer or heart attack -- then recover somewhat, but remain at a diminished capacity. Does the insurance stop paying out? It seems to me that you'd be back in the workforce, earning less income (not able to work 100%) and also have no insurance assistance any more.

DI is usually a short term coverage. Break a leg, minor surgery. Something that prevents you from working for a short period and coverage is only short term. From my experience, the coverage for was up to one year. Income replacement was tiered. 100% for the first 6 weeks. 75% for the next 6 weeks. Then 50% for the remainder of the year.

2. Critical illness insurance doesn't use the words "injury" in their descriptions, and I'm trying to find out what happens in case of illnesses that result from injury. For example, a car accident or sport accident (I'm a cyclist) leading to brain injury. If the brain injury is a recognized illness, for example in Sun Life Critical Illness, would that cover the situation in which a bike or car accident caused the injury?

From my experience, CI is usually a much more serious health issue. Our coverage covers heart attack, cancer and stroke. Just these 3 illnesses. Mere diagnosis pays out the full covered amount. One time payment. Not sure about injury that leads to illness. If you crash your bike and damage your brain, you have an injury, not an illness. My coverage would not consider this an “illness”.

3. As I'm self-employed, I believe that CI is really my only option at the moment. What do you think about someone in my situation getting CI, to be able to afford extra care or income replacement for being unable to work, in situations like: very serious car/bike accidents or major illness?
Hope that helps a little
 

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Re post #1, short opinions to questions:

1. You only "qualify" for DI if you have some sort of employment as you would have to prove your employment income (whether through an employer (group) or self-employment (individual).) (Making a claim is a whole different story. Going to the moon is alot easier.)

2. CI is for a "life-threatening" illness (eg. stage 4 cancer) - very stringent definitions as a lump sum is paid out.

3. Being a biker, since you're concerned about getting into an "accident", you may want to consider an Accidental Death or Dismemberment policy instead. The CI shouldn't be ruled out. Quickest route (unless you know a non-predatory insurance broker) - look into your professional association policy if you haven't to see what's offered.
 

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Discussion Starter #5 (Edited)
I guess as a 30 something year old, you are not used to talking to people rather than texting as you are doing here. If I wanted to know about medical insurance, I would PHONE an insurance provider and TALK to someone who is an expert in that subject, not post in a forum of non-experts.
I love talking to people; the problem is that I don't like talking to single-minded salespeople. I've phoned a couple insurance brokers before, and they seem to immediately start wanting to sell me on things and then started hounding me with follow up calls (and I eventually told them to forget about it). This makes me not trust them. It looks to me like their business is to sell me something, not to give an honest and impartial idea of what might be useful in my situation.

It makes me doubt the professionalism of insurance brokers.

I'm doing some preliminary research. Of course I will approach a broker eventually.
 

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Discussion Starter #6
Re post #1, short opinions to questions:

1. You only "qualify" for DI if you have some sort of employment as you would have to prove your employment income (whether through an employer (group) or self-employment (individual).) (Making a claim is a whole different story. Going to the moon is alot easier.)

2. CI is for a "life-threatening" illness (eg. stage 4 cancer) - very stringent definitions as a lump sum is paid out.

3. Being a biker, since you're concerned about getting into an "accident", you may want to consider an Accidental Death or Dismemberment policy instead. The CI shouldn't be ruled out. Quickest route (unless you know a non-predatory insurance broker) - look into your professional association policy if you haven't to see what's offered.
Thanks! And yes, I think DI wouldn't work in my current situation anyway due to the sporadic self employment.

Good idea to check the professional association policy. I will also take a look through a couple university alumni arrangements.

You mentioned CI is for life-threatening illnesses, but from what I read at that link [ SunLife CI ] it also covers things like blindness. Does that not mean that if some accident results in blindness, CI covers you? That seems to go far beyond just life-threatening illness... or am I misreading the intent of the plan?
 

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I love talking to people; the problem is that I don't like talking to single-minded salespeople. I've phoned a couple insurance brokers before, and they seem to immediately start wanting to sell me on things and then started hounding me with follow up calls (and I eventually told them to forget about it). This makes me not trust them. It looks to me like their business is to sell me something, not to give an honest and impartial idea of what might be useful in my situation.

It makes me doubt the professionalism of insurance brokers.

I'm doing some preliminary research. Of course I will approach a broker eventually.
... the proof is in the pudding. Amen.
 

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Thanks! And yes, I think DI wouldn't work in my current situation anyway due to the sporadic self employment.

Good idea to check the professional association policy. I will also take a look through a couple university alumni arrangements.

You mentioned CI is for life-threatening illnesses, but from what I read at that link [ SunLife CI ] it also covers things like blindness. Does that not mean that if some accident results in blindness, CI covers you? That seems to go far beyond just life-threatening illness... or am I misreading the intent of the plan?
... possibly as I interpret CI as covering "illnesses" ... blindness caused by an illness (eg. stroke?), and not an accident. But without the definition (I haven't checked), I can't be absolutely sure. Only the insurance company is absolute on that.
 

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Discussion Starter #9 (Edited)
And these wonderful insurance brokers that Longtimeago talks about, do they have a similar training to lawyers? Will I be able to dive into the nitty gritty legal text of what a policy will have -- for example, view sample legal text of a policy contract?

And how does one agree to a contract without seeing the precise writing? Normally, I look at the wording on a contract, then sign. Is that how CI and life insurance works as well? Or do I just hear some nice words from a non-legally-trained broker, trust them, sign up... and then receive the legal text in the mail later?

With insurance, I keep hearing that the policy contract will depend on the particular individual. So how does one ensure the specific wording of the contract, before signing?

Can I bypass the broker and check this kind of thing with the insurance company directly? I don't want just words, I want to see legal text in writing. If I'm signing up to pay premiums for the next 40 years I want to know exactly what we're agreeing to.
 

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And these wonderful insurance brokers that Longtimeago talks about, do they have a similar training to lawyers? Will I be able to dive into the nitty gritty legal text of what a policy will have -- for example, view sample legal text of a policy contract?

And how does one agree to a contract without seeing the precise writing? Normally, I look at the wording on a contract, then sign. Is that how CI and life insurance works as well? Or do I just hear some nice words from a non-legally-trained broker, trust them, sign up... and then receive the legal text in the mail later?

With insurance, I keep hearing that the policy contract will depend on the particular individual. So how does one ensure the specific wording of the contract, before signing?

Can I bypass the broker and check this kind of thing with the insurance company directly? I don't want just words, I want to see legal text in writing. If I'm signing up to pay premiums for the next 40 years I want to know exactly what we're agreeing to.
Where did you see me write anything about, 'wonderful insurance brokers'? Where did you even see me mention an insurance broker? Read my lips, I wrote 'insurance provider'. That means an insurance COMPANY. ie. Sunlife etc. Call them directly and ask to speak to someone who can answer your question. Here's Sunlife Customer Care for example:
1-800-361-6212, Monday to Friday, 8 a.m. to 8 p.m. ET. I do not insure through them by the way, I just picked an easy example.

They can tell you what their policies cover and do not cover like is blindness from a bicycle accident covered under CI or DI or not etc. Just don't let them try to fob you of on an agent etc. insist on speaking to someone in their head office who will explain their policies to you. Getting to talk to the person you want to talk to and NOT following their preferred procedure for dealing with someone is not always that easy to do but it can be done.

It's the 'systems' that we often find are not designed to suit us, they are designed to suit the businesses and how they prefer to do things. Ignore their systems and get them to do things the way you want to do them.

Your wish to make sure of what you are signing up to for 40 years is not unreasonable at all james4beach and stating just that may get you to a person who you feel comfortable is telling you it like it is. Persisting in a phone conversation with a company to get to the person you want to talk with is all it takes in my experience.
 

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Discussion Starter #11
This is great advice Longtimeago, sounds like the right course of action - thanks very much! I'll start on this today.

I misunderstood at first and thought you were saying I should speak to a broker/salesperson. I will phone the insurance company.
 

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I have critical illness insurance and I somewhat regret getting it. It covers only the listed conditions in the contract, I think there are around 30 "illnesses" it covers. Apparently they are very strict with the definitions of these, eg. it may list cancer as an illness but it has to be in a certain stage; heart attack has to be to a certain seriousness; etc. for them to pay out.

Personally, at least for my coverage, I think it is to expensive for what the payout would be along with the perceived strictness in the definitions of qualifying illnesses.

Mine is attached to my life insurance, a 30 year term, but the CI premium will go up every decade. I plan on cancelling my CI when the end of the first decade happens as the premium will double. I think that DI is better, I'd still check into it and see if they can work with your employment situation.

These are CI conditions listed on mine:
1. Alzheimer's disease
2. Aortic surgery
3. Aplastic anemia
4. Bacterial meningitis
5. Benign brain tumour
6. Blindness
7. Cancer (life threatening)
8. Coma
9. Coronary artery bypass surgery
10. Deafness
11. Heart attack
12. Heart valve replacement
13. Kidney failure
14. Loss of independent existence
15. Loss of limbs
16. Loss of speech
17. Major organ failure on waiting
list
18. Major organ transplant
19. Motor neuron disease
20. Multiple sclerosis
21. Occupational HIV
22. Paralysis
23. Parkinson's disease
24. Severe burns
25. Stroke

I'm no expert but hope this helps a bit...
 

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Quick background: I'm in my late 30s, healthy (no significant conditions), covered under provincial healthcare but no supplementary health.

Currently I do not have either kind of insurance. I left my job and will likely work independently for a while, as a self-employed professional, picking up contracts. I may also work for an employer again, but almost definitely not lifelong. I am able to earn a reasonably strong income as long as I'm in good health.

I'm trying to make sense of disability insurance (DI) vs critical illness (CI). Some questions:

1. DI appears to only pay out as long as you are unable to work. What if you get injured -- e.g. cancer or heart attack -- then recover somewhat, but remain at a diminished capacity. Does the insurance stop paying out? It seems to me that you'd be back in the workforce, earning less income (not able to work 100%) and also have no insurance assistance any more.

2. Critical illness insurance doesn't use the words "injury" in their descriptions, and I'm trying to find out what happens in case of illnesses that result from injury. For example, a car accident or sport accident (I'm a cyclist) leading to brain injury. If the brain injury is a recognized illness, for example in Sun Life Critical Illness, would that cover the situation in which a bike or car accident caused the injury?

3. As I'm self-employed, I believe that CI is really my only option at the moment. What do you think about someone in my situation getting CI, to be able to afford extra care or income replacement for being unable to work, in situations like: very serious car/bike accidents or major illness?
Without knowing your future, you probably need both of them. They are really two different products. The CI is designed to compensate you for the cost of certain illnesses and injuries and the DI is designed to replace your income in the event of all illnesses and all injuries.

Since they don't give either one away, or at least not the good ones. You know. The ones that actually pay are the good ones. I would probably lean towards the DI if you have to choose. As long as you have income, you will be in pretty good shape. It's not to say that with some issues a big lump sum of money would not come in handy but if you had your income you would probably still be OK.

As for the partial disability that I think you were alluding to in your 1st point. The good ones pay for that too. You can set it up that if you have a loss of income, due to illness or injury, even though you are still working in some capacity, they will compensate you for the loss. As long as there was an illness or an injury. So that's not a problem.

CI is good too and it is awesome if you get one of those pre-mentioned nasty conditions. At least it is awesome compared to not having CI and getting those nasty conditions, but the problem I have is some of those conditions wouldn't cost you much at all. Some conditions you would have no idea how much money you would need, so how do you figure out the benefit you need. Maybe factor in lost income, but how long will you have lost the income? Know one knows.

DI is more certain. Did you have an illness or injury? How much income did you lose? We'll cover that. Pretty simple.

Note: The good ones have a name. Non-Cancellable Disability Insurance. It is just a name but any DI salesperson knows when you say you want non-can DI insurance, that you don't want any junk. The non-cancellable pertains to them. You can cancel it anytime you want. But they can NEVER cancel it. You can give me any scenario you can think of and then ask me if they can cancel it then, and I will say; no they can't cancel the policy. Oh sorry. You can't lie on the application, but once you clear that hurdle, they can never cancel it.
 

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Discussion Starter #14
I like the sound of DI, but I'm not sure how I can get it when my self-employed (contract work) income is extremely unpredictable. It can jump from 0K to 200K in a year and is more like a series of random numbers. It will be very difficult to assess what income I am "missing out on", especially since I do a variety of work. So there is no way to answer this question of "how much income did you lose?"

In other words, DI may not be feasible for my kind of work. Is CI my only other option, or is there yet another kind of insurance I can look into?
 

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If your finances are in order and you live within your means I don't think critical illness would be necessary. You can put aside the money yourself - self insure.

Young, healthy, single, not in a high risk profession (risk of injury) or in a high paying profession that requires precise physical skills (surgeon, etc.) I don't think disability insurance would be necessary. Read the policy wordings carefully "Any Occupant Test", etc. As mentioned above, some are better than others.

If you have a wife and children that rely on you, your family lives pay cheque to pay cheque, massive debt, etc. than maybe put some further thought into it. That would however not solve the true problem. If you have a predisposition for mental health conditions that may lead you to be unable to perform "Any" occupation, then some further thought would be wise.

I've sat through more luncheon and dinner presentations hosted by insurers than I can count. They carefully target certain professions. Who can resist a free meal while in school.

Your car insurance policy should cover you well for injuries sustained as a driver, passenger or pedestrian (walking, cycling, etc) who has been injured in a automobile accident. Check your policy details. No policy, get some further advice.

I would try to get some advice from someone you can trust who can review your specific needs. Take my comments with a grain of salt, just my non professional opinions from someone living in Ontario. Depending on where you live, things may be very different.

It all depends on how much risk your willing to take. There's always a chance....
 

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Discussion Starter #16 (Edited)
I don't have car insurance because I don't have a car. I live in a central city area and use rental cars, or no car. So what many people typically have covered through car insurance, I have none of that.

I disagree with the feasibility of self insurance. For example even if I just suffered a brain trauma, such as a serious fall in sports / cycling / driving, my ability to focus and think coherently might be gone. My ability to earn income is directly tied to my ability to think coherently (and focus) in my field of expertise.

The fact I'm not a surgeon doesn't really change anything. Surgeons rely on steady hands and eyesight. In my case, I rely on straight thinking and focus, and also heavily on eyesight. There isn't much difference compared to a surgeon.

If I suffered an injury of that kind (brain damage, eyesight), I can kiss hundred of K of income goodbye. How would I self insure that? Even though my income is erratic, over a decade it still would gross over $1 million. If I had one of these injuries like blindness or brain trauma, I would think that I can't earn anywhere close to that any more.

Or to put it another way: if I remain in great health, I should be able to gross over $1 million income in the next 10 years.

OTOH if I had a brain injury or something horrible like a stroke that impeded my ability to work, that income would plummet pretty significantly (especially since I would need to take time off to rest and recover). What was once $1 million gross income might shrink to something like 500K or less. Wouldn't I be looking at a ~ 500K gross loss in case of serious illness/injury?
 

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Like I said, there's always a chance. If you can't deal with the risk, by all means purchase the insurance. That's what it's all about. Purchase a limit that's high enough that enables you to sleep better at night.

Even though I partake in a variety of high risk activities I'm willing to roll the dice. As I get older and have more and more assets, the need for insurance becomes smaller and smaller.

Build a business that run's itself and you don't have to worry so much about the insurance.
 

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I like the sound of DI, but I'm not sure how I can get it when my self-employed (contract work) income is extremely unpredictable. It can jump from 0K to 200K in a year and is more like a series of random numbers. It will be very difficult to assess what income I am "missing out on", especially since I do a variety of work. So there is no way to answer this question of "how much income did you lose?"

In other words, DI may not be feasible for my kind of work. Is CI my only other option, or is there yet another kind of insurance I can look into?
DI and CI are probably the only options.

To get the base policy, the insurer will look at a couple of tax returns to determine your income. Of course no one gets 100% protection of income. The max is around 85% of your take home pay to ensure some kind of motivation to go back to work, if on claim.

Now the base non-can policy just covers "total disability". Basically meaning you cannot work at all. Since you have a concern, rightfully so, about partial disability, this is added as a rider. You can get "partial disability" or "residual disability" as a rider. The second one "residual disability" is what I described above where they compensate you for the loss of income if you are working but at a reduced capacity. The other one, "partial disability" simply asks if you are working at a reduced capacity (they basically ask the doctor if you can work full time or not) and if the answer is yes you are working at a reduced capacity, they simply pay 50% of the base monthly amount. They don't bother calculating an actual loss. They pay that pre-determined amount.

I think some policies offer both residual and partial in the same rider but I can't remember. That would allow you to claim the highest amount or whatever can be calculated. You would choose.

Last comment. The standard definition of disability in a non-can policy, states: You cannot do the substantial duties of your regular occupation due to illness or injury. That definition is only for the 1st two years. After that they change it to: You cannot do the substantial duties on ANY occupation. By the way, most group DI plans have this definition.

There are basically three definitions of disability, with the other two added as a rider, for a small premium.

1) Any occupation (described above)
2) Regular occupation The question of whether you can do your regular occupation does not change in two years. it is for the life of the contract and therefore they never force you to go look for work in any other occupation. If you do find work in another occupation, by your own choice, they would cut off DI benefits.
3) Own occupation The question of whether you can do your regular occupation does not change in two years AND if you choose to work in some other occupation, they will still pay you the benefits, since you cannot do your own occupation.

In my opinion, #2, regular occupation is a must have on a DI policy. You want to maintain choice. If you cannot do your current job you want them to pay until you decide if you want to do some other occupation or not.

#3, Own occupation is more of a perk. If you decide to work in another occupation, you don't really need the benefits. The loss is still covered by reg. occ. Own Occ. is really for people like surgeons or dentists, who if they could not work with their hands due to an injury, might want to still work elsewhere but would never be able to replace the income they lost as a doctor. Not everyone need Own Occ. but they probably do and a few others.

Nothing is free. Since you hope to never put in a claim, buy only what you need, is my opinion. I think I mentioned, they don't give this stuff away. It is a little pricy but that is more because of the fact that it gets used (claims submitted) far too often. Which goes to the fact that it is really needed by anyone dependant upon their income. That covers about 95% of all working Canadians.
 

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Last important thing you need to know, if buying personal DI insurance.

Start dates. In a perfect world you would have your DI insurance kick in a couple weeks after the onset of an illness or injury. I think 30 day start is about the earliest most non-can DI policies offer. So if you were injured today, your benefits would start in 30 days. They also offer starts dates of 60 days, 90 days, 120 days, 180 days, 360 days and 720 days. The last few are rarely used unless someone is trying to improve some other group policy that might have a change of definition in a couple years, as described above.

So what is the best. As said, earlier is better but more expensive, premium wise.

I found the sweet spot to be 90 day starts. It is the best combination of having benefits kick in before a person goes completely bankrupt and keeping the price more manageable. If I recall, once you put together the policy that fits you best, a 90 day start will see a premium drop of almost 50% of what a 30 day start costs. This is for an age 65 benefit period. So if you are forty, if you waive just 2 months of benefits from a plan willing to pay 300 months (25 years x 12 months) of claims, you can save almost 50% on that pricy policy. It is a no brainer to me and the only people who have 30 day starts are the people that did not get this explained to them or had an agent who had a child starting college that year and needed a big commission cheque. Agents get paid on total premium.

Anyway, enough said. Those are about all of the main important things to think about when looking at DI insurance.
 

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J4B. Once you had a chance to review the coverages, policy wordings, premiums, etc. Let us know what you decide on.
 
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