Help & Answers

Definitions

A

Accelerated death benefit

A feature that lets you access part of your life insurance payout early if you are diagnosed with a terminal illness, so the money is available while you are still living.

Accidental death and dismemberment (AD&D)

Coverage that pays a benefit if you die or lose a limb, sight, or hearing because of an accident. It does not cover death from illness.

Any-occupation

A stricter disability definition where benefits are paid only if you cannot work at any job you are reasonably suited to, not just your own occupation.

Application

The form you complete to apply for coverage. It asks about your age, health, lifestyle, and finances so the insurer can assess your request.

Assignment of benefits

An arrangement where you let a provider, such as a clinic or dentist, bill your insurer directly so you do not pay the full amount up front.

Assuris

The not-for-profit organization that protects Canadian policyholders if their life insurance company fails, up to set limits on your coverage and benefits.

B

Beneficiary

The person or people you name to receive the payout from your policy when you pass away.

Benefit period

The maximum length of time a policy will keep paying you a benefit, common in disability insurance, such as two years or up to age 65.

Broker

A licensed professional who works for you, not one insurer, and compares policies from several companies to find a good fit.

Brokerage

A firm, such as PolicyAdvisor, that employs licensed brokers and offers products from many insurers rather than a single company.

C

Carrier

Another word for the insurance company that issues your policy and pays your claims. Also called the insurer.

Cash surrender value

The amount of money you would actually receive if you cancelled a permanent policy, after any fees or outstanding loans are subtracted.

Cash value

A savings component that builds up inside some permanent life insurance policies and can be borrowed against or withdrawn.

Children's insurance

A small life insurance policy on a child, often used to lock in low rates and guarantee they can buy more coverage later regardless of health.

Claim

A formal request you or your beneficiary makes to the insurer to receive the money your policy promises.

Co-payment

A fixed share of a cost that you pay yourself, such as 20 percent of a prescription, with the plan covering the rest.

Commission

The fee an insurer pays a broker for placing a policy. At PolicyAdvisor advice is free to you because the insurer pays this, not you.

Contestability period

A window, usually the first two years of a policy, during which the insurer can review your application for errors if a claim is made.

Contingent beneficiary

The backup beneficiary who receives the payout if your primary beneficiary has passed away or cannot be found. Also called the secondary beneficiary.

Conversion

The option to switch a term life policy to permanent coverage without a new medical exam, usually before a set age.

Conversion privilege

In group benefits, the right to move your coverage to an individual policy if you leave the plan, without proving you are healthy.

Convertible

A term life policy that includes the right to convert to permanent coverage later without answering new health questions.

Coordination of benefits

The rules that decide how two health plans, such as yours and a spouse's, share a claim so you are not paid more than the actual cost.

Coverage amount (sum insured)

The total amount your policy will pay out, also called the death benefit or face amount.

Covered conditions

The specific illnesses a critical illness policy will pay for, such as cancer, heart attack, and stroke, listed in the contract.

Creditor protection

A feature of some insurance products, such as segregated funds, that can shield your money from creditors if you meet certain conditions.

Critical illness insurance

Coverage that pays a tax-free lump sum if you are diagnosed with a covered serious illness such as cancer, heart attack, or stroke.

D

Death benefit

The money your insurer pays to your beneficiary when you pass away while the policy is in force. Usually tax-free in Canada.

Death benefit guarantee

A promise in a segregated fund that your beneficiary receives at least a set percentage of what you invested, even if markets fall.

Decreasing term

Term life insurance where the coverage amount shrinks over time, often used to match a mortgage balance that goes down as you pay it off.

Deductible

The amount you pay out of pocket on a claim before your insurance begins to pay, common in health and travel insurance.

Deferred sales charge

A fee you pay for selling an investment within a set number of years of buying it. The fee shrinks the longer you hold it.

Dependent

A family member, such as a spouse or child, who can be covered under your policy or benefits plan.

Direct billing

An arrangement where a provider bills your insurer directly, so you pay only your share, if any, at the time of service.

Disability insurance

Coverage that replaces a portion of your income if you are unable to work because of illness or injury.

Dispensing fee

The amount a pharmacy charges to fill a prescription, separate from the cost of the drug itself. Health plans may cover part of it.

Dividends

Payments some participating policies share with owners when the insurer performs well. They are not guaranteed and can be taken as cash or reinvested.

E

Elimination period

The waiting time after a disability begins before your benefit payments start, such as 90 days. Also called the waiting period.

Employee assistance program (EAP)

A confidential service in many group plans offering counselling and support for personal, family, or work challenges, often at no cost to you.

Emergency medical coverage

Travel insurance that pays for unexpected medical care, such as a hospital visit, if you get sick or hurt while away from your home province.

Endorsement

A written change added to your policy that adjusts its terms. Also called a rider in life insurance.

Exclusion

A specific situation or condition that a policy does not cover, listed in the policy contract.

Extended health coverage

Insurance that helps pay for care beyond your provincial plan, such as prescriptions, dental, vision, and paramedical services.

F

Face amount

The coverage amount stated on your policy, which is the base sum your beneficiary receives. Also called the sum insured.

Formulary

The list of medications a health plan agrees to cover. Drugs not on the list may not be reimbursed.

Free-look period

A short window after you buy a policy, often 10 days, when you can review it and cancel for a full refund if you change your mind.

G

Grace period

A short window, often 30 days, after a missed premium during which your coverage stays active and you can still pay.

Group insurance

Coverage offered to a group of people, such as a company's employees, usually at lower cost and with simpler health questions.

Guaranteed acceptance

A policy that accepts you without any health questions or medical exam. Approval is certain, but premiums are higher and payouts may be limited at first.

Guaranteed investment fund (GIF)

Another name for a segregated fund, an investment sold by insurers that combines market growth potential with certain guarantees.

Guaranteed issue

Coverage you can get without answering health questions or taking an exam. Everyone who applies is accepted, usually at a higher price.

Guaranteed renewable

A policy the insurer must renew each term as long as you pay premiums, even if your health has changed.

H

Health spending account (HSA)

An employer-funded account you can use for a wide range of eligible health and dental costs. Also known as a PHSP.

I

In-force

A policy that is active and fully paid up to date, meaning your coverage is currently working and claims can be paid.

Income replacement ratio

The share of your regular income that a disability policy will replace, often around 60 to 70 percent, since benefits are usually tax-free.

Insurable interest

A genuine stake in someone's life or property, such as a spouse or business partner, which you must have to insure them.

Insured

The person whose life or health the policy covers. If they pass away or make a claim, the policy responds.

Insurer

The insurance company that issues your policy, collects premiums, and pays valid claims. Also called the carrier.

IRCC

Immigration, Refugees and Citizenship Canada, the government department that sets the rules for programs such as the Super Visa.

Irrevocable beneficiary

A beneficiary who cannot be changed or removed without their written consent, giving them a firm claim to the payout.

J

Joint first-to-die

A policy covering two people that pays out once, when the first of them passes away. Often used by couples to protect shared debts.

Joint last-to-die

A policy covering two people that pays out only after both have passed away, often used for estate or tax planning.

L

Lapse

When a policy ends because premiums were not paid, leaving you without coverage.

Level term

Term life insurance where the coverage amount and premium stay the same for the whole term, such as 20 years.

Long-term disability

Disability coverage that replaces income for an extended period, sometimes years or up to retirement age, after any short-term benefits end.

Lump-sum benefit

A single, one-time payment from a policy, such as the tax-free amount a critical illness plan pays after a covered diagnosis.

M

Management expense ratio (MER)

The yearly cost of running an investment fund, shown as a percentage. A higher MER means more of your return goes to fees.

Maturity

The point at which a policy or investment reaches the end of its term or a set age, and its terms may pay out or change.

Maturity guarantee

A promise in a segregated fund that you get back at least a set percentage of your investment when it matures, even if markets drop.

Moratorium period

A stretch of time, often early in a critical illness policy, during which claims linked to certain pre-existing conditions may not be paid.

Mortgage protection insurance

Life or disability coverage designed to pay off or cover your mortgage if you pass away or cannot work. A personal life policy is often more flexible.

N

No-medical insurance

A policy you can qualify for by answering health questions instead of taking a medical exam, with faster approval but usually higher premiums.

Non-cancellable

A strong disability policy the insurer cannot cancel or reprice as long as you pay premiums, locking in your rate and terms.

Non-evidence maximum

In group benefits, the largest amount of coverage you can get without providing medical evidence of your health.

Non-smoker

A rating class for people who have not used tobacco or nicotine for a set period, usually 12 months, which earns lower premiums.

O

OSFI

The Office of the Superintendent of Financial Institutions, the federal regulator that oversees the financial strength of Canadian insurers.

Owner

The person or entity that controls the policy, pays the premiums, and can make changes. Often the same as the insured, but not always.

Own-occupation

A generous disability definition that pays benefits if you cannot do your specific job, even if you could work in another role.

P

Paid-up additions

Extra bits of permanent coverage bought using dividends from a participating policy, which increase both your death benefit and cash value.

Paramedical

Health services beyond a doctor's office, such as physiotherapy, massage, or chiropractic care, often covered by extended health plans.

Participating (par) policy

A whole life policy that can earn dividends when the insurer's participating fund performs well. Dividends are not guaranteed.

Permanent life insurance

Life insurance meant to last your whole life rather than a set term, and which often builds cash value over time.

PIPEDA

The Personal Information Protection and Electronic Documents Act, Canada's federal privacy law governing how businesses handle your personal data.

Policy

The contract between you and the insurer that spells out what is covered, what is not, and what each side must do.

Policy loan

Money you can borrow against the cash value of a permanent policy. Any unpaid balance reduces the death benefit.

Policyholder

The person who owns the insurance policy and is responsible for paying its premiums.

Pre-existing condition

A health issue you had before your coverage began. Some policies limit or exclude claims tied to it.

Premium

The amount you pay, monthly or annually, to keep your insurance coverage in force.

Primary beneficiary

The first person in line to receive your policy's payout. If they cannot receive it, the contingent beneficiary is next.

Probate

The legal process of validating a will and settling an estate. Some insurance products can pass money to beneficiaries outside of probate.

Provincial health plan

The public health coverage each province and territory provides, such as OHIP in Ontario, which private insurance is meant to top up.

Q

Quote

An estimate of what a policy would cost you, based on the details you provide, before you formally apply.

R

Rated policy

A policy priced higher than standard because the insurer sees added risk in your health or lifestyle. Also called substandard.

Reinstatement

Restoring a lapsed policy to active status, usually by paying missed premiums and sometimes answering health questions again.

Renewable

A term policy you can continue at the end of its term without a new medical exam, though the premium typically rises.

Repatriation

A travel insurance benefit that arranges and pays to bring you home for medical care, or to return your remains, if needed.

Reset feature

An option in some segregated funds that locks in market gains, raising your guaranteed amount if the investment has grown.

Residual disability

A benefit that pays a partial amount when you can work but earn less than before because of an ongoing disability. Also called partial disability.

Return of premium

A feature that refunds some or all of the premiums you paid if you never make a claim or outlive the policy term.

Revocable beneficiary

A beneficiary you can change or remove at any time without needing their permission.

Rider

An optional add-on that extends or customizes your policy, such as a child or critical illness rider.

RRIF

A Registered Retirement Income Fund, the account an RRSP usually becomes in retirement, from which you draw taxable income each year.

RRSP

A Registered Retirement Savings Plan, a tax-sheltered account for retirement savings where contributions can lower your taxable income.

S

Segregated fund

An investment sold by insurers that pools your money like a mutual fund but adds guarantees on your principal and a death benefit.

Short-term disability

Disability coverage that replaces income for a limited stretch, often a few weeks up to about six months, after a brief waiting period.

Simplified issue

A policy that asks a few health questions but skips the medical exam, offering quicker approval than fully underwritten coverage.

Smoker

A rating class for people who have used tobacco or nicotine recently, which leads to higher premiums than non-smoker rates.

Substandard

A rating applied when an insurer sees higher-than-average risk, leading to a higher premium. Also called a rated policy.

Super Visa insurance

Medical coverage required by IRCC for parents and grandparents visiting Canada on a Super Visa, meeting a minimum amount and term.

Surrender

Cancelling a permanent policy in exchange for its accumulated cash value, if any.

Survival period

The number of days you must live after a covered diagnosis before a critical illness policy pays out, often 30 days.

T

Term life insurance

Life insurance that covers you for a set period, such as 10, 20, or 30 years, at a lower cost than permanent coverage.

TFSA

A Tax-Free Savings Account, where your investments grow and can be withdrawn tax-free, with annual contribution limits set by the government.

Total disability

A state where you cannot perform the key duties of your work because of illness or injury, as defined by your policy.

Trip cancellation

Travel coverage that reimburses non-refundable costs if you have to cancel a trip before departure for a covered reason.

Trip interruption

Travel coverage that helps with extra costs if a covered event cuts your trip short after it has already begun.

U

Underwriting

The process an insurer uses to assess your risk, based on factors like age and health, to decide your eligibility and premium.

Universal life insurance

Permanent life insurance that combines lifelong coverage with a flexible investment component you can adjust over time.

V

Visitor insurance

Emergency medical coverage for people visiting Canada, such as tourists or new arrivals, who are not yet on a provincial health plan.

W

Waiting period

A set time you must wait after a policy starts before certain benefits become payable.

Waiver of premium

A benefit that lets you stop paying premiums while keeping your coverage if you become totally disabled and cannot work.

Whole life insurance

Permanent life insurance that covers you for your entire life and builds cash value over time.

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