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LONG TERM DISABILITY (LTD) INSURANCE

If you are disabled due to sickness or injury, Long Term Disability provides you with an income while you are away from work.  My Choice offers the following coverage options:

 

 

Coverage

Option 1 & 4

50% of monthly earnings

Maximum benefit - $16,000/month

Non-Evidence Maximum (NEM) - $12,000/month

Benefit Period – to age  65

 

Option 2 & 5

66 2/3% of first $2,250 of monthly earnings

plus

50% of the remainder

Maximum benefit - $16,000/month

Non-Evidence Maximum (NEM) - $12,000/month

Benefit Period - to age 65

 

Option 3 & 6

66 2/3% of first $2,250 of monthly earnings

plus

50% of the remainder

COLA (cost of living) to age 65 (3% maximum)

Maximum benefit - $16,000/month

Non-Evidence Maximum (NEM) - $12,000/month

Benefit Period - to age 65

 

        Under each option, the total benefit including other income (such as CPP/QPP benefits) may not exceed:

        85% of pre-disability after-tax earnings.


LONG TERM DISABILITY (LTD) DETAILS

The following is a further description of some of the specific elements of your LTD plan.

g    Evidence of Insurability

        Medical evidence will be required on insurance over $12,000 and to increase LTD coverage on subsequent re-enrollments.

g    Indexation

(Option 3 only)

        On the first of January each year the monthly income is increased based on the increases in the Consumer Price Index but shall not exceed 3%.  The increase commences on the first of January following the payment of the initial monthly installment.

g    Maximum Disability Period

        Benefits will not be payable beyond age 65, unless you satisfy the Qualifying Disability Period while age 64, in which case benefits will be payable for a maximum of 12 months.

g    Pre-existing Conditions

        No benefits are payable for any disability beginning within twelve months of your effective date of insurance if the disability is caused by, partly attributable to or is a consequence of a sickness or injury for which you have received medical treatment or services or took prescription drugs or medicine within ninety days before your effective date of insurance.

g    Qualifying Disability Period

        The greater of 17 weeks or the end of the benefit period provided under the Short Term Disability Income benefit. 

g    Recurrent Disability

        If a disability recurs and it is due to the same or related causes, it will be considered as one continuous disability and will not be subject to the Qualifying Disability Period unless you have returned to active, full-time employment for a period of 6 consecutive months or longer.

        If new disability is due to unrelated causes you may be eligible for a new disability period, subject to the Qualifying Disability Period, if you have returned to active work for at least one full day.

g    Reductions and Integration of Benefits

        The monthly income payable under this benefit will be reduced by any disability or retirement benefit which is payable or which would have been payable had you made satisfactory application under:

- The Canada/Quebec Pension Plans

- A Workplace Safety Insurance Board (WSIB) act or equivalent provincial act.

- A provincial auto insurance law.

- Any other government plan.

        The amount of disability income is reduced so that the sum of all income, compensation, indemnity and benefits for which you would be eligible on account of disability, from your employer, a government body, or under any group insurance or pension plan in which your employer contributes, may not exceed 85% of your net monthly income determined at the onset of disability.

g    Rehabilitative Employment

        If you are disabled, the Insurer may recommend that you undergo some suitable rehabilitative training program which would take into account the nature and limitations of your disability.

g    Subrogation

        In the event of any payment under this coverage, the Insurer shall be subrogated to all of your rights of recovery therefore against any person or organization and you shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights.  You shall do nothing to prejudice such rights.

 

 

g    Total Disability

        During the initial assessment period, disability is assessed on the basis of the duties you regularly performed for the employer before disability started. The initial assessment period is the waiting period plus the next 24 months of disability. During this time you are considered disabled if, because of disease or injury, there is no combination of duties you can perform that regularly took at least 60% of your time at work to complete.

        If disease or injury prevents you from performing a duty, it will also be considered to prevent you from performing:

1. others that are performed only in order to complete that duty; and

2. others that can only be performed after that duty is completed.

        After the initial assessment period, you are considered disabled if disease or injury prevents you from being gainfully employed. Gainful employment means work:

1. you are medically able to perform;

2. for which you have at least the minimum qualifications;

3. that provides income of at least 50% of your monthly earnings; and

4. that exists either in the province or territory where you worked when you became disabled or where you currently live.

        The availability of work will not be considered in assessing disability.

g    Waiver of Premium

        If receiving Long Term Disability benefits, Great-West Life will waive the payment of premiums beginning with the premium for the first full policy month for which benefits became payable and continuing for each full policy month for which benefits are payable.

g    Exclusions

        Injury or illness resulting from civil unrest, insurrection or war, whether war be declared or not, or participation in a riot.

        Self-inflicted injury, while sane or insane.

        Flight or attempted flight on board a plane or other aircraft if you are part of the crew or perform any function relating to the flight, or participate in the flight as a parachutist.

        Injury or illness resulting from committing, attempting to commit, or provoking an assault or criminal offense.

g    Termination of Benefit

        Age 65 or earlier retirement.

 

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