Critical Illness vs. Long-Term Disability

WHICH COVERAGE IS RIGHT FOR YOU?

A great career, a happy family, a beautiful home —  everything you’ve worked so hard to achieve, as well as your ability to enjoy it, depends upon your health.

Despite the many measures you may take to ensure your wellness, life can be unpredictable. Recent statistics from Canadian Cancer Society indicate that:

  • 1 in 2 Canadians will develop cancer in their lifetime
  • 60% of people diagnosed with cancer survive at least 5 years

And according to Stats Canada:

  • a 35-year-old has a 50% chance of being disabled for 3 months or longer
  • and a 38% chance of having a disability lasting longer than five years

Clearly, the chances of being diagnosed with a life-altering illness or injury are higher than ever. However, people are surviving and living through these challenging situations with greater frequency and for longer than ever before. The impact can be devastating, both financially and emotionally.

Aside from living a healthy lifestyle, what is the best way to protect your income and the life you have built with it? Both Long-Term Disability and Critical Illness insurance are solutions that can help. However, there is often confusion about these 2 unique types of protection.

SO WHAT’S THE DIFFERENCE?

First and foremost, the payouts are quite different:
Long-Term Disability (LTD) Insurance offers a regular monthly payout after a waiting period of typically 90 or 120 days, payable to age 65, while

Critical Illness (CI) Insurance offers a one time lump sum payout of the entire CI benefit 30 days after diagnosis

No two situations are the same, and as a result, there is no one perfect solution.
An LTD claim can last for decades, and pay out millions of dollars for a long-lasting illness or injury, but is typically paid in monthly increments after the waiting period, and while you are unable to work. CI claims are paid out in full 30 days after diagnosis of one of the covered conditions, whether you are working or have a loss of income or not.

Let’s look at a quick breakdown of some other key differences.

Long-Term Disability (LTD) Insurance

Essentially, LTD assures that you will continue to receive a portion of your income in the event that you are unable to work due to injury or illness. Your ability to work is your greatest asset, and LTD is the most effective way to protect it.

HOW MUCH ARE YOU WORTH?

Based on current annual income, here are two examples of potential earnings to age 65, assuming a 5% increase per year. This is the risk that LTD Coverage looks to protect.

AT AGE 35:

$60,000 = $3,986,331

$96,000 = $6,378,129

$180,000 = $11,958,993

AT AGE 45:

$60,000 =$1,983,957

$96,000 = $3,174,332

$180,000 = $5,951,872

WHAT QUALIFIES AS A DISABILITY?

Disability insurance covers illnesses or injuries that impact your ability to work. Some of the most common causes of LTD claims are mental health disorders, musculoskeletal (back pain, arthritic conditions), cancer, heart disease, and injury as a result of accidents.

It is important to understand that different types of policies provide varying definitions of Disability, and the better the policy, the more reasonable the definition is to satisfy in order to satisfy and thus receive a disability benefit.

HOW IS IT PURCHASED?

There are three common ways that people obtain Long-Term Disability Insurance:

  1. Coverage provided through your employee benefit plan
  2. Purchasing a stand-alone individual policy
  3. Supplementing an existing group or other disability plan, which may have inferior definitions, or limited coverage amounts

For example, an executive earning $250,000 might be eligible for as much as $10,000/month of disability income protection. However, their group plan may provide coverage that is limited to $5,000, as an example. In this case, the executive is well under-insured, and may be eligible for a discounted “top-up” policy to get to the appropriate level of coverage based on their income.

Individual disability policies can include Riders that provide additional benefits, including:

  1. Increasing disability benefit to keep pace with the cost of living
  2. Guaranteed option to increase insurance in the future without medical evidence
  3. Occupational HIV protection for health professionals
  4. Potential for a Refund of Premiums if you never have a claim

Individual policies are also fully portable. If you lose your job or have stopped working for a period before age 65, you may be eligible to receive disability benefits even if you did not have employment income at the time.

Critical Illness Insurance (CI)

Critical Illness insurance is designed specifically to help with the financial needs associated with recovering from a serious illness.

The benefit can be used in any way you choose:

  • Replace lost income for self and spouse/caregiver
  • Repay your mortgage and other debts
    Gain access to private medical services or treatment outside Canada
  • Private nursing, home care and childcare services
  • Take an extended vacation
  • Make modifications to your home and/or vehicle
  • Maintain your lifestyle and retirement planning

HOW IS CRITICAL ILLNESS INSURANCE PURCHASED?

Critical Illness is not included in as many employee benefit plans, so it is up to each individual to consider their own needs and seek out this valuable protection. Policies can be obtained on an individual basis, in a similar fashion to life insurance, where premiums can be fixed for a level term like 10 or 20 years, or on a permanent basis.

Coverage is not tied to your ability to work or earn an income, and benefits can be used for any purpose you desire. Since LTD benefits are tied to earned income reported on tax returns, CI is often used to bridge the gap for people who may not take significant income, but still have a lot at risk if they had to step away to deal with an illness. It is also used often to protect a non-income earning spouse, since the working spouse’s income would likely be impacted if they family were dealing with a serious illness.

BENEFITS OF CI:

Benefits are paid out as a tax-free lump sum, 30 days after diagnosis of a covered condition. This provides a quick solution to replace lost income, pay for excess care, eliminate debt, or simply provide peace of mind and reduce financial stress.

CI Policies can be structured to include some of the following benefits:

  • Term Policies can be Convertible, without medical questions, to Permanent coverage
  • Some policies provide a full Refund of 100% of all Premiums paid if you never have a CI claim
  • Many policies also include ancillary benefits to help get a Second Medical Opinion to be confirm a diagnosis or treatment plan, or to help access specialized care tailored for your condition

Both CI and LTD can serve as valuable solutions, depending upon your specific situation. Nobody knows what the future holds, but when we have protection for both the short term, while also covering the long-term risks as well, we have a solid foundation for financial well-being.

Our team at SC Insurance is always happy to answer your questions specific to your own situation. We’re here to help protect your wealth by protecting your health.

WHAT QUALIFIES AS A CRITICAL ILLNESS?

There are Basic Plans that cover cancer, heart attack and stroke, and Comprehensive Plans that cover a longer list of illnesses. The majority of claims under all plans are for cancer, which make up approximately 70% of all CI claims in Canada.

BELOW IS A LIST OF CONDITIONS INCLUDED IN MANY COMPREHENSIVE CI PLANS.

Some plans may vary, and the definitions of each condition are available for review. Most plans also include additional conditions which are eligible for a partial benefit payout, when one of the following conditions is not met.

  • Acquired brain injury
  • Aortic surgery
  • Aplastic anemia
  • Benign brain tumour
  • Bacterial meningitis
  • Blindness
  • Cancer (life-threatening)
  • Coma
  • Coronary artery bypass surgery
  • Deafness
  • Dementia, including Alzheimer’s disease
  • Heart attack
  • Heart valve replacement or repair
  • Kidney failure
  • Loss of independent existence
  • Loss of limbs
  • Loss of speech
  • Major organ transplant
  • Major organ failure on waiting list
  • Motor neuron disease
  • Multiple sclerosis
  • Occupational HIV infection
  • Paralysis
  • Parkinson’s disease and specified atypical parkinsonian disorders
  • Severe burns
  • Stroke

Note: This list is subject to change, and intended as a summary of coverage provided by many Comprehensive CI plans. The list of covered conditions and definitions for any policy or insurance company can be provided upon request.

Recommended Articles