Please note the following exclusions under the Loan Protection plan:
The insurer will not pay a claim or refund the single premium if your death or critical illness or total disability is in any way related to a pre-existing condition.
No benefits will be payable if the claim results directly or indirectly from or is in any way related to:
- War, whether declared or not, or an act of war, terrorism or insurrection;
- Acquired Immune Deficiency Syndrome (AIDS), AIDS Related Complex (ARC), or Acquired Human Immunodeficiency (HIV), if any of these conditions first manifested itself prior to the Effective Date of Insurance;
- Direct or indirect participation in a criminal act, or any attempt to commit a criminal offense, including but not limited to operating a motor vehicle while the concentration of alcohol exceeds the legal limit in the province of the occurrence;
- Alcohol or drugs other than as legally prescribed by a physician;
- Travel in or descent from a non-scheduled aircraft;
- Intentional—including attempted—self-inflicted damage, destruction or injury, regardless of mental state or competency;
- Cosmetic or elective surgery, complications arising therefrom, whether the surgery or complications occurred prior to, or after, the Effective Date of Insurance;
- Death, illness or injury arising from a communicable disease (or complications thereof) contracted during an outbreak of such communicable disease recognized as an Epidemic or Pandemic by the World Health Organization.
The Monthly Disability Benefit will not be paid for Total Disability caused or contributed to by childbirth, abortion, miscarriage, or pregnancy, whether existing on the Effective Date of Insurance or developing subsequently.
Critical Illness Benefit and Life Insurance Accelerated Death Benefit
Neither the Critical Illness Benefit nor the Accelerated Death Benefit will be paid in the event of a diagnosis of cancer resulting from any medical investigation initiated:
- Within 90 days following the effective Date of Insurance; or
- As a result of any signs or symptoms, which were first manifest within 90 days following the Effective Date of Insurance.
In the event of such a diagnosis, the insurance coverage for Critical Illness under the Certificate of Insurance will be terminated and any premium paid for the Critical Illness coverage refunded. Further, we do not pay the Critical Illness benefit for a diagnosis, illness or bodily infirmity which is not specifically within the definition of Cancer, Heart Attack or Stroke or which is specifically listed as an exclusion from one or more such definitions.
Exclusions–Loss of Employment Insurance
Labour dispute or lockout
For the purposes of this exclusion:
- Labour dispute means a voluntary and simultaneous work stoppage or disruption of work by a group of employees, of which you are a part, acting together against one or more employers in an industry or territory.
- Lockout means the action of employer in temporarily closing place of employment, without terminating employment, as a result of a labour dispute.
General Exclusions–Loss of Employment Insurance
We will not pay loss of employment insurance benefits, in cases such as:
- resignation, retirement or voluntarily surrender of employment;
- if employment is terminated as a result of intoxication, drug abuse, dishonesty, fraud, conflict of interest, refusal to carry out duties or willful or criminal misconduct;
- unemployment as a result of being self-employed, a seasonal employee or an elected government official; or
- unemployment as a result of the expiration of a specific contract of employment.
To submit a Life, Critical Illness, and Disability coverage claim, please call us at 1-866-937-8406.
Our Administrator will help you complete a claim report, which constitutes the first step in the claim submission process.
Once the claim forms are completed, Co-operators Life will begin assessing your claim, contact you directly with any additional questions, and keep you apprised of the status of your claim.