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• affects 1 in 4 women / 1 in 5 men before retirement
• 94.1% of the critical illness claims are paid
• protect yourself and your family if you get seriously ill

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Ageas' Critical Illness Cover under LowStart and YourLife Plans

Ageas Protect has beefed up its Critical Illness cover to ensure more peace of mind for its clients. With Ageas Protect’s LowStart and YourLife plan offerings, you can choose the amount of coverage and premiums you want.

Quick Facts on Ageas Critical Illness

Critical Illnesses Covered by Ageas

The Critical Illness benefit will pay the benefit amount (or a portion) for the following critical illnesses:

The benefit will be paid if the covered individual survives for 10 days after the critical illness is diagnosed and if the diagnosis falls within the definition specified in the policy.

Carcinoma in Situ of the Breast.  This involves total mastectomy surgery where the insured person survives for at least 14 days from the day of the diagnosis. The coverage will pay the lower of £25,000 or 50% of the sum insured.  The cover does not include: Surgery, prophylactic mastectomy or other procedures done without historical evidence or cancer in situ, as well as lumpectomy, partial mastectomy and partial or total subcutaneous mastectomy.

If a claim for a covered critical illness is paid out, the coverage will stop and succeeding claims for carcinoma in situ will no longer be payable.

What Is the Critical Illness Cover of Ageas Protect?

The Critical Illness cover aims to protect the family against specific critical illness by paying the benefit upon diagnosis of a covered critical illness for the person insured or for his child.

Amount of Coverage

The amount of coverage (sum assured) may change throughout the life of the policy, depending on the plan you choose:

1. YourLife Plan

   You can opt for a level sum assured, an increasing sum assured or a decreasing sum assured.

   • Level Sum Assured. The amount of cover remains the same throughout the duration of the policy.
   • Increasing Sum Assured. 5% increase in the sum assured every year. Payout will depend on the amount of the sum assured at the time of diagnosis/death.
   • Decreasing Sum Assured. Mainly designed for those who need to pay off a long term debt (i.e. mortgage), the amount of decrease may be designed to coincide with the amount of loan still outstanding. The payout (upon) will be based on the amount of sum assured at the time of death or diagnosis of covered critical illness.
2. LowStart Plan

   The amount of sum assured may decrease over time if the client chooses not to increase premiums over the years.

What You Will Receive

The YourLife Plan and the LowStart Plan will payout the benefits based on the reason of the claim, as stated below.

1. Death of the person/s covered

   The plan will pay the sum assured (at the time of the claim) minus any previous payments for diagnosis of ductal cancer in situ of the breast and for total disability (if this is added to the basic plan).

2. Diagnosis of a Covered Critical Illness

   Once diagnosed with a critical illness and the diagnosis meets the prescribed definitions, the benefit amount will be paid out minus:

   • Benefit payments made for diagnosis of ductal carcinoma in situ of the breast
   • Benefit payments made for total disability
3. Diagnosis of ductal cancer in situ of the breast

   The plan will pay £25,000 or 50% of the sum assured, whichever is smaller.

4. Diagnosis of a children’s critical illness for the child of the person insured

   The payment will be £25,000 or 50% of the benefit amount, whichever is lower. The payment can be doubled if there is no treatment available in the country and a treatment that has been shown to be effective is available elsewhere.

Additional Optional Benefits

Depending on the Type of Plan taken out, there are additional benefits to be paid out. Check the Cover Summary of the Policy to see whether it includes the Additional Benefits mentioned here.

Waiver of Premium. Premiums are waived for the time that the person insured is incapacitated for a period of more than 26 weeks. Premium payments will resume when the person insured is no longer incapacitated or when the cover ends. For Joint Life policies, the Waiver of Premium benefit will apply to the person who has the cover.

Total Permanent Disability.  In the event that the Insured Person becomes permanently disabled but not critically ill, this cover will pay the benefit amount. The total and permanent disablement should meet the criteria set forth in the policy and the Person Insured should be incapacitated for at least 26 weeks before the benefit becomes payable. Once this is paid, the policy no longer becomes effective and no further payments on claims will be made.

Total Disability. In the event that the Insured Person becomes totally disabled based on the criteria set forth in the policy, this cover will pay a specified benefit. The Person Insured should be incapacitated for more than 26 weeks for the benefit to be payable.

What You Are NOT Covered For

The client will not receive any Critical Illness payouts for:

• Illnesses that are not part of the list of covered critical illnesses
• Critical illnesses that may be part of the list of covered critical illnesses but do not meet the company’s definition of that specific critical illness
• Failure to provide medical or other related evidence required by the company when claiming for the benefits
• Failure to provide full disclosure of one’s health condition and other relevant matters during the application, especially when such disclosure would have affected the acceptance or denial of the application or offering the cover with different conditions
• Policies that have lapsed
• The cause of the illness is excluded from the cover and fall under the exclusions specified in the policy

Payment may also be denied for the following instances:

• Critical illness was caused by an illegal or criminal act or resulted by abuse of alcohol or drugs.
• The insured failed to provide accurate information that could have caused the company to either deny the application or change the premium rates. (i.e. Misstatement of age)

Also, the Critical Illness cover will not pay benefits for children’s critical illness for:

• Diagnosis of a children’s critical illness, where the child fails to survive 10 days after the diagnosis
• Diagnosis of an illness which falls under the list of covered children’s critical illnesses but do not meet the company’s definition of that specific critical illness
• Diagnosis of a covered critical illness after the maximum children’s critical illness benefits have already been received
• Congenital conditions, where the child was born before the start of the coverage

Additional Benefits/Covers:

Depending on how your policy is structured, you also stand to get the following:

If you are covered for Total Permanent Disability or Total Disability, you will receive the benefit amount or a portion of it, if you meet the definition for Total Permanent Disability, even if your illness is not included in the list of covered critical illnesses or fails to meet its definitions. The disability will be considered permanent when you are incapacitated for at least 26 weeks.

If you are covered for the Waiver of Premium benefit, premiums are waived if you are rendered disabled and incapacitated for at least 26 weeks and will continue to be waived when the cover ends or when you are no longer incapacitated.

Making a Claim

Once diagnosed with a critical illness, you can file a claim with Ageas. You need to provide medical reports or any other evidence, which will shoulder all reasonable costs Ageas requires.

Please note: The diagnosis should be made by a consultant practicing in a country belonging to the list of eligible countries provided by Ageas.

This article is for informational pruposes only and should not be considered a financial advice. Contact Ageas directly for information about their products.

Last updated on: 25.07.2012

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