Accident and Sickness

Creditor Group Accident & Sickness Insurance

In case of total disability caused by an accident or sickness, Creditor group accident and sickness insurance takes care of your monthly loan re-payments towards the financing or lease of a vehicle while totally disabled*. Total disability is when an accident or sickness causes the inability to perform all duties of one’s occupation. With an eligible disability insurance claim, the insured monthly payment of the loan will be paid to the financial institution while disabled, to relieve the burden on you and your loved ones.

* Depending on the coverage offered to you by your dealer, you may be covered for the entire insurance term, or up to certain number of months per certificate or per claim. Please refer to your certificate of insurance for the details of the coverage, definitions, conditions, limitations and exclusions.

Some insurance programs offer accidental disability only. Accidental disabilities are typically less expensive and do not require underwriting. Make sure you choose the right type of disability insurance for you as purchasing accidental disability does not cover disabilities caused by illness.

Waiting Period

With most disability insurance products, you can choose the type and duration of the waiting period. There are two types of waiting periods: Elimination and Retroactive.

Retroactive vs. elimination chart

Depending on the program offered by your dealer, Hospitalization benefit may be included with the retroactive plans. In that case, if the total disability requires the insured to be hospitalized for at least 72 hours, the waiting period may be waived and the payment of benefits would start immediately.

As with any insurance product, there are eligibility requirements and you need to make sure you are aware of the limitations and exclusions as listed on the certificate.

Eligibility Requirements

  • be within the eligible age range as indicated on the certificate of insurance
  • meet the minimum hours of work requirement as stated on the certificate of insurance

Note: eligibility requirements may vary depending on the insurance program offered to you by your dealer. Please refer to the eligibility section of your certificate of insurance. At the time of purchase of insurance coverage, after reviewing the eligibility requirement, you need to decide if you are eligible for the coverage. If unsure, please contact our eligibility line at 1-800-761-4655.

Supplemental Health Questionnaires & Underwriting

Unlike individual insurance, creditor group insurance does not require as much information regarding your health and medical history. Health questions and underwriting are only required when applying for insurance above certain dollar amounts. However, pre-existing condition clause (see below) applies to any amount applied for, and therefore, you need to make sure you understand how this clause works.

If a supplemental health questionnaire or underwriting is required, most insurance programs provide temporary insurance while the application is being processed (refer to your certificate for details). If the insurance is rejected, the declination letter will be mailed to you, the temporary insurance terminates and any premiums paid would be refunded to the financial institution advancing the loan. If approved, you will receive an approval letter and the insurance will be in force as of the date approved.

20 Day Free Look

You will have 20 days after the effective date of the insurance to decide whether or not you want the coverage. If not, the certificate should be returned to our divisional headquarters or the dealer you purchased the insurance from and we will cancel the insurance and refund any premium paid jointly to you and/or the financial institution named on the certificate.

Pre-exisiting Conditions

Your coverage contains Limitations and Exclusions which are set out in detail on the back of the Certificate. In particular, your claim for benefits will not be covered if it is caused or contributed to by a Pre-existing Condition.

In general, a Pre-existing Condition means any condition for which you have consulted a doctor, received treatment, taken medicine, or generally had symptoms within the 6 month period before you purchase insurance. However, if you are symptom and treatment free for the 6 months following your purchase, and have not consulted a doctor, your condition will not be considered Pre-existing (Note: The actual periods may vary from 6 to 24 months depending upon the terms of Certificate).

For example, in case of accident and sickness insurance, if the insured is unable to work solely due to a car accident, the fact that the insured was diagnosed with skin cancer prior to the effective date of the insurance and undergoing treatment since, does not affect the payment of the claim and is not considered a pre-existing condition.

However, if the disability is due a persistent back pain caused by an accident prior to the effective date of insurance, then it could be considered a pre-existing condition and no benefit would be paid.

Pex Chart

Note: The determination of pre-existing condition is based on a case by case basis. The above is intended for illustrative purposes only and is not intended to bind the Company. In the event there is any discrepancy between it and the Certificate, the wording of the Certificate will prevail. For greater certainty regarding your coverage, please refer to your Certificate. For questions regarding eligibility or pre-existing conditions, contact 1-800-761-4655.

Limitations and Exclusions

As with any insurance product, there are some limitations and exclusions varying from product to product and from provider to provider. Make sure to refer to the back of the insurance certificate for a complete list.

Here are some common examples of the limitations and exclusion you would see on group creditor insurance:

  • Pre-existing condition or claim caused directly or indirectly as a result of treatment for a pre-existing condition
  • Intentionally self-inflicted injury while sane or insane
  • War or any act of war whether declared or undeclared
  • Suicide
  • Participation in a criminal act or attempt to commit a criminal offense, including but not limited to operating a motor vehicle, vessel or aircraft while the concentration of alcohol in 100ml exceeds 80mg
  • Chronic or excessive use of alcohol
  • Drug or substance use apart from controlled drugs used as legally prescribed by and on the advice of a physician
  • Pregnancy, childbirth, or termination of pregnancy
  • Cosmetic or elective surgery

In addition to the general limitations and exclusions above, below are some limitations that are specific to disability insurance:

  • If total disability is caused or contributed to by mental, nervous or psychiatric condition or disorder, after a benefit period of three months, payments will only be made if the insured is regularly attending a licensed psychiatrist, a licensed psychologist or a licensed neurologist.
    • If total disability is caused or contributed to by disease or disorder of the neck or back including but not limited to lumbar, thoracic or cervical spine, after a benefit period of two months, payments will only be made if the insured is under the care of a licensed specialist such as a neurologist, a neurosurgeon, a physiatrist, an orthopaedic surgeon or a rheumatologist.