Standard and Preferred Issue Plans

Review the below information, which defines medical conditions found in the enrollment form health questions.

Note: Health questions vary based on the product being sold and not all of the medical conditions listed below will be applicable.

AIDS (HIV-Positive)

AIDS is a disease causing a deficiency within the immune system of the body. Anyone having the HIV antibody present in his or her body will eventually develop the disease. The consequence of this disease will likely be death, since there is no known cure. Death will usually occur within five to ten years once the disease manifests itself. This terminal illness should be treated as other diseases without a known cure.

Alcoholism

The moderate social use of alcohol will not affect an applicant’s insurability. Moderate would be three alcoholic drinks daily for men and two alcoholic drinks daily for women. When used to a greater degree or to the extent that the applicant’s personal life and occupation are affected (that is more than moderate drinking), the enrollment form is usually subject to a Guaranteed Issue or Installment Plan.

Alzheimer’s Disease

A degenerative brain disorder characterized by progressive memory loss and, oftentimes, a disruption in personality, behavior and/or mood. It is the most common form of dementia.

Amputation

Amputation refers to the removal of a limb necessitated by a disease.

Angina

Angina refers to chest pain caused by inadequate blood supply to the heart muscle. The coronary arteries may narrow due to atherosclerosis. This narrowing causes varying symptoms depending on the severity of the blockage. The disease may eventually cause a complete heart attack or remain asymptomatic, especially for people with limited activities that place fewer demands on the muscle. This disease is a serious condition and usually a precursor of major problems. Extensive evaluation is usually necessary to determine the severity of this health problem. Persons having no other health problems may be written Standard Issue coverage only after this condition has remained stable for three years.

Blood Disorder

Blood diseases or disorders affect the production of blood and its components, such as blood cells, hemoglobin, blood proteins and the mechanism of coagulation.

Blood Vessel Disease

See Coronary Artery Disease.

Brain Tumor

See Cancer immediately below.

Cancer (Other Than Skin)

Cancer is a general term related to any malignant neoplasm. Included in this category are tumors, carcinoma, lymphoma, melanoma and any metastasis. Surgery, radiation, chemotherapy or any combination of these methods may be used to treat tumor cells within the body. Low-grade malignancies often occur; however, without adequate medical information on the enrollment form, the underwriting department assumes that any cancer is major cancer. Major cancer is uninsurable for three years from the date of last treatment for Standard Issue policies. Standard Issue Plans may be submitted after three years; otherwise, only Guaranteed Issue or Installment Plans can be written.

Chronic Lung Disease

Chronic lung disease is a disease process that causes decreased ability of the lungs to perform their function. This could include dyspnoea, with or without chronic cough, and less than normal breathing capacity. Other names: chronic bronchitis, chronic obstructive pulmonary disease, chronic obstructive lung disease, emphysema, pulmonary fibrosis, cystic fibrosis, sleep apnea. Allergenic or seasonal asthma is not included in this category.

Cirrhosis

Cirrhosis refers to widespread disruption of normal liver structure by fibrosis and the formation of regenerative nodules that is caused by any of various chronic progressive conditions affecting the liver.

Congestive Heart Failure

Congestive heart failure refers to a condition where the heart muscle cannot adequately pump blood to meet the requirements of body tissue. It usually occurs with advanced coronary artery disease. If the applicant has been treated for or diagnosed as having congestive heart failure, it will generally require a Guaranteed Issue or Installment Plan version.

Coronary Artery Disease

Coronary artery disease is the narrowing of the coronary arteries, preventing adequate blood supply to the heart. The narrowing is usually caused by atherosclerosis to the point where the heart muscle is damaged due to lack of blood supply.

Dementia

A brain disorder associated with the development of cognitive impairments such as deterioration in memory, language skills, executive functioning and impaired reasoning. Common types of dementia include senile, vascular, Lewy Body and Alzheimer’s disease.

Diabetes and High Blood Pressure

Diabetes is a metabolic disorder causing elevated blood sugar levels. Applicants with diabetes treated with insulin and/or oral medications coupled with high blood pressure (hypertension) require Guaranteed Issue Plans.

Diagnosis

A diagnosis is the act of identifying a disease from its signs and symptoms.

Disease or Disorder of the Circulatory/Vascular System

The circulatory/vascular system includes the structures of the heart, arteries, blood vessels and lymph involved in circulating blood throughout the body. This includes applicants that have been diagnosed and/or treated for anomalies of the circulatory/vascular system, including, but not limited to: aneurysm, peripheral vascular disease, stenosis, heart failure, cardiomyopathy or coronary artery disease.

Disease, Disorder or Failure of the Kidneys

This refers to the diminished function of the kidney; may be acute and temporary, or may progress to complete loss of kidney function. Other names: renal failure, renal insufficiency, renal transplant.

Disease or Disorder of the Liver

The term “liver disease” applies to many diseases and disorders that cause the liver to function improperly or cease functioning.

Disease or Disorder of the Lungs

This applies to any disease or disorder that occurs in the lungs or that causes the lungs to not work properly. There are three main types of lung disease: airway disease, lung tissue disease and lung circulation disease.

Drug Abuse

Often involves an illicit substance (nonprescription drugs) that causes addiction, habituation or a marked change in consciousness.

Heart Attack

Myocardial infarction is typically called a heart attack. This occurs when the heart muscle suffers damage or death due to insufficient blood supply to the area. This impairment requires a Guaranteed Issue or Installment Plan for a period of three years. After this period, a Standard Issue can be considered based on the extent and severity of the injury and residual damage. Use good judgment when submitting cases with a history of MI.

Heart Condition

A heart condition refers to a medical history including open heart surgery, bypass surgery, coronary angioplasty, heart attack, angina or stroke.

Multiple Sclerosis

This is an inflammatory disease of the central nervous system in which the myelin nerve sheath is damaged. The duration of the disease is variable; some patients die a few months after onset, while the average duration is much longer. There’s no cure for the disease, but it sometimes goes into remission for long periods of time.

Paralysis

Paralysis refers to temporary or permanent loss of function due to an injury or disease. It can be complete or partial and may affect any number of limbs. Prognosis is related to the degree of adjustment (psychologically and physically) and the presence of other complications (including those to the kidneys, bones and respiratory tract, and whether the damage to the spinal cord is partial or complete).

Psychosis

Psychosis is a symptom of a mental disorder in which individuals have disturbances of such magnitude that there is a personality disintegration and loss of contact with reality. This is often found in paranoid disorders, schizophrenia and disorders that are associated with severe disruption in social functioning, which can require hospitalization when acute.

Seizures (Epilepsy)

Epilepsy is a disorder characterized by sudden, brief attacks of altered consciousness or sensory phenomena. Convulsive seizures are most common. Many seizure disorders can be controlled or reduced by the use of medication.

Stroke (Cerebrovascular Disease)

Cerebrovascular disease refers to any impairment of the brain or spinal cord resulting from a blood vessel disorder. The most common impairments in this group include stroke (also known as cerebral vascular accident) and transient ischemic attack. The latter, TIA, is often referred to as ministroke(s). Aneurysms are also included in this group. After three years, the Standard Issue Plans could be used to cover these disorders by themselves without associated residuals such as paralysis.

Systemic Lupus Erythematosus

Lupus erythematosus is a chronic multisystem inflammatory disease that may range from benign to fatal. No cure is available, but medical treatment often lessens or controls the symptoms. It may involve the joints (causing arthritis), skin, kidneys, heart, lungs, liver or nervous system. Symptoms may include fever, rash, arthritis, chest pain or abdominal pain, and it may cause liver enlargement, protein in the urine or a hemolytic anemia. Lupus generally requires a Guaranteed Issue or Installment Plan, particularly if there’s a significant major organ involvement.

Terminal Illness

Terminal illness refers to an irreversible medical condition that would normally be fatal within a two-year period. If the agent has difficulty in determining if a medical condition is terminal, they should contact TruStage Life of Canada’s customer service for guidance before taking an enrollment form.

Treatment

Canadian laws affirm that office and laboratory procedures as well as medications prescribed by, and under the supervision of, a doctor constitute treatment if rendered specifically to relieve or retard the progression of the conditions listed on the enrollment form. The general rule is that most medications and procedures commonly mentioned on the enrollment form are considered treatment. Because new techniques and new medications are continuously introduced, it’s impossible to definitively list those that constitute treatment. The best approach to completing these questions is to ask the applicant why a procedure was performed or why a medication is taken and let his answers dictate the appropriate responses to these questions.