Page 5 - iA Excellence -Field Underwriting Guide - Updated on July 2019

DISABILITY EXCLUSION RIDERS AND Sometimes, without being fraudulent, an applicant
MODIFICATIONS (NOTICE OF DISCREPANCY) may unwillingly omit to disclose medical, non-
When assessing disability applications, these medical or financial information, or reduce its
represent the most common method of handling a importance.
medically impaired risk. Exclusion riders are used in According to the incontestability clause of the
underwriting disability every time it is possible to contract, if a claim is submitted within two years of
do so. By excluding coverage for disability arising the policy, we are entitled to verify the medical, non-
from an existing impairment, we are able to grant medical and financial history of the insured.
insurance against disability from all other causes
instead of declining the application. If misrepresentation is found, in addition to denying
the claim, we may rescind or modify the contract
Modifications could be for:
according to the established insurability of the
— Smoker rates insured based on the new information received. It
— Different occupational class is, therefore, very important to inform your clients to
make full disclosure to the best of their knowledge
— Extending the waiting period
when answering the questions asked at the time
— Reducing the benefit period of their application and during the underwriting
— Reducing the amount applied for process.

— Offering a different “own occupation” definition
Eligibility considerations

Dealing with your client
Landed immigrants/Permanent residents
Pre-qualifying your client If you have clients who are not yet Canadian citizens,

In order to manage the expectations of your client you may be able to offer them full coverage under
and make efficient use of your time, we have added certain conditions.
five quick eligibility questions to our application (AP- Permanent residents are eligible for our fully
ALLE) on page 2: Pre-requisite for Eligibility for our underwritten disability products without any
Superior Program and Universal Loan Insurance. limitations.
Use this tool to determine the coverages that your Temporary residents, such as nannies under the
client may be eligible for. Live-In Care Giver program or newcomers with a
In addition, you should also review our list of valid work permit, may be easily insurable as well,
Automatic Denials in Appendix A before meeting subject to some limitations. In such cases, eligibility
with your client. needs to be managed by the Head Office.
Generally:
Illustrations
• If in Canada for more than three years: Most
The illustration is an important part of the application of them are insurable without any limitations,
that must be submitted with the application. Both and no proof of residency is requested.
the application and the illustration must be signed
by the applicant. Should there be a difference • If in Canada for less than three years:
between the application and the illustration, the Waiting period is 90 days, and maximum
signed illustration will be used for the underwriting benefit period is two years.
process, and a signed notice of discrepancy to the Special medical requirements, such as hepatitis
contract will be required upon delivery. screening, etc., may be required if the time of
arrival in Canada is less than one (1) year.
Misrepresentations
Fraudulent applications jeopardize our ability to
effectively maintain valuable disability coverage for
customers at competitive prices. The intent is to
protect the insurer and its policyholders from any
fraudulent activity. 5

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