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The Critical Illness plan is an insurance policy that pays out a lump sum in the event the Insured Person is diagnosed with a specified Critical Illness during the ongoing term of the policy.It provides benefits of up to NGN30,000,000 in the event the policyholder suffers a heart attack, stroke, cancer, coronary bypass, has a major organ transplant (heart, kidney, liver, bone marrow, lung, pancreas), kidney failure or falls into a coma during the term of the policy.
It provides benefits of up to NGN30,000,000 in the event the policyholder suffers a heart attack, stroke, cancer, coronary bypass, has a major organ transplant (heart, kidney, liver, bone marrow, lung, pancreas), kidney failure or falls into a coma during the term of the policy.
Features of the Critical Illness Policy
- The minimum entry age is 18, maximum entry age is 67 and the ceasing age is 70.
- The cover amount ranges between NGN500,000 to NGN30,000,000.
- The policy term is from 3 to 15 years.
- Premium payment frequency is monthly, quarterly or annually.
- An optional 10% cash back is available at the end of the policy term.
- Option to renew the policy at the end of the policy term.
- All applicants are required to fill out a medical questionnaire and a medical test is required for cover above NGN10,000,000 as well as applicants above 46 years old.
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Questions and Answers.
What is underwriting?
Underwriting allows us to balance the premium you pay with the possibility of a claim. Without it, we would charge everyone with the same age, gender and cover, the same premium irrespective of their health. To ensure that you pay the right premium we assess each person individually by considering your health (morbidity). This means we may ask you for personal medical and financial information, but be rest assured that we will treat all your information as confidential.
What underwriting decisions can be made?
Our aim is to offer you the standard premium rate. If we are unable to do this, we will give you an alternative (non-standard terms). When underwriting, we consider your health and lifestyle against the ‘norm’ to ensure that you enjoy cover that
is commensurate to the premium rates.
Is the policy right for me?
The policy is suitable for you if you are looking for affordable cover to provide financial protection for yourself and your family should you fall critically ill.
What are the benefits provided by the policy?
a) Lump sum cover amount
You decide how much cover you would like when you apply for the policy. The amount of your chosen cover will be shown on your Certificate of Policy Commencement, which will be sent to you when we receive your first premium and issue your policy. Please note that you may increase or decrease your cover voluntarily at any time, but this change is limited to once a year, subject to the minimum and maximum limits.
b) Cashback option
If you select the cash back option indicated in the Certificate of Policy Commencement, a cash back benefit equal to 10% of the total Premiums paid will be paid to you at the end of the Policy Term. The benefit becomes available, provided that no claim has been submitted and the Policy has not lapsed. Where the cash back option is selected, the premium payable will be marginally higher than where the cash back option is not selected. Please note that your Policy will never have a surrender
value. This means that we will not pay any Premiums, cover amount or cash back amount to you if you surrender value. This means that we will not pay any Premiums, cover amount or cash back amount to you if you surrender your policy before the end of your chosen Term
Who may be covered by the policy?
The policy can cover any individual subject to age limits. The person who is covered by the policy is known as the Insured Person. You may buy the policy and also be the Insured Person. Subject to certain conditions, and provided that they have
given consent, you may also make someone else the Insured Person. The Policyholder (the person who contracts with Old Mutual and is responsible for paying the Premiums) and any Insured Person must be at least 18 years old. The maximum entry age of the Insured Person for the Plan is 67 years old and will end when the Insured Person reaches the age of 70.
Who are the beneficiaries of the policy?
Next of Kin
The Next of Kin is/are the person(s) nominated by the Policyholder/Insured Person to receive the proceeds in the event of the insured event occurring. It is unlikely that the Insured Person would want to nominate a Beneficiary for these “survival benefits”, however, up to 5 beneficiaries may be nominated. The Insured Person may revoke or change the beneficiary at any time during the term of the policy. The Policyholder may only nominate Beneficiaries of Proceeds if the Policyholder and the Insured Person are the same person.
If there is no valid beneficiary nomination, the benefit payment will be made to the Insured Person (or his or her estate where relevant).
Beneficiaries of Ownership
If the Policyholder and the Insured Person is not the same Person, the Policyholder may nominate a Beneficiary for Ownership to become the new Policyholder and as a result the new premium payer in the case of the death of the Policyholder.
How long will my policy last?
You may choose the term which suits your needs. There is a choice of a term between 3 to 15 years.Your policy will end if:
Your policy reaches the end of the policy term.
- We pay a claim.
- You stop paying your Premiums before the end of the policy term and use up all 3 reinstatement periods.
- When the Life Assured attains the age of 70.
You may choose to renew your policy at the end of the Term.This renewal of your policy is subject to the Insured Person meeting the minimum requirements.
How much does the policy cost?
Our Financial Advisers will provide you with a quotation which will tell you how much the Policy will cost you. The quotation will depend on:
- your personal circumstances – for example your age, gender and health status;
- the amount of critical illness cover you select;
- whether you select the cashback option;
- how long you want the cover to last.
How regularly will Premiums have to be paid?
You will be required to pay Premiums on a regular basis. You may choose to pay your Premiums in advance on a monthly, quarterly, half-yearly or annual basis. Premiums will be payable on the first day of the chosen Premium payment period whilst the policy is in force.
Does the Insured Person or I have to go for medical tests or complete medical questionnaires as part of my application?
Medical tests will only be required for the Insured Person, depending on the level of cover you choose. However a medical questionnaire is part of the application irrespective of which level of cover is selected.
Can I change my policy after it has started?
Yes. You may increase your cover provided you meet Old Mutual’s requirements for doing so. Please talk to a Financial Adviser to find out more about the requirements. Increases to your cover may require further medical testing. You may also reduce the amount of the cover, as long as the Premium does not drop to below our minimum Premium at the time. Speak with an Old Mutual adviser or visit an Old Mutual office when you plan to increase your cover.
Can my Premium payments change in the future?
Yes, if you have requested either a voluntary increase or decrease to your Premium and cover amount at any time. We may review your policy at any time, and if the Premiums you are paying at that time are not enough to maintain the current level of cover, you may either:
- continue paying the same Premiums and reduce the level of cover, or
- increase your Premiums to maintain the same level of cover.
Our aim is to efficiently manage your policy so that it remains affordable to you. Therefore, increases to your Premium will only happen in exceptional circumstances, for example a change in laws, adverse claims experience or prolonged poor economic conditions.
What will happen if I stop paying Premiums?
If there is non-payment of Premiums by the Premium Due Date, the benefits provided herein shall cease on such a date and there shall be no cover provided within that period, unless and until the Premium is received. The next Premium has to be received within 6 months for us to reinstate your cover and we will only allow this three times for the duration of the contract term thereafter it will lapse. For the avoidance of doubt, if a claim is made during a period of non-receipt of an outstanding Premium, the No Premium, No Cover rule shall apply.
May I change my mind and cancel my policy?
Yes, you may. You have 30 days from the date of issue of your policy certificate to write and ask us to cancel your policy. This is called the cool-off period. If you decide to cancel your policy within the cool-off period we will refund any Premiums you have paid. If you decide to cancel your policy after the cool-off period, we will not refund any Premiums that you may have paid (except Premiums paid more than one month in advance). Your cover will continue until the due date of your next Premium after which it will stop.If payment is made by bank mandate or salary deduction we will instruct your payment channel to stop making Premium deductions. Any Premiums deducted after you have cancelled your policy will be paid back to you. You may cancel your policy before receiving any documents by contacting us.
How do I make a claim?
You may make a claim at any Old Mutual Branch. Old Mutual will require proof that the Insured Person has suffered a Critical Illness. We will specify our requirements, which may include evidence that is not in the possession of the person entitled to receive the benefit. To initiate a claim under the Policy, the following documents are required:
- The completed claim form
- A certified copy of the ID of the claimant
- Proof of Address
- Comprehensive specialist/doctor’s report or completed medical questionnaire
- Account details for the payment of the Benefit Amount
- The proof of change of name (where applicable)
When will the policy not pay out the cover amount?
The Benefit Amount will not be payable if the Insured Event occurs as a result of:
- A condition for which the Insured Person has received or should reasonably have received medical advice, a diagnosis or treatment during the two (2) years before the cover began, if the Insured Event occurs within two (2) years after the cover began.
- Intentional self-inflicted injuries and/or attempted suicide.
- An accident that occurred when the Insured Person was under the influence of intoxicating liquor or of a drug (unless administered under the orders of a qualified medical practitioner).
- Nuclear activity or radioactivity.
- Natural disasters such as floods and earthquakes.
- Any violation of criminal law by the Insured Person.
- Willful exposure to danger by the Insured Person except in an attempt to save human life.
- War, enemy hostilities, commotion, insurrection, revolution, military seizure of power or the usurping of power or any act of any person acting on behalf of or in connection with any organisation with activities directed towards the overthrow by force of the government de jure or de facto or to the influencing of terrorism or violence.
Additional exclusions may be applied on a case-by-case basis depending on the occupation or leisure pursuits of prospective applicants. Individual loadings may be applied in such instances.
What about taxation?
The tax treatment of any benefits taken from this Policy will depend on the personal circumstances of the claimant, including their country of residence. Please consult your relevant financial professional if you are in any doubt as to the extent to which you may be liable to any tax under this Policy. If the Policy is held in trust, then different taxation rules may apply. Old Mutual is unable to provide individual tax guidance and recommends that you always seek professional tax advice.