Here are some common insurance terms. Please review your policy for specific details of your coverage.

  1. The Insured: The insured is the person who is covered by the insurance policy.  Under a Family Plan only, this would be the policyholder, his/her spouse or partner and eligible children.
  2. Pre-Existing Condition: This is a condition for which the insured has received medical advice or treatment within the past 24 months preceding the date of issue of the policy.
  3. Total Disability: Benefits are paid for Total Disability when the insured is unable to perform each of the substantial duties of their business or occupation (or usual activities if currently unemployed).
  4. Partial Disability: Benefits are paid for Partial Disability when the insured is able to perform one or more, but not all of the important duties of their normal business or occupation (or usual activities if currently unemployed).
  5. Sickness Confinement Benefit: This is paid for each day the insured is totally disabled and continually confined to bed and is required by a Medical Practitioner to be under the full time care and attention of a registered nurse.
  6. Fracture Benefit:
    • Minor Fracture: This is the breaking of the nose, teeth, ribs, fingers, thumbs or toes.
    • Major Fracture: This is the breaking of any other other bone in the body which is not a minor fracture.
  7. Family Plan: This is a plan effected by the policyholder and covers the policyholder, spouse/partner and eligible children.
  8. Policyholder: Under a Family Plan, the policyholder is the person named on the Policy Schedule to whom benefits will be made payable in the event of a claim.