CHILD OASIS AT A GLANCE - INDIVIDUAL CRITICAL ILLNESS INSURANCE
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Ind i vi d u a l C ri t ica l I l l n e ss Insuran ce
Child Oasis
At a G l an c e
Table of Contents Child Oasis..........................................................................2 Built-in features.................................................................3 Basic policy...............................................................................................3 Benefit type.............................................................................................3 Coverage period......................................................................................3 Premium payment period.......................................................................3 Critical condition benefit........................................................................3 Critical conditions....................................................................................4 Survival period.......................................................................................11 Supplementary benefit.........................................................................12 Advance payment for Coronary Artery Bypass Surgery......................12 Policy extension.....................................................................................13 Non-cancellable.....................................................................................13 Conversion.............................................................................................13 Optional benefit riders....................................................14 Return of Premium at Expiry................................................................14 Return of Premium at Death................................................................16 Exceptions........................................................................17 General exceptions................................................................................17 Exception for certain critical conditions..............................................18 Return of Premium at Expiry................................................................19 Return of Premium at Death................................................................19 Termination......................................................................20 Medical referral service...................................................21 Counselling & support services.......................................22 Important information....................................................23
Child Oasis
Child Oasis™ is designed to provide families with the financial resources that
will help support the recovery and care of a child in the event of a critical
condition and to help ensure their child’s future insurability.
This brochure provides a brief description of certain important features of
the Child Oasis plan and the optional benefit riders which can be added.
For purposes of this brochure, references to "you" and "your" are to be read
as references to the owner.
2
Built-in features
Basic policy
The basic policy provides the owner with a one-time lump-sum benefit if the
insured has a critical condition which meets one of the definitions set out in
the policy and the survival period has been satisfied. The critical condition
must be diagnosed in writing by a physician who practices medicine in
Canada, the United States or other approved jurisdictions.
Benefit type
The benefit type is a level critical condition benefit, where the benefit
amount will remain the same throughout the coverage period.
Coverage period
The coverage period is to age 25.
A conversion option is available on the policy expiry date (see the Conversion
section of this brochure for more details).
Premium payment period
Premium is payable to age 25.
Critical condition benefit
The critical condition benefit is the benefit amount purchased.
3
Built-in features (cont.)
Critical conditions
The basic policy covers the following 24 critical conditions, of which 5 are
childhood related:
• Aortic Surgery • Heart Valve Replacement
• Aplastic Anaemia • Kidney Failure
• Bacterial Meningitis • Life-Threatening Cancer
• Benign Brain Tumour • Loss of Limbs
• Blindness • Loss of Speech
• Cerebral Palsy* • Major Organ Failure on Waiting List
• Coma • Major Organ Transplant
• Congenital Heart Disease* • Muscular Dystrophy*
• Coronary Artery Bypass Surgery • Paralysis
• Cystic Fibrosis* • Severe Burns
• Deafness • Stroke
• Heart Attack • Type 1 Diabetes Mellitus*
* childhood-related critical condition
4
Built-in features (cont.)
Critical conditions (cont.)
For the purposes of the policy:
Aortic Surgery means the undergoing of surgery for disease of the aorta
requiring excision and surgical replacement of the diseased aorta with a
graft. Aorta refers to the thoracic and abdominal aorta but not its branches.
Aplastic Anaemia means chronic persistent bone marrow failure, confirmed
by biopsy, which results in anaemia, neutropenia and thrombocytopenia
requiring blood product transfusion, and treatment with at least 1 of
the following:
• marrow stimulating agents;
• immunosuppressive agents; or
• bone marrow transplantation.
Bacterial Meningitis means meningitis, confirmed by cerebrospinal fluid
showing growth of pathogenic bacteria in culture, resulting in neurological
deficit documented for at least 90 days from the date of diagnosis.
Exception: No benefit will be payable under this critical condition for
viral meningitis.
Benign Brain Tumour means a non-malignant tumour located in the cranial
vault and limited to the brain, meninges, cranial nerves or pituitary gland.
The tumour must require surgery or radiation treatment or cause irreversible
objective neurological deficits.
Exception: No benefit will be payable under this critical condition for
pituitary adenomas less than 10 mm.
Benefits for Benign Brain Tumour are subject to the Exception for certain
critical conditions provision as explained later in this brochure.
Blindness means the total and irreversible loss of vision in both eyes,
evidenced by:
• the corrected visual acuity being 20/200 or less in both eyes; or
• the field of vision being less than 20 degrees in both eyes.
Cerebral Palsy means a non-progressive clinical disorder characterized by
spasticity or incoordination of movements.
5
Built-in features (cont.)
Critical conditions (cont.)
Coma means a state of unconsciousness with no reaction to external stimuli
or response to internal needs for a continuous period of at least 96 hours,
and for which period the Glasgow coma score must be 4 or less.
Exception: No benefit will be payable under this critical condition for
medically induced coma.
Congenital Heart Disease means any one of the following heart defects
described below:
• total anomalous pulmonary venous connection;
• transposition of the great arteries;
• atresia of any heart valve;
• single ventricle;
• hypoplastic left heart syndrome;
• truncus arteriosus;
• tetralogy of Fallot;
• Eisenmenger syndrome;
• Ebstein’s anomaly; and
• double outlet left or right ventricle.
The following heart defects also satisfy the definition of Congenital Heart
Disease, if surgery is performed for correction of the heart defect:
• coarctation of the aorta;
• pulmonary stenosis;
• aortic stenosis;
• discrete subvalvular aortic stenosis;
• ventricular septal defect; and
• atrial septal defect.
The diagnosis must be corroborated by cardiac imaging.
For greater certainty, non-surgical or trans-catheter techniques such as
balloon valvuloplasty and percutaneous atrial septal defect closure do not
satisfy the definition of surgery.
6
Built-in features (cont.)
Critical conditions (cont.)
Coronary Artery Bypass Surgery means the undergoing of heart surgery
to correct narrowing or blockage of 1 or more coronary arteries with
bypass grafts.
For greater certainty, non-surgical or trans-catheter techniques such as
balloon angioplasty or laser relief of an obstruction do not satisfy the
definition of surgery.
Cystic Fibrosis means a condition resulting in chronic lung disease or
pancreatic insufficiency. The diagnosis must be confirmed by a positive
sweat test.
Deafness means the total and irreversible loss of hearing in both ears, with
an auditory threshold of 90 decibels or greater within the speech threshold
of 500 to 3,000 hertz.
Heart Attack means the death of heart muscle due to obstruction of
blood flow, that results in the rise and fall of biochemical cardiac markers
to levels considered diagnostic of myocardial infarction, with at least
1 of the following:
• heart attack symptoms;
• new electrocardiogram (ECG) changes consistent with a heart attack; or
• development of new Q waves during or immediately following an
intra-arterial cardiac procedure including, but not limited to, coronary
angiography and coronary angioplasty.
Exception: No benefit will be payable under this critical condition for
elevated biochemical cardiac markers after an intra-arterial cardiac
procedure including, but not limited to, coronary angiography and coronary
angioplasty, in the absence of new Q waves.
For greater certainty, ECG changes suggesting a prior myocardial infarction
does not satisfy the above definition of Heart Attack.
7
Built-in features (cont.)
Critical conditions (cont.)
Heart Valve Replacement means the undergoing of surgery to replace any
heart valve with either a natural or mechanical valve.
For greater certainty, heart valve repair does not satisfy the definition of
Heart Valve Replacement.
Kidney Failure means chronic irreversible failure of both kidneys to function,
as a result of which regular haemodialysis, peritoneal dialysis or renal
transplantation is initiated.
Life-Threatening Cancer means a tumour characterized by the uncontrolled
growth and spread of malignant cells and the invasion of tissue.
Exception: No benefit will be payable under this critical condition for the
following forms of cancer:
• carcinoma in situ;
• Stage 1A malignant melanoma (melanoma less than or equal to 1.0 mm
in thickness, not ulcerated and without Clark level IV or level V invasion);
• any non-melanoma skin cancer that has not metastasized; or
• Stage A (T1a or T1b) prostate cancer.
Benefits for Life-Threatening Cancer are subject to the Exception for certain
critical conditions provision as explained later in this brochure.
8Built-in features (cont.)
Critical conditions (cont.)
Loss of Limbs means the complete severance of 2 or more limbs at or above
the wrist or ankle joint as the result of an accident or medically required
amputation.
Loss of Speech means the total and irreversible loss of the ability to speak
as the result of physical injury or disease for a period of at least 180 days.
Exception: No benefit will be payable under this critical condition for all
psychiatric related causes.
Major Organ Failure on Waiting List means irreversible failure of the heart,
both lungs, liver, both kidneys or bone marrow, and transplantation must be
medically necessary. To qualify under Major Organ Failure on Waiting List,
the insured must become enrolled as the recipient in a recognized transplant
centre in Canada or the United States that performs the required form of
transplant. For the purposes of the survival period, the date of the critical
condition is the date of the insured’s enrollment in the transplant centre.
Major Organ Transplant means irreversible failure of the heart, both lungs,
liver, both kidneys or bone marrow, and transplantation must be medically
necessary. To qualify under Major Organ Transplant, the insured must
undergo a transplantation procedure as the recipient of a heart, lung, liver,
kidney or bone marrow, and limited to these entities.
9Built-in features (cont.)
Critical conditions (cont.)
Muscular Dystrophy means dystrophy of skeletal muscles confirmed by
electromyography and muscle biopsy.
For greater certainty, spinal muscular atrophy does not satisfy the definition
of Muscular Dystrophy.
Paralysis means total loss of muscle function of 2 or more limbs as a result of
injury or disease to the nerve supply of those limbs, for a period of at least
90 days following the precipitating event.
Severe Burns mean third degree burns over at least 20% of the
body surface.
Stroke means an acute cerebrovascular event caused by intra-cranial
thrombosis or haemorrhage, or embolism from an extra-cranial source, with:
• acute onset of new neurological symptoms, and
• new objective neurological deficits on clinical examination,
persisting for more than 30 days following the date of the critical condition.
These new symptoms and deficits must be corroborated by diagnostic
imaging testing.
Exception: No benefit will be payable under this critical condition for:
• transient ischaemic attacks; or
• intracerebral vascular events due to trauma.
For greater certainty, lacunar infarcts which do not have the neurological
symptoms and deficits set out above, persisting for more than 30 days, do
not satisfy the definition of Stroke.
Type 1 Diabetes Mellitus means type 1 diabetes mellitus, characterized by
insulin deficiency and continuous dependence on exogenous insulin for
survival.
The survival period for this critical condition is 90 days from the date of
diagnosis, during which there must be evidence of dependence on insulin
for survival.
10Built-in features (cont.)
Survival period
The survival period is the number of days the insured must be alive and not
have experienced irreversible cessation of all functions of the brain after the
date the written diagnosis is made. The survival period is:
• 90 days for Bacterial Meningitis, Paralysis and Type 1 Diabetes Mellitus;
• 180 days for Loss of Speech; and
• 30 days for all other critical conditions.
The diagnosis must satisfy the definition of the critical condition.
11Built-in features (cont.)
Supplementary benefit
This benefit provides the owner with a one-time lump-sum benefit amount
for one occurrence of either, but not both, of the following events:
• If a written diagnosis is received, confirmed by biopsy, that the insured
has one of the following forms of cancer:
• malignant melanoma to a depth of 1.0 mm or less, excluding
malignant melanoma in situ;
• ductal carcinoma in situ of the breast; or
• early prostate cancer diagnosed as T1a or T1b.
• If the insured undergoes coronary angioplasty which means an
interventional procedure to unblock or widen a coronary artery that
supplies blood to the heart to allow an uninterrupted flow of blood.
The supplementary benefit will be the lesser of:
• 10% of the critical condition benefit amount then in effect; and
• $25,000.
The policy does not terminate as a result of the payment of the
supplementary benefit and the critical condition benefit will not be
reduced by the amount of the payment.
Advance payment for Coronary Artery Bypass Surgery
Great-West will pay the owner an advance on the critical condition benefit
if the insured has Coronary Artery Bypass Surgery. The advance payment
amount will be the lesser of:
• 10% of the critical condition benefit amount then in effect; and
• $10,000.
The advance payment will become payable on the date the surgery
is performed.
The critical condition benefit will be reduced by the amount of this advance
payment. The balance of the critical condition benefit will be paid if you
satisfy the survival period. The advance will not have to be repaid if the
insured does not survive the survival period.
12Built-in features (cont.)
Policy extension
If the coverage period ends during the survival period, the policy will
continue in force until the earlier of:
• the date of the insured’s death; and
• the date the critical condition benefit becomes payable,
unless the policy has already been terminated under the provisions of
the policy.
Non-cancellable
While the policy is in force, Great-West cannot change the policy, raise the
premium or terminate the policy other than as explained under the heading
Termination in this brochure.
Conversion
The policy expires on the insured’s 25th birthday. Two months prior to the
policy expiry date, the owner may apply to convert all or a portion of the
benefit amount on the policy expiry date, without proof that the insured is
insurable, into a critical illness insurance policy of a plan type then offered
by Great-West and made available for conversion. If no other plan type is
made available by Great-West at the time of conversion, we will make a plan
available that will provide coverage to the insured’s 75th birthday.
The benefit amount for the new policy will be subject to any minimum and
maximum limits under Great-West’s rules then in effect. The premium for the
new policy will be based on the insured’s age 25 and Great-West’s rules and
rates then in effect. A smoker declaration will be required.
If a return of premium rider is attached to the Child Oasis policy at the
time of conversion, the premium paid for the Child Oasis policy will not be
included in the return of premium benefit calculation for the new policy.
13Optional benefit riders
Return of Premium at Expiry
Provides for the return of the eligible premium paid for the policy if the
policy is in force on the insured’s 25th birthday.
The return of premium at expiry benefit will be the eligible premium paid
for the policy from the date the Return of Premium at Expiry Rider was
added to the policy to the insured's 25th birthday multiplied by the
appropriate percentage in the table below.
Insured’s nearest age at effective date of the rider % of premium
10 and under 100%
11 90%
12 80%
13 70%
14 60%
15 50%
14Optional benefit riders (cont.)
Return of Premium at Expiry (cont.)
To be eligible for the return of premium benefit, the insured must be living
on the policy expiry date and not have experienced irreversible cessation of
all functions of the brain.
For purposes of determining the return of premium benefit, premium is the
sum of the policy fee, premium for the benefit amount and any optional
benefit rider(s), and any premium ratings. It will not include any interest, any
additional fees or any premium waived by Great-West.
If the benefit amount is reduced or an optional benefit rider is removed, the
return of premium benefit will be reduced accordingly.
Reinstatement — the Return of Premium at Expiry optional benefit rider will
not be available for reinstatement if the rider or the policy is terminated for
any reason (such as the policy lapsed due to non-payment of premium).
15Optional benefit riders (cont.)
Return of Premium at Death
Provides for the return of the eligible premium paid for the policy if the
insured dies from any cause.
The return of premium benefit will be the eligible premium paid for the
policy from the date the Return of Premium at Death Rider was added to the
policy to the date of the insured’s death.
For purposes of determining the return of premium benefit, premium is the
sum of the policy fee, premium for the benefit amount and any optional
benefit rider(s), and any premium ratings. It will not include any interest, any
additional fees or any premium waived by Great-West.
If the benefit amount is reduced or an optional benefit rider is removed, the
return of premium benefit will be reduced accordingly.
Reinstatement — the Return of Premium at Death optional benefit rider will
not be available for reinstatement if the rider or the policy is terminated for
any reason (such as the policy lapsed due to non-payment of premium).
16Exceptions
General exceptions
Benefits are not payable under the policy where a critical condition is
contributed to or caused by:
• intentionally self-inflicted injury;
• attempt at suicide, while the insured is sane or insane;
• committing or attempting to commit an assault, battery or criminal
offence, whether or not the insured is charged with a criminal offence;
• operating a motorized vehicle while the concentration of alcohol in
100 millilitres of blood exceeds 80 milligrams;
• the use of any drug, poisonous substance, intoxicant, or narcotic,
unless prescribed for the insured by a licensed physician and taken in
accordance with directions given by the physician;
• war and any hazard arising from war; or
• intentional injury inflicted by you or a person who stands to gain
directly or indirectly from any benefit otherwise payable under
the policy.
17Exceptions (cont.)
Exception for certain critical conditions
No benefit will be payable under Life-Threatening Cancer, Benign Brain
Tumour, or any forms of cancer set out in the Supplementary Benefit section
of this brochure if, within the first 90 days following the later of:
• the benefit effective date; or
• the last date of reinstatement of the policy,
the insured has any of the following:
• signs, symptoms or investigations that lead to a diagnosis of cancer
(covered or excluded under the policy), or Benign Brain Tumour,
regardless of when the diagnosis is made; or
• a diagnosis of cancer (covered or excluded under the policy) or
Benign Brain Tumour.
This medical information as described above must be reported to
Great-West within 6 months of the date of diagnosis. If this information
is not provided, Great-West has the right to deny any claim for cancer or
Benign Brain Tumour or, any critical condition caused by any cancer or
Benign Brain Tumour or its treatment.
Upon receipt, Great-West will provide confirmation to you that the
Exception for Certain Critical Conditions provision applies. You may, by
written request, elect to maintain the policy in force provided the written
request is received by Great-West within 30 days of the date of the
confirmation to you. Otherwise, the policy will terminate and any premium
paid from the benefit effective date or the last date of reinstatement of the
policy will be refunded.
If you elect to maintain the policy in force, benefits are not payable under
the policy for Life-Threatening Cancer, Benign Brain Tumour or any forms
of cancer set out in the Supplementary Benefit provision, or any other
critical condition which is contributed to or caused by any type of cancer or
Benign Brain Tumour.
In all other respects, your rights and the rights of Great-West will remain
the same under the policy.
18Exceptions (cont.)
Return of Premium at Expiry
The return of premium at expiry benefit will not be payable if the critical
condition benefit or any other benefit that results in the termination of the
policy is payable.
Return of Premium at Death
The return of premium at death benefit will not be payable if the critical
condition benefit or any other benefit that results in the termination of
the policy is payable.
19Termination
The policy will terminate on the earliest of:
• the date the critical condition benefit becomes payable;
• the date the policy is terminated for the reason explained under the
heading "Exception for certain critical conditions" in the Exceptions
section of this brochure;
• the date on which Great-West receives a written request from you to
terminate the policy;
• the date of the insured’s death; and
• the policy expiry date, unless the policy has been extended for the
reason explained under the heading "Policy extension" of this brochure,
unless the policy has already been terminated under the provisions of
the policy.
If the policy terminates for any reason above, the portion of any premium
paid for any complete months remaining in the premium period will
be refunded.
20Medical referral service
from Best Doctors, Inc.
Make an informed health care decision.
If a claim is submitted for a critical condition covered under a Child Oasis
policy, Best Doctors, Inc. may be contacted. Access to the following services
provided by Best Doctors® will be available:
• InterConsultation™ — provides an in-depth review of the insured’s
medical records, personalized medical evaluation and treatment
recommendations from specialists affiliated with medical institutions
throughout the world.
• FindBestDoc™ — provides the names and professional profiles of
up to three top surgeons or other specialists based on the insured’s
geographic preference, who have been identified by other doctors as
the “best” for treating the insured’s condition.
• FindBestCare® — provides assistance with medical appointments and
monitoring of the treatment process to help ensure the insured’s
medical priorities are met.
For all of these services, access to a Best Doctors Personal Advocate will be
provided. The Personal Advocate will be the liaison with the physicians who
are reviewing the insured’s case, keeping the claimant informed of the
progress and providing assistance related to the above services.
Helping you at a critical time in your life.
The Great-West Life Assurance Company is not obligated to provide the services of Best Doctors,
Inc. described above and may change or cancel access to these services at any time without notice.
21Counselling & support services
from Shepell•fgi
How will you and your family cope with your critical illness?
If a claim is submitted for a critical condition covered under a Child Oasis
policy, Shepell•fgi™ may be contacted. For up to one year after diagnosis,
access will be available to:
• Professional counselling services — confidential support and assistance
from skilled counsellors to assist with personal or emotional issues.
Includes up to 12 sessions for the insured and immediate family
members.
• Child to elder care resources — community resource referrals for any
child care, elder care or parenting concerns one may face when dealing
with a critical illness or condition.
• Legal and financial consultation — professional financial advice to help
with day-to-day budgeting given possible changes in employment or
financial situation, as well as general legal consultation on wills, trusts,
estate planning or any related legal issues.
• Registered dieticians — information from registered dieticians to help
answer questions about changes to the diet that may be required as a
result of the insured’s condition.
• Online information library — a convenient reference source for
personal, family and healthy lifestyle information from a website loaded
with resources, fact sheets, articles and links to information that may be
of help to you and your family.
• Homecare resources — homecare referrals are available to assist should
post-operative care or help with general home care be required.
• Smoking cessation — support and guidance for the insured through a
smoking cessation program.
• Online stress management — internet based, self-paced, interactive
program to help deal with the symptoms and management of stress.
The Great-West Life Assurance Company is not obligated to provide the services of Shepell•fgi
described above and may change or cancel access to these services without notice.
22Important information
Child Oasis contains many valuable features and benefits which are
described in greater detail in the Summary of Policy Benefits to be
delivered with any policy issued.
We recommend owners read their policy carefully upon delivery as it
contains important definitions and exceptions. This brochure is not and
does not form a part of any contract. In the event of any inconsistency
between the information contained in this document and the terms and
conditions contained in the policy, the terms and conditions in the policy
will prevail.
Great-West's understanding of current taxation legislation as it applies to
critical illness insurance (CI) is that the lump-sum CI benefits are not taxable
provided the policy is an accident and sickness policy for tax purposes.
The Canada Revenue Agency (CRA) generally accepts that CI policies
providing no Return of Premium (ROP) benefits are accident and sickness
policies. The CRA has not provided its view regarding the tax treatment of
CI policies containing ROP benefits. The taxation of optional ROP benefits
is subject to interpretation by the CRA.
The tax information provided above is for general information only. It is
not to be relied upon as providing legal or tax advice. You should consult
with your professional legal and/or tax advisor about your particular
circumstances.
The Great-West Life Assurance Company is not obligated to provide the
services of Best Doctors, Inc. or Shepell•fgi described in this brochure and
may change or cancel access to these services at any time without notice.
Best Doctors and Shepell•fgi will not charge for the services they provide.
The costs of any travel, lodging and medical treatment are not part of
the FindBestCare service provided by Best Doctors. Provision of this
service is conditional on a demonstrated ability to pay for all such costs.
We recommend that you inform the insured’s physician that these services
are available.
The critical illness or condition definitions in the Child Oasis contract may
be more restrictive than those for which Best Doctors or Shepell•fgi provide
services. These services may be provided even though the insured may not
be entitled to benefits under the Child Oasis policy. Any representations or
warranties concerning these services are those of Best Doctors or Shepell•fgi
and not Great-West.
23About Great-West
At Great-West, we take pride in our history of serving the financial security
needs of Canadians. For more than 100 years, we have helped our clients
develop their financial security plans.
With over 65 years’ experience in the disability insurance market and more
than 100 years’ experience in the life insurance market, Great-West has
established a solid reputation for providing quality products and services.
Great-West is a leading provider of living benefits for Canadians, based on
insurance in force and new premium income.
For current information on Great-West’s ratings and financial strength, see
the Corporate Information section on www.greatwestlife.com.
For more information about how critical illness insurance
may fit your needs, ask your representative for an illustration.
24Best Doctors, InterConsultation, FindBestDoc and FindBestCare are trademarks or registered trademarks of Best Doctors, Inc. in the United States and other countries.
Shepell•fgi is a trademark of HRCO Inc.
Great-West Life and the key design and Child Oasis are trademarks of The Great-West Life Assurance Company.
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