Critical Illness & the Benchmark definition Challenge
By now most people have heard of “Critical Illness Insurance” an insurance benefit that protects the individual while they are still alive. This type of insurance plan pays a lump sum benefit tax-free in the event that you survive one of the covered illnesses or conditions (most plans have 20 plus covered conditions) by thirty days, in most cases.
The more serious conditions are Heart Attack, Stroke, Cancer (life threatening) Coronary bypass surgery, Kidney failure, Multiple Sclerosis and a number of other conditions.
However, the real dilemma is whether you will actually get paid should you suffer from one of the twenty plus covered conditions while your policy is in force.
Would you believe that depending on where you are when you have a heart attack, for instance, would determine when and if you get paid.?
The new standardized benchmark definitions that many of the Insurance Companies are adopting may prevent some heart attack victims with a critical illness plan from getting paid.
Let me explain why: Most Insurance Companies are adopting the definition of heart attack that uses a test called “Biochemical Markers” which, along with other factors, determine that a heart attack did happen. Some hospitals, however, use a test involving “elevations in cardiac enzymes” to determine that a heart attack did occur.