CLHIA-ACCAP

15 Accidental death and dismemberment benefits provide a lump-sum payment if the insured person dies as a result of an accident. Usually, the same sum is paid on the loss of both hands, both feet, one hand and one foot or the sight of both eyes due to accidental bodily injury. Half the amount may be payable for the loss of a single hand or foot. This coverage is available on a group or individual basis for a variety of timeframes and activities, ranging from scheduled aircraft coverage for the duration of a trip to full 24-hour coverage for all types of accidents. At the end of 2014, some 96,000 group contracts in Canada covered 18.8 million people. An additional 2.2 million Canadians were covered under individual personal accident contracts. Many life insurance policies also include accidental death benefits. Extended health care plans reimburse the insured person for a variety of hospital and medical expenses not covered by provincial government plans. They typically pay for extra charges for semi-private or private hospital rooms, prescription drugs, special duty nursing and other paramedical services, ambulance services, crutches, artificial limbs, prostheses and medical appliances, wheelchair rental and vision care. Frequently, the individual is responsible for a small dollar amount, called the deductible, and a percentage of the costs, called coinsurance. At the end of 2014, 124,000 group contracts covered nearly 10.7 million workers and their 14.3 million dependents for extended health care benefits. Beyond this, group contracts also provided 618,000 workers and dependents with supplementary hospital expense insurance only, and 772,000 workers and their dependents with prescription drug expense insurance only. Individually purchased contracts covered more than 1.9 million people for extended health care and an additional 106,000 for supplementary hospital care benefits. With the ongoing modifications to provincial funding for health care programs, private insurers have designed new benefits and expanded the existing benefits offered under health care plans in order to meet the needs of many Canadians. For example, coverages under travel health insurance were redesigned to fill the void created by provincial health plan cutbacks. During 2014, in addition to travel health coverage included as part of extended health care plans, over 9.7 million Canadians were also provided with travel health protection as a separate benefit. Dental plans reimburse a variety of expenses depending on the contracts, but coverage typically helps to pay for preventive and maintenance services and root canals, periodontal cleanings and scalings. It may also extend to major restorative procedures, such as crowns, bridges, dentures, braces and orthodontic services. By the end of 2014, 100,000 group-insured contracts provided nearly 15.2 million workers and dependents with dental care benefits. An additional 444,000 were covered under individual policies. Dental coverage has grown steadily over the years. Critical illness insurance is a product introduced to meet the evolving health care needs of Canadians. These policies pay a lump sum if the policyholder is diagnosed with a life altering illness (such as cancer, heart attack, stroke, Multiple Sclerosis or Parkinson's Disease) as listed in the policy. At the end of 2014, 1.7 million Canadians were covered under critical illness plans on either a group or an individual basis. Long-term care insurance is a product that provides financial support for people who become unable to care for themselves because of a chronic illness or disability. Services may be provided on an inpatient (e.g., rehabilitation facility, chronic care facility, nursing home, etc.), outpatient, or at-home basis. At the end of 2014, 348,000 Canadians were covered under long-term care insurance plans, with almost 75 per cent through group arrangements.

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