Family Accident Reimbursement Plan

Accident Insurance + Critical Illness Insurance
Only $39.95/month for the whole family

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Introducing a comprehensive group accident insurance plan with a Critical Illness Insurance component, designed for the whole family.

The Family Accident Reimbursement Plan is ideal for supplementing costs not covered by your provincial health insurance or existing employer extended health and dental plans. Regardless of the size of your family, all eligible family members can be insured under one set monthly rate of $39.95.

Your coverage also includes a Critical Illness Insurance component, which pays out a lump-sum amount that you can spend however you see fit. That’s one less thing to worry about while you or someone in your family recovers from a serious illness.

Key Benefits

Accidental Insurance Benefits

Accidental Insurance Benefits are payable if the loss, treatment required, or expenses incurred are due to injury caused by an accident.

  • Permanent Total Disability Benefit of $100,000
  • Accidental Death Benefit of $20,000

Expense Reimbursement Benefits

  • If a Dependent Child requires multiple dental treatments due to an accident, the Dependent Child is eligible for coverage for those treatments within 7 years after the accident occurs.
  • Full hospital services coverage (including hospital room and other necessary hospital services such as a registered nurse, wheelchairs, casts and prescription drugs)
  • Coverage for select medical treatments by a physiotherapist, athletic therapist, registered massage therapist, chiropractor or osteopath
  • Funeral expense benefit maximum of $5,000

NOTE: Your Family Accident Reimbursement Plan coverage will be secondary to any other existing benefits from a primary insurer such as your Provincial Health Coverage or employer benefits. Any benefit payouts under your policy will be coordinated with your primary insurers and plans so that the total benefits paid out will not exceed the actual loss incurred.

Critical Illness Insurance Benefits

  • Critical Illness Insurance provides a tax-free, one-time lump-sum payment to spend any way you need
  • 4-illnesses covered for all insureds:
    • Cancer (Life-Threatening)
    • Coronary Artery Bypass Surgery
    • Heart Attack
    • Stroke

  • 6 child-specific conditions covered for Dependent Children only:
    • Cerebral Palsy
    • Down’s Syndrome
    • Congenital Heart Disease
    • Muscular Dystrophy
    • Cystic Fibrosis
    • Type 1 Diabetes

Full Benefits Listing

For all benefits except Critical Illness, the following benefit amounts are payable if the loss, treatment required or expenses incurred are due to injury caused by an accident and independent of all other causes. In reference to the Critical Illness Insurance benefit, you must be diagnosed with the covered critical illness after the effective date of your coverage.

Once your application is approved, an Insurance Benefits Summary with full coverage details will be provided with your certificate.

View Benefits Summary

Important Things To Note

The Family Accident Reimbursement Plan is designed to include an Insured Adult, their Spouse and any number of Dependent Children qualifying under the eligibility definitions stated below.

Adult is defined as the parent or legal guardian of a Dependent Child who is attending a school within an eligible school board. At the time of application, the Insured Adult must be a permanent resident of Canada, under 65 and have Provincial Health Coverage.

Spouse is defined as the legal or common-law spouse of an Insured Adult. At the time of the application, the Spouse must be a permanent resident of Canada, under 65 and have Provincial Health Coverage. Only one individual will qualify as a Spouse under the policy.

Dependent Child/Children means any natural child, step-child or legally adopted child of an Insured Adult. Dependent Children are eligible to apply provided they are permanent residents of Canada, under age 21 (up to age 24 if they are enrolled full-time at a post-secondary school), and the Insured Adult also applies for coverage.

  • Any Insured Adult, Spouse or Dependent Child is not eligible for insurance under more than one Family Accident Reimbursement Plan.
  • No benefits will be paid if the accident causing injury occurs, or the expenses for the injury are incurred, outside of Canada.
  • No benefits will be paid for services which are insured services or basic health services under a provincial medical care or hospital plan.
  • Dental benefits are for the excess of expenses paid, payable, or insured under a government sponsored dental care plan, or any other health plan providing accidental dental benefits.
  • Coverage under this Policy will be secondary to any other benefits from a primary insurer or plan and will be coordinated with any other insurer or plan so that the total benefits from all insurers or plans will not exceed the actual loss incurred, in accordance to the Canadian Life and Health Insurance Association Inc. (CLHIA) Guidelines.
  • Complete Exclusions and Limitations can be found below. You will also receive a complete listing of the Exclusions and Limitations in your Insurance Benefit Summary.
  • Coverage is subject to a Pre-Existing Condition Exclusion. In general terms, this means that no benefit will be paid during the first 24 months after you purchase this insurance for any medical condition which was present in the 24 months previous to your purchase.
  • The insured person must survive for 30 days after first being diagnosed for a benefit payment to be made.
  • If the insured person is diagnosed with cancer within the first 90 days of coverage, a benefit will not be payable and cancer will no longer be considered a covered condition.
  • Any covered condition diagnosed prior to the effective date of coverage is excluded.
  • No benefit will be paid if the covered condition results from: attempted suicide, alcohol or drug abuse, war or armed forces service, self-inflicted injury, taking poison or inhaling gas, or participation in a criminal act. For blindness, coma, deafness, loss of limbs, severe burns, paralysis or stroke, no benefit will be paid if the condition is a result of participating in hazardous sports or activities. There is also an exclusion for certain pilots.

GENERAL EXCLUSIONS

The following exclusions also apply for all benefits:

  1. The Policy does not cover:
    1. sickness or disease either as a cause or effect except as otherwise provided under the Critical Illness Benefit;
    2. suicide or attempt thereat;
    3. Injury for which compensation is payable under any Workers’ Compensation Act, except in the case of Accidental Death, and Dismemberment or Total and Permanent Loss of Use benefits;
    4. the expense of a brace or similar device used for non-therapeutic purposes or solely for the purpose of participating in sports or other leisure activities;
    5. expenses incurred for mouthguards or treatment of Temporal Mandibular Joint (TMJ) dysfunction, whatever the cause;
    6. expenses incurred for private magnetic resonance imaging (MRI) scans;
    7. Injury resulting from repetitive/strenuous activity (e.g. overexertion, strains, etc.);
    8. taking any drug other than as prescribed by a licensed Physician; or
    9. participation in a criminal act or any attempt to commit a criminal offense, including but not limited to operating a motor vehicle while the concentration of alcohol in 100 milliliters of the Insured Person’s blood exceeds 80 milligrams.
  2. No benefits or expenses are payable under the Policy for treatment or services which are insured services or basic health services (e.g. Physician’s fees) under the provincial medical care or hospital plan applicable to an Insured Person whether or not that Insured Person is covered thereunder.
  3. Benefits payable under the terms of subsection 3.4 shall be for the excess of expenses paid, payable, or insured under any government sponsored dental care plan or other dental plan or policy or any health plan providing accidental dental benefits.
  4. Coverage under this Policy will be secondary to any other benefits from a primary insurer or plan and will be coordinated with any other insurer or plan so that the total benefits from all insurers or plans shall not exceed the actual loss incurred, in accordance to the Canadian Life and Health Insurance Association Inc. (CLHIA) Guidelines.
  5. No benefits or expenses will be payable under the Policy
    1. for treatment or services if the Accident causing the claimable event occurs, or
    2. if the expenses for such treatment or services for the Injury caused by such Accident is incurred, outside of Canada.
  6. An Insured Person cannot be covered under more than one Family Plan under the policy.

CRITICAL ILLNESS

Exclusions

In addition to the general policy Exclusions and Limitations, the Critical Illness Benefit will not be paid if a Covered Condition results directly or indirectly from any one or more of the following:

  1. any illness, disease, mental, nervous or psychiatric condition or disorder for which any one of medical advice, treatment, service, prescribed medication, diagnosis or consultation, including consultation to investigate and/or diagnose (where diagnosis has not yet been made) was received by the Insured Person or would have been received by a prudent individual within the 24 months immediately preceding the Issue Date of an Insured Person’s coverage. This exclusion applies for the first 24 months following the Issue Date of the Insured Person’s coverage under this policy;
  2. taking poison or inhaling gas, whether voluntarily or involuntarily, not connected with the employment of the Insured Person;
  3. taking any drug other than as prescribed by a licensed Physician;
  4. participation in a criminal act or any attempt to commit a criminal offense, including but not limited to operating a motor vehicle while the concentration of alcohol in 100 milliliters of the Insured Person’s blood exceeds 80 milligrams;
  5. declared or undeclared war or any act thereof;
  6. active full-time service in the armed forces of any country;
  7. intentionally self-inflicted injury, while sane or insane; or
  8. flying as a student pilot or flying as a privately licensed pilot for less than 25 hours or more than 400 hours per year.

In addition, no benefit will be paid if the Insured Person suffers a Stroke as a result, directly or indirectly, from amateur or professional boxing, bungee jumping, B.A.S.E. jumping, cliff diving, mountain climbing, motor vehicle racing or speed competition on land and/or water, parachuting or underwater activities, including scuba diving and snuba diving.

Limitations

  1. Cancer (Life-Threatening)

    The Critical Illness Benefit for Cancer (Life-Threatening) will not be paid if, within the first 90 days following the Issue Date of the coverage, such Insured Person has a Diagnosis of Cancer (Life-Threatening) or any signs, symptoms or investigations that lead to a Diagnosis of Cancer (covered or excluded under the policy), regardless of when the Diagnosis is actually made.

    In addition, an Insured Dependent Child who is a natural child of an Insured Participant born on or after the Issue Date of such Insured Participant’s coverage under this Policy is not entitled to the Critical Illness Benefit for Cancer (Life-Threatening) if Cancer (Life-Threatening) was diagnosed while such Dependent Child was in the womb.

    This medical information must be reported to the Company within six months of the Date of Diagnosis. If this information is not provided, the Company has the right to deny any claim for Cancer (Life-Threatening) or any Covered Condition caused by any Cancer or its treatment.


  2. All Covered Conditions excluding Cancer (Life-Threatening)

    An Insured Dependent Child who is a natural child of the Insured Participant born in the 10-month period immediately following the Issue Date of such Insured Participant’s coverage under this Policy will not be entitled to the Critical Illness Benefit if, within 30 days of birth such Insured Dependent Child has any of the following:

    1. a Diagnosis of a Covered Condition; or
    2. the Dependent Child’s parent or physician notice or become aware of any sign, symptom, condition or medical problem that leads to a Diagnosis of a Covered Condition at any time in the future.

  • One low monthly price of $39.95 covers all eligible family members.
  • Insureds are billed monthly by pre-authorized debit.
  • Coverage can be cancelled at any time at the request of the Insured Adult.
  • Coverage will terminate on the earliest of the following dates:
    1. August 31st following the policy year in which the Insured Adult or Insured Spouse reaches age 65
    2. The date of any unpaid premiums
  • For Dependent Children, coverage terminates at age 21 (or at age 24 if receiving full parental support while attending university, college, CEGEP or trade school on a full-time basis).

How to Apply

To apply, simply download and complete the PDF application, and submit the completed application to:

Special Markets Solutions
Industrial Alliance Insurance and Financial Services Inc.
400 - 988 Broadway W, PO Box 5900, Vancouver, BC V6B 5H6

The product can be purchased any time of the year and renews automatically each September 1st.

We offer a 60-day money-back guarantee. If you are not fully satisfied with your coverage,you may cancel it by marking “CANCEL” on your Group Insurance Certificate and returning it to us within 60 days from the effective date. You’ll receive a full refund of any premiums already paid.

Claims Information

Download the claim form here

  • If you or your child is injured while insured under the Family Accident Reimbursement Plan, a claim form is required to be completed and submitted to Industrial Alliance Insurance & Financial Services Inc.
  • When completing the form, please follow the instructions found on the Claims Information Sheet and at the bottom of the Standard Claim Form.
  • Please mail the completed claim form to:

    Industrial Alliance Insurance and Financial Services Inc. – Claims Department
    400-988 Broadway W. PO Box 5900
    Vancouver, BC V6B 5H6

    Or email to claims@ia.ca

  • Claims must be received within 90 days of the date of the Accident, and no later than one year, whether or not expenses are incurred.
  • In providing this claim form for the convenience of the claimant, the Company does not admit any liability or waive any of the terms and conditions of the policy. Provision of this claim form does not indicate coverage. Only eligible claims will be paid.

Benefit Payment

  • All benefits payable under the Policy on behalf of Children are payable to or at the direction of the Parent/Legal Guardian.
  • All benefits payable under the Policy on behalf of an Adult are payable to the Adult Insured or in the case of Accidental Death to the Estate of the Adult Insured or designated beneficiary. Critical Illness is payable to the Insured, except for the Dependent Child in which case the benefit is payable to the Insured Adult.
  • Full details on Claims procedures will be found on the Insurance Benefits Summary provided to Insureds.

Contact Us

Our Client Service Specialists will be happy to help you with any questions you might have.

Phone:
1.800.266.5667 (toll-free)
604.737.3802 (Vancouver)
Monday to Friday 6:30 a.m. - 4:30 p.m. Pacific Time

Email:
solutions@ia.ca

Address:
Special Markets Solutions
Industrial Alliance Insurance and Financial Services Inc.
400 - 988 Broadway W, PO Box 5900, Vancouver, BC V6B 5H6

Your protection and satisfaction are our top priorities. That is why we offer a 60-day money-back guarantee. If you are not fully satisfied with your coverage, you may cancel it by marking “CANCEL” on your Group Insurance Certificate and returning it to us within 60 days from the effective date. You’ll receive a full refund of any premiums already paid.