| Benefit Payable:
The benefit payable would be 66.67% of the insured's weekly salary to a maximum of $1,000 per week for both accident and sickness (covers earnings up to $77,990 annum). Benefit Period:
A Benefit Period is: - the period of time after the waiting period during which the Insured is continuously disabled; plus
- if the disability is not continuous, any period of time during which the disability is considered to be a recurrence.
A Benefit Period will not continue for more than 24 calendar months from the date disability benefit payments commenced. Definition of Temporary Total Disability:
TTD Benefits are payable for disability periods that start while a person is insured under the policy. The Insured is considered disabled if disease or injury prevents him/her from performing a substantial portion of the duties he regularly performed for the Employer . A disability period is: - the waiting period; plus
- the Benefit Period
The waiting period for disability due to injury or disease starts when the
Insured first becomes disabled and last for 30 consecutive days. A disability is considered to be caused by an accidental injury only when: - it occurs as a direct result of an accident, independent of all other causes; and
- disability occurs within 30 days after the accident.
Otherwise, the disability is considered to be caused by sickness or disease. Exclusions:
No benefits will be paid for: - any period preceding the date the insured is first treated by a legally licenced doctor of medicine or in which he/she does not participate or cooperate in a reasonable and customary treatment program.
A reasonable and customary treatment program is systematic treatment that:
a) is performed or prescribed by a legally licenced doctor of medicine; and
b) is of the nature and frequency usually required for the condition involved.
Where considered appropriate by the insurer for the severity of the condition, the treatment must be prescribed by and if appropriate, performed or supervised by a certified specialist for the condition involved.
If substance abuse contributes to an insured's disability, the treatment program must include participation
in a recognized
substance withdrawal program.
- any period for which the person is entitled to benefits under any Workers' Compensation Act or similar law.
- the scheduled duration of a lay-off, unless the insured becomes disabled before notice of lay-off.
- the scheduled duration of a leave of absence. A leave of absence is considered to start on the date agreed upon by the Insured and his/her employer. If a child is born before a period of Maternity Leave is scheduled to start, the leave is considered to start on the date of birth.
- any period when the Insured has earned income.
- disability resulting from or associated with treatment performed for cosmetic purposes only.
- a period of confinement in a prison or similar institution.
- disability arising from active participation in war, insurrection or voluntary
participation in a riot.
Notice of Disability Requirement:
Initial notice of a Temporary Total Disability income claim should be submitted to the Administrator, The Norfolk Group, no later than 30 days after
disability starts.
The insurer will not be liable for short term disability income claims for which initial notice is submitted more than 3 months after the earlier of: - the end of the waiting period; or,
- the date the policy terminates.
Disability income benefits will only be payable for periods for which the Administrator has received satisfactory proof that the Insured is entitled to benefits. Monthly Premium Rates:
Occupational Class
(see below) | |
Rate per $10 of benefit per month |
| Monthly Cost per $250 of weekly benefit |
| Monthly Cost per $500 of weekly benefit |
| Monthly
Cost per $750 of weekly benefit | Monthly Cost per $1,000 of weekly benefit (Maximum) |
| Class 1 | | | | $34.35 | | Class 2 | | | | $36.60 | | Class 3 | | | | $46.05 | | Class 4 | | | | $49.73 | | Class 5 | | | | $58.50 | |
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Note: Benefits payable following a 30 day waiting period for a maximum of 24 months, subject to a weekly benefit of 66.67% of weekly income to a maximum of $1,000.00 per week. Determining your monthly cost:
Determine your weekly TTD benefit based on 66.67% of weekly earnings, subject to a maximum benefit of $1,000/week. Divide the weekly benefit amount by 10, then multiply the result by your Class Rate per $10 to get the monthly premium rate. Example:
Class 1 | Class 3 | Weekly Earnings: $1,200
Weekly Benefit: $800
Monthly Premium: $36.64 | Weekly Earnings: $2,308
Weekly Benefit: $1,000 (max)
Weekly Premiums: $61.40 |
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*In the Class 1 example, the weekly earnings of $1,200 are multipied by 66.67% to
arrive at a weekly benefit of $800.04. Divide this number by 10 and multiply the result by the Rate per $10 of benefit per month column (in this case $0.458) to arrive at a monthly premium of $36.64.
In the Class 3 example, although the weekly earnings are $2,308, the maximum weekly benefit available is $1,000 and so that amount is used. In this case we've divided $1,000 by 10 to get 100 and then multiplied that by the rate of $0.614 to get a monthly premium of $61.40
It's that simple to determine your cost for Coverage A. You can also purchase Coverage B (Permanent Total Disability), Coverage C (Critical Illness) or Coverage D (Accidental Death & Dismemberment Insurance). Coverages A, B C and D may be purchased separately or together. What is my Occupational Class?
Insurers base their rates for Disability Coverage in part on the nature of the work being performed as part of your regular duties. Use the table below to determine your Occupational Class. Please contact us if it's not clear what category matches your particular job. Class 1 | White collar workers, including office workers; sales staff; Accountants; IT contractors; Paramedical professionals; and similar occupations with no manual labour involved; retail sales clerks, etc. |
Class 2 | On work site Managers of construction, Superintendents, and similar occupations with no manual labour involved | Class 3 | Nurses, light manufacturing; assembly line workers; and similar occupations | Class 4 | On site manual workers not exposed to unusual risks such as electricians; carpenters; plumbers; painters; cooks; auto body; millwrights; limousine drivers, taxi-drivers and short haul truck drivers | Class 5 | Heavy manual workers exposed to considerable accident risks, including auto mechanics; long haul truckers; rough carpenters; farmers; |
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Coverage B (can be purchased alone or together with other coverage)
Permanent Total Disability (PTD) Benefits
After 25 months of "continuous total disability" and if the insured person is
"permanently and totally disabled", the insurer will pay a Permanent Total Disability Benefit of 5 times annual earnings subject to a maximum of $500,000. Applicants should purchase PTD coverage in an amount equal to 5X their annual earnings. If a lesser benefit is purchased the maximum payable shall be the principal sum purchased. "Continuous Total Disability"
which must result from such injuries and commence within thirty (30) days after the date of accident, means the Insured Person's complete inability during the first 25 months thereof to perform the substantial duties of his occupation. "Continuous Total Disability" that results from a sickness, means the Insured Person's complete inability during the first 25 months thereof to
perform the substantial and material duties of his occupation. "Permanently and totally disabled" means the Insured Person's complete inability, after one year of continuous total disability as defined above, to engage in any occupation or employment for which the Insured Person is fitted by reason of education, training or experience for the remainder of his/her life. Monthly Premium Rates:
Occupational Class
(see below) | | Monthly Premium per $50,000 |
| Monthly Premium per $250,000 |
| Monthly Premium per $500,000 |
| Class 1 | | | | | Class 2 | | | | | Class 3 | | | | | Class 4 | | | | | Class 5 | | | | |
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Determining your monthly cost:
Determine your PTD benefit based on 5X annual earnings, subject to a maximum benefit of $500,000. (Divide the benefit amount by 1000, multiply the result by your Class Rate per $1,000 to get the monthly premium rate). Example:
Class 1 | Class 3 | Annual Earnings: $62,400
5X earnings = $312,000
Monthly Premium: $12.48 | Annual Earnings: $120,000
5X earnings = $600,000 but maximum is $500,000
Monthly Premium: $39.50 |
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In the Class 1 example, the annual earnings of $62,400 are multipied by 5 to arrive at
a benefit of $312,000. Divide this number by 1000 and multiply the result by the Rate per $10 of benefit per month column (in this case $0.135) to arrive at a monthly premium of $42.12.
In the Class 3 example, the annual earnings are $120,000, this is multiplied by 5 to arrive at $600,000. But the maximum benefit available is $500,000 and so that amount is used. In this case we've divided $500,000 by 1000 to get 500 and then
multiplied that by the rate of $0.142 to get a monthly premium of $71.00 It's that simple to determine your cost for Coverage B. You can also purchase Coverage A (Temporary Total Disability), Coverage C (Critical Illness), or Coverage D (Accidental Death & Dismemberment Insurance). Coverages A, B
C and D may be purchased separately or together. What is my Occupational Class?
Insurers base their rates for Disability Coverage in part on the nature of the
work being performed as part of your regular duties. Use the table below to determine your Occupational Class. Please contact us if it's not clear what category matches your particular job.
Class 1 | White collar workers, including office workers; sales staff; Accountants; IT contractors;
Paramedical professionals; and similar occupations with no manual labour involved; retail sales clerks, etc. | Class 2 | On work site Managers of construction, Superintendents, and similar occupations with no manual labour
involved | Class 3 | Nurses, light manufacturing; assembly line workers; and similar occupations | Class 4 | On site manual workers not exposed to unusual risks such as electricians; carpenters; plumbers; painters; cooks; auto body; millwrights; limousine drivers, taxi-drivers and short haul truck drivers | Class 5 | Heavy manual workers exposed to considerable accident risks, including auto mechanics; long haul truckers; rough carpenters; farmers; |
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Coverage C (can be purchased alone or together with other coverage)
$50,000 Critical Illness Benefit (CI) Critical Illness Benefits protect against the financial consequences of TEN critical illnesses and conditions. A tax-free, lump-sum benefit of $50,000 is payable after you are diagnosed with any one of the named conditions and survive for 30 days (for Cancer only, diagnosis must be made 90 days or more after coverage becomes effective). Conditions include: - Cancer,
- Kidney Failure,
- Stroke,
- Deafness,
- Recipient Major Organ Transplant,
- Heart Attack,
- Multiple Sclerosis,
- Paralysis,
- Blindness,
- Coronary By-Pass.
A separate Health Statement must be completed, and there is a 24 month pre-existing condition exclusion. Coverage is renewable on an annual basis to age 65. Monthly Premium Rates for $50,000 Critical Illness Benefit:
Attained Age | Non-Smoker | Smoker | Male |
Female | Male | Female | 18 - 24 | $5.59 | $7.26 | $7.41 | $7.50 | 25 - 34 | $10.45 | $14.95 | $15.18 | $19.53 | 35 - 44 | $20.29 | $25.88 | $46.39 | $50.88 | 45 - 54 | $52.55 | $47.87 | $151.33 | $125.52 | 55 - 64 | $125.85 | $91.77 | $385.27 | $267.68 |
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Coverage D (can be purchased alone or together with other coverage)
Accidental Death & Dismemberment (AD&D) Insurance
Benefit Payable:
Applicants may purchase 24 hour, 365 days per year coverage in units of
$50,000, subject to a maximum of $500,000. Description of Coverage:
Accident Only: The Principal Sum as stated in the Insured Person's
Application, or a portion thereof will be payable if injury shall result in any of the specified losses within one year from the accident, provided however, that not more than one (the largest) of such benefits shall be paid with respect to all injuries from one accident. Please see the policy booklet for the complete Loss Schedule and conditions. Exclusions: - The Policy does not cover loss caused by or resulting from any one or more of the following:
- intentionally self-inflicted illness or injury;
- committing or attempting to commit a criminal offence
- service, including part-time or temporary service in the armed forces of any country;
- injuries received if convicted of operating a vehicle when the Insured
Person's blood contains more than 80 milligrams of alcohol per 100 millilitres of blood;
- injuries received during aircraft travel except for the purpose of transportation where the Insured Person is travelling as a passenger.
Nuclear, Chemical, Biological Terrorism Exclusion:
The policy excludes benefit payment for any losses, directly or indirectly arising out of, contributed to or caused by, or resultiing from or in connection with any act of nuclear, chemical, biological terrorism (as defined in the policy
booklet) regardless of any other cause or event contributing concurrently or in any other sequence to the loss.
Limited War Exclusion Clause:
The Policy does not cover loss consequent to war whether declared or not,
between specified countries, or war in Europe. Please see policy booklet for details. Monthly Premium Rates:
Occupational Class
(see below) | | Monthly Premium per $50,000 |
| Monthly Premium per $250,000 |
|
Monthly Premium per $500,000 |
| Class 1 | | | | | Class 2 | | | | | Class 3 | | | | | Class 4 | | | | | Class 5 | | | | |
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Determining your monthly cost:
Simply choose the amount of AD&D coverage you require (available in units of $50,000 to a maximum of $500,00), and find the rate for your Occupational Class (described in the table below). Example:
Class 1 | Class 3 | $250,000 of coverage
Monthly Premium: $22.50 | $300,000 of Coverage*
Monthly Premium: $36.00 |
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*Note that in the Class 3 example, we've shown an amount of $300,000 of Coverage although that amount is not listed in the table above. This is because you can choose any multiple of $50,000 up to $500,000. Simply divide the amount you've chosen by
1,000, then multiply the result by the Monthly Rate per $1,000 column to determine your cost. In this case, we've multiplied 300 X $0.12 to arrive at a monthly premium of $36.00 It's that simple to determine your cost for Coverage D (Accidental Death & Dismemberment Insurance). You can also purchase Coverage A (Temporary Total Disability), Coverage B (Permanent Total Disability) or Coverage C (Critical Illness Benefits). Coverages A, B, C and D may be purchased separately or together. What is my Occupational Class?
Insurers base their rates for Disability Coverage in part on the nature of the work being performed as part of your regular duties. Use the table below to determine your Occupational Class. Please contact us if it's not clear what
category matches your particular job. Class 1 | White collar workers, including office workers; sales staff; Accountants; IT contractors; Paramedical professionals; and similar occupations with no manual labour involved; retail sales clerks, etc. | Class 2 | On work site Managers of construction, Superintendents, and similar occupations with no manual labour involved | Class 3 | Nurses, light manufacturing; assembly line
workers; and similar occupations | Class 4 | On site manual workers not exposed to unusual risks such as electricians; carpenters; plumbers; painters; cooks; auto body; millwrights; limousine drivers, taxi-drivers and short haul
truck drivers | Class 5 | Heavy manual workers exposed to considerable accident risks, including auto mechanics; long haul truckers; rough carpenters; farmers; |
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