This is a life insurance benefit that also gives you the option to accelerate some or all of the death benefit in the event that you meet the criteria for a qualifying event described in the policy. This policy or certificate does not provide long-term care insurance subject to California long-term care insurance law. This policy or certificate is not a California Partnership for Long-Term Care program policy. This policy or certificate is not a Medicare supplement policy. The Chronic Illness Accelerated Death Benefit Rider provides you access to your policy’s death benefit if you have a qualifying chronic illness.
Qualifying Chronic Illness
To qualify as chronically ill, you must be certified by a Licensed Health Care Practitioner within the preceding 12-month period as:
- unable to perform, without Substantial Assistance from another person, at least two Activities of Daily Living (ADLs) for a period of at least 90 consecutive days due to a loss of functional capacity; or
- Requires Substantial Supervision to protect such Insured Person from threats to health and safety due to Severe Cognitive Impairment;
You must be deemed a “chronically ill person” as defined under the federal Health Insurance Portability and Accountability Act (Public Law 104-191), as amended.
ADLs: Bathing, Dressing, Toileting, Transferring, Continence, Eating.
Severe Cognitive impairment is a loss or deterioration in intellectual capacity that is comparable to (and includes) Alzheimer’s disease and similar forms of irreversible dementia. Proof of the determination is required prior to receiving any accelerated death benefit.
Chronic Illness Accelerated Death Benefit
If you have a qualifying chronic illness, you can file a claim to accelerate your death benefit. You can choose to receive your chronic illness benefit in one lump-sum payment or in periodic payments. We will divide the Chronic Illness Accelerated Death Benefit Amount you elect into equal periodic payments over the requested period. Such periodic payments may extend for no more than 24 months from inception. If you request to receive the Chronic Illness Benefit in periodic payments beyond the 12-month period from the initial certification submitted in support of your claim, a new certification must be provided as described by the rider for each benefit period.
Under certain circumstances where an insured’s mortality (i.e., our expectation of the insured’s life expectancy) is not significantly changed by a Qualifying Chronic Illness and, the accelerated death benefit may be zero. See the rider for details. Payments received under this chronic illness accelerated death benefit rider are not part of a health, long-term care, or nursing home insurance policy and may not be sufficient to cover medical, nursing home or other bills.