The Critical Illness Insurance benefit is underwritten by either United States Fire Insurance Company (as a Rider to the Group Hospital Fixed Indemnity Insurance) or Windsor Life Insurance Company (as Group Critical Illness Insurance) or Sirius America Insurance Company (as Group Critical Illness Insurance) depending on the UBA Gap Product and state.
The answer is No.
Only one payment is allowed during the lifetime of the Covered Person as defined by the terms and conditions of the Group Policy or Certificate of Insurance benefit rider. After the payment is made to the Covered Person, this benefit will terminate for that particular Covered Person only.
Example of Multiple Critical Illnesses for one Covered Person:
What that means is that if the Covered Person had a first diagnosis of a Covered Critical Illness (Invasive Cancer) but then later has a heart attack for the first time as well. He/she will ONLY get the claim for the first diagnosis of the first occurrence Covered Critical Illness if he/she met all the requirements for that diagnosis, met the terms and conditions of the certificate rider. He will NOT be eligible for 2 payments - only one.
Example of Termination after Payment:
What that means is if there is a Covered Member and Covered Spouse, the Spouse is unfortunately diagnosed for the first time for a heart attack and met all the requirements to get the lump sum payment. She receives the lump sum payment and her coverage ends for Critical Illness Insurance Benefit. Meaning she will no longer be eligible to receive any future Critical Illness Insurance coverage. The Covered Member hasn't had a first diagnosis of a Covered Critical Illness yet so his coverage is still in force and would be eligible if he met the requirements per the terms, conditions, definitions outlined in the Certificate of Insurance for a first diagnosis of a Covered Critical Illness.
Read the Certificate(s) of Insurance for your plan carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Certificate(s) of Insurance and/or Certificate Riders. Coverage may vary or may not be available in all states. You'll find complete coverage details in the Certificate(s) of Insurance and/or Certificate Riders. Depending on state, the Critical Illness Benefit is either underwritten by United States Fire Insurance Company (as a Rider to the Group Hospital Fixed Indemnity Insurance) or Windsor Life Insurance Company or Sirius America Insurance Company (as Group Critical Illness Insurance). Coverage for Critical Illness Insurance Benefit ends at age 65 and is available to Covered Member and Eligible Spouse only. The insurance described in this Help Guide article provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act.
Important: HealthyAmerica and United Business Association (UBA) are not authorized to pay claims or be involved in the claims decision process. All claim decisions are made by the TPA claims administrator and the insurance carrier.
AH-3508 | HASA-1000