Critical illness insurance benefits and costs in Ontario

Life can be so unpredictable. Things could be going great in one moment, and then the next thing you know, your world has turned upside down.

Critical illness is one of the most difficult challenges anybody can face. It not only causes pain and suffering but financial hardship as well.

Critical illness insurance benefits and costs in Ontario

Critical illness insurance in Ontario gives a lump-sum benefit to insured individuals diagnosed with a covered medical condition. This financial support can provide a sense of relief, helping you manage your bills while you focus on recovery.

Is this type of coverage really necessary?

If a serious illness would put you in financial distress, critical illness insurance can protect you. You may not need it If you are financially stable, have significant savings, and have employer health benefits.

What is critical illness insurance?

A cancer patient being treated by a doctor

Critical illness insurance provides a one-time lump sum payment if a policyholder is diagnosed with a critical illness such as:

    • Heart attack
    • Stroke
    • Cancer
    • Multiple Sclerosis
    • Organ transplant
    • Parkinson’s disease
    • Coma
    • Aortic surgery
  • Kidney Failure


The cash benefits from critical illness insurance can be used for many other expenses, including:

  • Rent or mortgage
  • Household expenses
  • Travel expenses due to medical care
  • Medical treatments not included by OHIP


Critical illness insurance benefits can also replace lost income while you are in recovery.

Who should buy Critical Illness Insurance?

Many people can benefit significantly from critical illness insurance coverage. Check if you fall under these categories: 

  • Self-employed
  • With no employer health benefits or has inadequate coverage
  • Entirely dependent on your income for living expenses and other bills
  • Has no significant savings or wealth
  • Has a family history of serious illnesses like cancer, stroke, or cardiovascular diseases

Consider buying critical illness insurance for your peace of mind and financial security.  Avoid the negative impact of a serious illness on your financial standing.

The Cost of Critical Illness Insurance in Ontario

The premiums of critical illness insurance varies but they are generally calculated based on factors such as: 

Age: Generally, younger people pay lower premiums compared to older people as the latter are at a higher risk of developing critical illnesses.

Health Status: Pre-existing health conditions increase the cost of premiums or may exclude them from coverage.

The desired amount of coverage: The lump sum benefit you want also affects the cost of premiums. Higher amount of coverage will increase your premiums.  

Policy Features: Policies may have different terms and conditions, including the number of covered illnesses, waiting periods, and added options, which can affect the overall cost.

Choice of insurer: Different insurers offer different rates for the same level of coverage. Shopping around for the best policy is essential for you to get the best rates. The average premiums for critical illness insurance in Ontario ranges from $30 to $150 per month.

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Comparison of Critical Illness Insurance vs Disability Insurance

While both types of insurance provide cash benefits in the event of a critical diagnosis, they still have different features. They both protect you against the financial repercussions of critical health-related setbacks but their objectives are dissimilar.

Below are the key differences between these two types of insurance coverage.

Feature/Description Critical Illness Insurance Disability Insurance
What triggers the benefits? Diagnosis of a critical illness (Stroke, cancer, heart attack) Inability to work as a result of an accident, injury, or illness
What can the cash benefits be used for? Anything (medical bills, rent, mortgage, credit cards, education, living expenses) Replaces a percentage of your income while unable to work
Duration of benefits & coverage One-time lump-sum payment (Fixed amount) Payments continue until you go back to work or reach the maximum duration based on the policy
Required employment Paid regardless of ability to work Paid only if you cannot work due to a disability or illness
Medical conditions covered Serious illnesses like cancer, stroke, organ transplant, etc. Any illness of injury that prevents you from working
Suitable For Large expenses such as mortgage, medical bills, credit cards, etc. Income replacement if you are unable to work for an extended period of time

Which one is better for you? You may want to get critical illness insurance if you have insufficient employer benefits to cover expensive bills.  It will be a valuable source of funds for treatment costs, rehabilitation, and other medical bills.

Disability insurance is ideal if you need to replace any lost income due to a disability or illness. It will allow you to recover and heal without the added strain of financial worries.

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How Much Coverage Do I Need for Critical Illness Insurance?

You can evaluate your situation to determine the answer. 

Many people buy critical illness insurance to cover a mortgage, medical expenses not covered by the OHIP and other huge bills. They consider how much income would be lost during recovery, and the amount needed for daily living expenses.

A typical critical illness insurance policy would have $50,000 cash benefits but higher amounts are available.

As an example, a person earning around $5,000 a month would want to have enough funds to sustain 6 months of lost income and additional cash for other unexpected expenses.  $5,000 x 6 months plus a buffer of $10,000 would mean $40,000 in critical illness coverage.

What isn’t covered by critical illness insurance?

If your critical illness insurance policy does not mention a medical condition, it may not be covered.

Understanding an insurance policy can be difficult as it contains many terms and detailed explanations that are not simple for the average person to understand.

Pre-existing conditions not covered by critical illness insurance

Below are a few examples of situations not usually covered by critical illness insurance.

  • Critical illnesses that are not indicated in the policy.  For instance, a neurological condition would be considered as critical by many but if it is not listed in your policy, you won’t be approved if you make a claim.
  • Non-critical illnesses: Many medical conditions are perceived as serious but don’t necessarily fall under the critical illness category. 
  • Diabetes, chronic pain, depression, high blood pressure, asthma, or fibromyalgia are not usually covered. 
  • Pre-existing conditions and conditions due to drug use or alcohol use are also not covered.

A disability insurance policy, however, may cover these illnesses if they prevent you from earning a living.

Please note that self-inflicted injuries and illnesses from high-risk activities may be excluded from coverage.

Would you like to find the best critical illness insurance policy? Let us know by filling out the short online form below.

FAQS on Critical Illness Insurance

Here are some FAQs regarding critical illness insurance to help you understand how it works and if it is the right coverage for you.

Man having chest pains at work

What are considered critical illnesses?

A critical illness usually refers to a severe health condition that puts your life at risk or is life-altering. They are also often long-term illnesses that seriously affect the lives of the patients. Cancer, stroke, heart attack, and organ transplant are just some examples.

The specific illnesses covered by a policy differ among the various insurance companies. 

Is critical illness a lifetime coverage?

Yes, critical illness insurance in Ontario is typically lifetime coverage although it still depends on the plan you choose and the insurance provider. 

Some critical illness insurance plans are permanent policies that are valid until the insured cancels it or dies.

Is critical illness insurance the same as life insurance?

No. Life insurance protects your finances against the unexpected such as death. Like critical illness insurance, it pays out a lump sum benefit, tax-free. However, the conditions for payment of benefits are not the same. Life insurance benefits are provided upon the death of the insured whereas critical illness insurance benefits are living benefits.

Am I required to undergo a medical exam to get critical illness insurance?

A medical exam may or may not be required for critical illness insurance in Ontario. It depends on the insurer and the policy you apply for. Some insurers will just ask you health questions while others will require a medical exam.

Can you get paid more than once under a critical illness insurance policy?

No. You can only receive one lump sum benefit upon diagnosis. Even though you may be diagnosed with another critical illness, you can only get compensated once during your lifetime.

How long does receiving the lump sum payment from a critical illness insurance policy take?

Most policies have a required survival period (for example, 30 days after a diagnosis), before the lump sum benefit is released. The insured must reach the required survival period to qualify for the cash benefits. 

How long is the waiting period for critical illness insurance?

The waiting period is the number of days before the insurance company will process the lump sum benefit. It begins after the medical diagnosis is made. If your policy has a waiting period of 30 days, your claim will be processed only after such time has passed. Some conditions may have a longer waiting period, i.e., 90 days.

Can I get both critical illness insurance and disability insurance?

Yes. You can get critical illness insurance and disability insurance for optimum protection.

Critical illness insurance offers a lump sum payment whereas disability insurance replaces the monthly income of the insured while he is recovering or cannot work. 

Many individuals get both types of insurance plans to maximize coverage. 

Can I get critical illness insurance coverage through my employer?

Many employers provide group critical illness insurance, but they usually have smaller amount of coverage. If you quit your job, your coverage will also stop. It is better to buy a personal policy for better and long-term protection.

What happens to the premiums paid if I don’t get diagnosed with a critical illness?

Some policies offer the option to return a portion of the paid premiums if a claim is never made. But this option could make premiums more expensive.

Critical illness insurance can provide valuable financial security for anyone diagnosed with a life-threatening or life-changing medical condition. With the right policy, you can have peace of mind that you are well-prepared financially if it does happen. 

Discover the important benefits of critical illness insurance in Ontario. Compare multiple quotes tailored to your needs with the lowest possible rates to save time and money.

How to buy critical illness insurance in Ontario

Critical illness insurance is one of the best ways to shield your finances against a serious disease. An illness can inhibit you from work, resulting in lost wages.

Man in his forties buying insurance online

But how do you buy critical illness insurance?

Do you need to visit an insurance expert in person? And how do you make sure your policy is the right fit for you?

While critical illness insurance is not something to buy frivolously, you don’t need to go to an insurance company to apply in person.

You can buy a policy online right in your own home. But before you do, knowing your best options is essential so you can get the best coverage and price. Ensure the policy you choose is the best match to your needs.

Fortunately, our insurance partners can help you by providing you with the most competitive quotes to compare. Fill out the short online form below and get competitive quotes from top insurers.

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