Terms & jargon

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A collection of insurance terms and what they mean.

DiagnosisClaimantPortability
Actively at work

Actively at work means you perform all the functional and crucial duties of your occupation for a full workday at:

  • your employer’s place of business;
  • an alternate place approved by your employer; or
  • a place where your employer requires you to travel.

You are considered actively at work on any day that is not your regular scheduled workday (e.g. vacation or holiday), provided you were actively at work on the preceding scheduled workday and you are not confined to hospital or otherwise incapacitated from reporting to place of employment for your employer. If you are on parental leave under a Provincial or Federal program, you are considered actively at work.

Activities of daily living
Activities of daily living refer to a standard list of basic tasks of everyday life health professionals use when measuring someone’s ability to function independently. They are the things many people do when they get up in the morning and get ready to leave the house:

  • Bathing — the ability to wash oneself in a bathtub, shower or by sponge bath, with or without the aid of assistive devices; 
  • Dressing — the ability to put on and remove necessary clothing, braces, artificial limbs or other surgical appliances with or without the aid of assistive devices; 
  • Toileting — the ability to get on and off the toilet and maintain personal hygiene with or without the aid of assistive devices; 
  • Bladder and bowel continence — the ability to manage bowel and bladder function with or without protective undergarments or surgical appliances so that a reasonable level of hygiene is maintained; 
  • Transferring — the ability to move in and out of a bed, chair or wheelchair, with or without the aid of assistive devices; and 
  • Feeding — the ability to consume food or drink that already has been prepared and made available, with or without the use of assistive devices.
Claimant

An individual who makes a claim for benefits under the policy.

Date of diagnosis

Date of diagnosis means the date on which an insured person is first diagnosed with a given covered condition. For the covered conditions “Major organ failure on waiting list” and “Kidney failure,” the date of diagnosis will be considered to be the date on which the insured person was added to a recognized organ waiting list.

The date of diagnosis must occur while the policy is in force.

Claim
Claim means a formal request to the insurer and supporting documents for payment of a benefit amount under a PARACHUTE policy.
Diagnosis
Diagnosis means the medical diagnosis (including diagnostic measures) by a physician of an insured person with a covered condition as defined within the policy. The diagnosis must be made according to generally accepted medical classification systems including, but not limited to biopsy, bone scans, CT-scan, hematological tests, MRI or X-rays. Any tests or examinations that must be performed in order to satisfy the covered condition requirements must be conducted by a physician who is not the insured person, their relative or business associate nor live with them.
Coverage amount vs benefit amount

Coverage amount means the dollar amount of insurance coverage applicable to an insured person that is used to determine the benefit amount payable for any claim. This amount is listed on the policyholder's Summary of Coverage under "Face Amount".

Benefit amount is the dollar amount of coverage that is all or a portion of the face amount a claimant could be paid in the event of loss according to the terms of the policy.

For example, if Mary is insured with a face amount of $50,000 and has an approved claim for early stage thyroid cancer, the benefit amount payable would be 10% of her coverage amount, or $5,000.

Full-Time Resident of Canada
Full-time resident of Canada means an individual who is a resident of Canada and who is covered by a Canadian Provincial or Territorial Health Care Insurance Plan.
Insured person
Insured person refers to you, your spouse or your dependent child who are insured under the applicable PARACHUTE voluntary insurance policy. An insured person cannot be insured as both the policyholder and as a spouse or dependent.
Life support
Life support means a person is under the regular care of a licensed physician for nutritional, respiratory and/or cardiovascular support when irreversible cessation of all functions of the brain has occurred.
Maximum amount without medical questions or non-evidence maximum
Maximum amount without medical questions, also known as the non-evidence maximum, means the maximum coverage amount available under the policy without requiring you, your spouse, or your dependents to provide satisfactory evidence of insurability. It is often called the guaranteed issue amount. Higher face amounts are available subject to medical evidence in the form of a short online questionnaire approved by the insurer.
Out of pocket medical expenses
Out of pocket medical expenses means medical expenses that are not reimbursed by public (Provincial health plans) or private medical insurance. They include deductibles, co-insurance, and co-payments for covered services plus all costs for services that are excluded from your medical insurance.
Physician

Physician means a medical doctor who is legally qualified and lawfully entitled to practice medicine and prescribe and administer drugs or perform surgery, and who is operating in accordance with and within the scope of his or her licence in the jurisdiction where he or she provides such services.

The Physician must not be the insured person, a relative or business associate of the insured person, or reside with any such person.

Policy
Policy means an insurance contract that provides benefits to those it insures.
Policyholder
Policyholder refers to the person to whom a policy is issued.
Portable
Portable means that once you are insured, if you leave your employment, you can take your coverage with you and continue your policy.
Specialist

Specialist means a licensed physician who has been trained in the specific area of medicine relevant to the covered condition for which a benefit amount is being claimed, and who has been certified by a specialty examining board. In the absence or unavailability of a specialist, and as approved by the insurer, a covered condition may be diagnosed by a qualified physician practicing in Canada or the United States of America.

Specialists include, but are not limited to: cardiologists, neurologists, nephrologists, oncologists, ophthalmologists, burn specialists and internists. The specialist must not be the insured person, a relative of or business associate of the insured person, or reside with any such person.

Sponsoring group
A sponsoring group is an entity such as an employer or association, the employees or members of which are eligible for PARACHUTE Insurance products.
Summary of coverage
The Summary of coverage, or any replacement of such document, is a document which the insurer issues to you. It summarizes the benefit amount for which you, your spouse or your dependents are insured. The summary of coverage and the policy itself form part of your contract of insurance.
Survival period

Survival period means the period starting on the date of diagnosis and ending 14 days later, except where modified elsewhere under your policy. The survival period does not include the number of days on life support.

The insured person must be alive at the end of the survival period and must not have experienced irreversible cessation of all functions of the brain. For those conditions that have a qualifying period, for example 90 days for bacterial meningitis and paralysis, the survival period runs concurrently with that condition’s qualifying period.

Unit of coverage
This means a fixed quantity (such as the dollar amount of coverage) that the insurer uses as a standard of measurement for purchasing insurance.
Full definitions and benefit provisions can be found in the policy and all coverage is subject to the terms and conditions of the policy
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