Critical Illness Insurance

Published on: May 29, 2025

Brian Goldfinger and the Case of the Critical Illness Policy

Critical Illness sounds like a great deal.

If you purchase a Critical Illness Policy of insurance, and you get diagnosed with any of the illnesses identified under the policy, you get paid a great big lump sum of cash.

Depending on the policy and the premiums you get paid, that lump sum could be $100,000; $250,000, $500,000 or even $1,000,000 or greater.

Sounds too good to be true; right?

But beware. Things aren’t always as they appear. When things sound too good to be true, that’s often because they are.

Critical Illness policies are marketed in such a way to seem like they are a safety net should things go wrong. And sometimes, things go really wrong and the policies pay out. But, in my experience, more often than not, insurers find a way to get out of paying benefits.

I call it a bait and switch.

What do I mean by that? Let’s take a look.

Insurers cleverly market these policies as an affordable means to get coverage. They are “living policies”. That means that the recipient of the benefits is generally alive in order to recover benefits. These policies aren’t life insurance. Nor are they disability insurance. One of the triggering events needs to happen, and the person must survive the triggering event.

Those illnesses, or triggering events can be plentiful. They are marketed in a broad based way, like “cancer” is covered. The insurer doesn’t into great detail about the sort of cancer, or the severity or stage of the cancer. They simply market the coverage as for cancer. Or a heart attack. Broad and general terms are first used to lure a customer in. And that luring is very tempting. Cancer and heart attacks are quite common. So, buying insurance to cover such claims makes sense on first review.

Here are a few other common critical illnesses which are marketed to consumers in broad terms:

Cancer

Cancer of specified severity

Heart Conditions

Aortic surgery
Cardiomyopathy
Coronary artery bypass surgery
Heart attack
Heart valve replacement or repair

Neurological Conditions

Stroke
Acquired brain injury
Bacterial meningitis
Benign brain tumor
Coma
Dementia, including Alzheimer’s Disease
Motor neuron disease (incl. ALS)
Parkinson’s Disease and specified atypical Parkinsonian disorders
Paralysis

Autoimmune Conditions

Aplastic anaemia
Multiple sclerosis
Occupational HIV infection

Sensory & Mobility Conditions

Blindness
Deafness
Loss of limbs
Loss of speech
Loss of independent existence
Severe burns

Transplants & Organ-Related Conditions

Kidney failure
Major organ transplant
Major organ failure on waiting list

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Published on: March 10, 2022

Critical Illness Claims

By Goldfinger Injury Lawyers

Sometimes things which are presented to you sound too good to be true. This can ring true in the sale of insurance products; such as critical illness insurance. When things sound too good to be true, they should be looked at with skepticism.

Our law firm handles critical illness claims. Anyone can purchase a critical illness policy and receive coverage (provided that they are approved for said coverage). More often than not these policies are sold by independent insurance brokers/agents.

As with any industry, there are some excellent brokers/agents. And there are some less than excellent agents/brokers.

Ultimately selling insurance is largely a commission based business. The more policies which an insurance broker sells, the more money s/he will earn. That means there is a direct financial incentive for a broker to sell you a policy of insurance; whatever that policy might be.

Many people want to protect themselves in the event of injury, disability or illness. One of the ways of doing so is by purchasing a critical illness policy. Of all of the living policies, the critical illness policy is the equivalent to hitting the jackpot on the slots in Vegas. It’s a lump sum payout for a critical illness as defined by the policy. This is attractive for many consumers when comparing it to a disability policy which pays a monthly disability benefit which is subject to an all source offset and whereby the definition of disability changes at the two year mark. One lump sum from the insurance company sounds much better to most people. There is no need to worry about an on going multi year relationship with the insurance company. If all goes well the insured can receive his/her lump sum payout and move on with their lives. As oppose to a long term disability claim where the insured will be in a month to month relationship with the insurance company until the end of the claim (which can take many years to wrap up).

Critical illness policies are high risk, high reward policies which insurance companies don’t so easily pay out on. They will require substantial medical evidence in order to approve your claim. It’s not as easy to get approved as you will think.

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Published on: October 1, 2020

Buying Insurance over the Phone? Read this important case

By Goldfinger Injury Lawyers

More and more; people are purchasing insurance or renewing their insurance policies over the phone. This can relate to car insurance, mortgage insurance, life insurance, disability insurance, critical illness insurance, health/medical insurance. It doesn’t matter what type of insurance it is; the reality is that we are placing more emphasis on purchasing these policies over the phone.

An important decision came across my desk when it comes to the purchase or renewal of insurance over the phone. It’s an important read for anyone. The decision is Estate of Donald Farb v. Manulife et. al., 2020 ONSC 3037; the entirety of which can be read by clicking the link here.

The decision was written by the Honourable Justice E. Belobaba who is one super duper smart Judge. Ready his decision doesn’t require a law degree to understand. It’s easy to read and makes sense to lawyers and non-lawyers alike.

So, if you’re buying insurance; no matter the type over the phone; here’s what you need to know from this decision:

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Published on: July 1, 2014

Understanding your Critical Illness Policy & Litigating Critical Illness Claims

By Goldfinger Injury Lawyers

The idea behind Critical Illness Insurance sounds great.

If you suffer from a particular critical illness, then the insurance company will pay you a lump sum.

What sort of critical illnesses are covered are defined by the policy.

It all sounds great, and sounds like a very lucrative proposition. For many, this sort of insurance bets AGAINST your very own health. People think that if they sustain a heart attack, then they’ll be entitled to a lump sum under the policy. So, eating that hamburger and skipping that workout might actually pay out in the long term if your critical illness policy works the way you think it works.

Unfortunately, many of these policies don’t work they way that you think they work, or the way that the broker who sold you the policy explained it to you.
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