To be eligible for this plan, you must be able to sign the following health declaration.
If you answer Yes to one of the questions, you are not eligible.
In the past five (5) years
The insured hereby declares that he or she:
- Has not been hospitalized due to a suicide attempt, depression, anxiety, chronic fatigue or any other emotional disorder.
The insured declares
That he or she has never had any of the following conditions:
- Acquired immunodeficiency syndrome (AIDS), or affection connected to AIDS (ARC) or any immunodeficiency disorder or undergone a test indicating the presence of the AIDS virus or antibody to the AIDS virus.
- Heart failure, cardiomyopathy.
- Currently being treated for cancer, have been diagnosed with metastatic cancer, have had two (2) or more cancers in the past (other than the basal cell carcinoma) including cancer reccurence.
- Stroke, paralysis or two (2) or more transient ischemic attacks (TIA).
- Liver cirrhosis, chronic hepatitis B, hepatitis C.
- Insulin-dependent diabetes.
- Chronic renal disease, been on dialysis, have undergone or are waiting for an organ transplant.
- Amputation as a result of illness.
- Ataxia, transverse myelitis, myasthenia gravis or post-polio syndrome.
- Cystic fibrosis, pulmonary fibrosis, chronic respiratory disease requiring the use of oxygen.
- Motor neurone disease, amyotrophic lateral sclerosis, primary lateral sclerosis, Kennedy syndrome, multiple sclerosis,
Parkinson's disease, Huntington's Chorea.
- Memory loss, dementia, Alzheimer disease.
- Bladder or bowel incontinence requiring regular use of incontinence supplies.
- Dizziness, vertigo, loss of consciousness or numbness for which no diagnosis has been made.
- Osteoporosis with fractures or systemic lupus erythematosus.
- Been treated or have been advised to reduce the use of alcohol or drugs due to dependency.
- Awaiting an investigation or a scheduled surgery that has not yet been completed.
The insured also declares
That he/she is not receiving at this time or has not been advised to receive
- Care in a hospital, psychiatric, convalescence home and rehabilitation centre.
- Physiotherapy at home or requires the assistance of medical accessories such as: cane, walker, wheelchair.
- Assistance with two or more of the daily living activities such as bathing, eating, dressing, walking, taking medication, toileting, or using the toilet.