Suitability of LTC, Life Insurance & Annuities in Canada
Table of Contents
| 
   Chapter 1: Care Around the World  | 
  
   1  | 
 
| 
   Inverse Care  | 
  
   1  | 
 
| 
   Impoverishing Care  | 
  
   1  | 
 
| 
   Fragmented Care  | 
  
   2  | 
 
| 
   Unsafe Care  | 
  
   2  | 
 
| 
   Conditions Contributing to Health Care Costs  | 
  
   2  | 
 
| 
   Universal Health Care  | 
  
   2  | 
 
| 
   Primary Health Care  | 
  
   3  | 
 
| 
   Secondary Health Care  | 
  
   4  | 
 
| 
   Tertiary Health Care  | 
  
   4  | 
 
| 
   The Canadian Healthcare System  | 
  
   6  | 
 
| 
   Critical Illness Insurance  | 
  
   12  | 
 
| 
   Characteristics of Critical Illness Insurance (Critical Illnesses)  | 
  
   13  | 
 
| 
   Should Individuals Buy Critical Illness Insurance?  | 
  
   14  | 
 
| 
   Achieving Quality Health Care  | 
  
   15  | 
 
| 
   Long-Term Care  | 
  
   19  | 
 
| 
   Long-Term Care Reform in Canada  | 
  
   22  | 
 
| 
   Fixing Long-Term Care Act, 2021  | 
  
   22  | 
 
| 
   Visitor Policy  | 
  
   24  | 
 
| 
   Continuous Quality Improvement  | 
  
   25  | 
 
| 
   Air Conditioning  | 
  
   26  | 
 
| 
   Palliative Care Philosophy  | 
  
   26  | 
 
| 
   Infection Prevention and Control  | 
  
   26  | 
 
| 
   Calculating Direct Care Targets  | 
  
   27  | 
 
| 
   Medical Directors  | 
  
   27  | 
 
| 
   Staffing  | 
  
   27  | 
 
| 
   Medical Accessibility  | 
  
   27  | 
 
| 
   Sustainability  | 
  
   27  | 
 
| 
   A Citizen’s Responsibility When Aging  | 
  
   28  | 
 
| 
   Entering Old Age with Dignity  | 
  
   30  | 
 
| 
   Too Few Trained Professionals in the LTC Industry  | 
  
   31  | 
 
| 
   Meeting the Challenge  | 
  
   33  | 
 
| 
   Informal Caregiver  | 
  
   34  | 
 
| 
   Determining Personal Long-Term Care Risk  | 
  
   34  | 
 
| 
   CLHIA Funding Recommendations  | 
  
   37  | 
 
| 
   Fear of Institutionalization  | 
  
   38  | 
 
| 
   Today’s Realities  | 
  
   38  | 
 
| 
   Changing Populations and Changing Family Rolls  | 
  
   40  | 
 
| 
   Late Life Frailty  | 
  
   40  | 
 
| 
   To Recap  | 
  
   41  | 
 
| 
   Changes in Health Can Result in Financial Depletion  | 
  
   41  | 
 
| 
   Affording the Cost of Insurance  | 
  
   41  | 
 
| 
   Preparing for Future Costs  | 
  
   42  | 
 
| 
   All Ethnic, Religious, and Racial Segments are Affected  | 
  
   42  | 
 
| 
   Making Decisions Based on Genetics and Family History  | 
  
   43  | 
 
| 
   ADL: Activities of Daily Living  | 
  
   43  | 
 
| 
   Making a Logical Assessment  | 
  
   44  | 
 
| 
   Case Managers  | 
  
   44  | 
 
| 
   Insurance Affordability  | 
  
   45  | 
 
| 
   When There is no Insurance Policy in Effect  | 
  
   46  | 
 
| 
   Policy Application  | 
  
   46  | 
 
| 
   Policy Contracts Have Improved Over the Years  | 
  
   47  | 
 
| 
   Qualifying for Long-Term Care Benefits under Policy Terms  | 
  
   49  | 
 
| 
   Women and Long-Term Care  | 
  
   50  | 
 
| 
   Finding Caregivers  | 
  
   50  | 
 
| 
   Children as Caregivers  | 
  
   51  | 
 
| 
   Paid Caregivers  | 
  
   52  | 
 
| 
   Adult Day Care and Adult Day Health (or Medical) Care  | 
  
   52  | 
 
| 
   Community-Based Care  | 
  
   53  | 
 
| 
   Respite Care  | 
  
   54  | 
 
| 
   Assisted Living Facilities  | 
  
   55  | 
 
| 
   Assisted Living National Program Guidelines 2019 to 2020  | 
  
   60  | 
 
| 
   Introduction  | 
  
   60  | 
 
| 
   Objective  | 
  
   61  | 
 
| 
   Expected outcomes  | 
  
   61  | 
 
| 
   Funding recipients  | 
  
   61  | 
 
| 
   Program recipients, clients, and individuals  | 
  
   63  | 
 
| 
   Activities  | 
  
   70  | 
 
| 
   Expenditures  | 
  
   71  | 
 
| 
   Funding  | 
  
   74  | 
 
| 
   Reporting requirements and monitoring and oversight activities  | 
  
   74  | 
 
| 
   Personal information  | 
  
   75  | 
 
| 
   Accountability  | 
  
   75  | 
 
| 
   Official languages  | 
  
   75  | 
 
| 
   Definitions  | 
  
   75  | 
 
| 
   Contact information  | 
  
   76  | 
 
| 
   Related links  | 
  
   76  | 
 
| 
   Summary of federal classification system for institutional care  | 
  
   76  | 
 
| 
   Locating Assisted Living Facilities  | 
  
   78  | 
 
| 
   Long-Term Care Insurance Policies  | 
  
   79  | 
 
| 
   Policy Terms  | 
  
   83  | 
 
| 
   Participants  | 
  
   83  | 
 
| 
   Premium Due Dates  | 
  
   84  | 
 
| 
   Automatic Withdrawable Premium Fund  | 
  
   84  | 
 
| 
   Policy Reinstatement  | 
  
   84  | 
 
| 
   Premium Guarantees  | 
  
   85  | 
 
| 
   Premium Waivers  | 
  
   85  | 
 
| 
   Return of Premium upon Death  | 
  
   85  | 
 
| 
   Long-Term Care Policy Benefits  | 
  
   86  | 
 
| 
   Time Limits  | 
  
   86  | 
 
| 
   Benefit Amounts  | 
  
   86  | 
 
| 
   Cancelation Guarantees  | 
  
   86  | 
 
| 
   Policy Ending Date  | 
  
   86  | 
 
| 
   Policy Incontestability  | 
  
   87  | 
 
| 
   Policy Effective Dates  | 
  
   87  | 
 
| 
   Dependency Determination under the Policy  | 
  
   88  | 
 
| 
   Defining Activities of Daily Living  | 
  
   89  | 
 
| 
   Bathing  | 
  
   89  | 
 
| 
   Continence  | 
  
   89  | 
 
| 
   Dressing  | 
  
   89  | 
 
| 
   Feeding  | 
  
   89  | 
 
| 
   Toileting  | 
  
   89  | 
 
| 
   Transferring  | 
  
   89  | 
 
| 
   Policy Exclusions and Limitations  | 
  
   90  | 
 
| 
   Inflation Protection  | 
  
   91  | 
 
| 
   Filing a Long-Term Care Claim  | 
  
   91  | 
 
| 
   Continuous Versus Individual Claims  | 
  
   93  | 
 
| 
   Considering Need  | 
  
   93  | 
 
| 
   
  | 
  
   
  | 
 
| 
   Chapter 2: Life Insurance in Canada  | 
  
   95  | 
 
| 
   Insurance Agents  | 
  
   95  | 
 
| 
   Life Insurance Contracts (terms)  | 
  
   96  | 
 
| 
   Life’s a Gamble  | 
  
   97  | 
 
| 
   Defining Risk  | 
  
   98  | 
 
| 
   Comfort Level  | 
  
   99  | 
 
| 
   Insurance Risks, Perils & Hazards  | 
  
   100  | 
 
| 
   Chance of Loss  | 
  
   100  | 
 
| 
   Morale & Moral Hazards  | 
  
   101  | 
 
| 
   Law of Large Numbers  | 
  
   101  | 
 
| 
   Types of Risk  | 
  
   102  | 
 
| 
   Pure & Speculative Risks  | 
  
   103  | 
 
| 
   Investment Risk  | 
  
   104  | 
 
| 
   Issuance  | 
  
   104  | 
 
| 
   Insurable Interest in Life Insurance  | 
  
   106  | 
 
| 
   A Fairytale Case Study  | 
  
   107  | 
 
| 
   Stranger Originated Life Insurance (STOLI)  | 
  
   108  | 
 
| 
   Life & Viatical Settlement Agreements  | 
  
   110  | 
 
| 
   Definitions  | 
  
   110  | 
 
| 
   Understanding the Viatical Product  | 
  
   112  | 
 
| 
   How do Viatical Settlements Work?  | 
  
   113  | 
 
| 
   Purchasing Partial Policies  | 
  
   113  | 
 
| 
   Viatical Participant Confidentiality  | 
  
   113  | 
 
| 
   Paying the Viator  | 
  
   113  | 
 
| 
   Buyer’s Remorse  | 
  
   114  | 
 
| 
   Following Payment for the Life Policy  | 
  
   114  | 
 
| 
   Checking Health Status through Physicians  | 
  
   114  | 
 
| 
   Extra Policy Benefits  | 
  
   114  | 
 
| 
   Other Available Options  | 
  
   115  | 
 
| 
   Viatical Settlement Development  | 
  
   115  | 
 
| 
   Medical Underwriting  | 
  
   116  | 
 
| 
   Insurance Underwriting  | 
  
   117  | 
 
| 
   How Consumers View Them  | 
  
   118  | 
 
| 
   Policy Ownership Transfer  | 
  
   119  | 
 
| 
   Policy Premium Payments  | 
  
   120  | 
 
| 
   Outstanding Policy Loans  | 
  
   122  | 
 
| 
   Additional Investment Fees  | 
  
   123  | 
 
| 
   Escrow Trust Accounts  | 
  
   124  | 
 
| 
   Personal Information Protection & Electronic Documents Act  | 
  
   124  | 
 
| 
   Insurance Policy Effective Dates  | 
  
   125  | 
 
| 
   Material Facts  | 
  
   126  | 
 
| 
   Beneficiary Designations in General  | 
  
   126  | 
 
| 
   
  | 
  
   
  | 
 
| 
   Life Insurance  | 
  
   129  | 
 
| 
   Changing Social Times  | 
  
   129  | 
 
| 
   Two Basic Insurance Terms: Premium & Peril  | 
  
   130  | 
 
| 
   Winning and Losing the Insurance Gamble  | 
  
   130  | 
 
| 
   Determining the Need for Life Insurance  | 
  
   131  | 
 
| 
   Estate Planning: Procedures, Not Products  | 
  
   132  | 
 
| 
   Providing for Others Through Planning  | 
  
   133  | 
 
| 
   Using Discipline to Achieve Security  | 
  
   134  | 
 
| 
   Clarifying Client Objectives  | 
  
   134  | 
 
| 
   The Need for Broader Knowledge  | 
  
   134  | 
 
| 
   Basic Goals of Life Insurance  | 
  
   135  | 
 
| 
   Life Insurance Trusts  | 
  
   135  | 
 
| 
   Trust Beneficiaries  | 
  
   136  | 
 
| 
   Life Insurance is a contract  | 
  
   136  | 
 
| 
   An Estate Planning Tool  | 
  
   137  | 
 
| 
   Term Insurance is All About the Payout  | 
  
   137  | 
 
| 
   Whole Life Insurance: The Granddaddy of Them All  | 
  
   138  | 
 
| 
   Endowment Insurance Policies: Forced Savings  | 
  
   138  | 
 
| 
   Universal Life: Separating Expenses  | 
  
   139  | 
 
| 
   Variable Universal Life: Few Guarantees  | 
  
   139  | 
 
| 
   Survivorship Life: Insuring Two or More People  | 
  
   141  | 
 
| 
   Single Premium Whole Life: One Payment  | 
  
   142  | 
 
| 
   Buy-Sell Agreements  | 
  
   142  | 
 
| 
   
  | 
  
   
  | 
 
| 
   Chapter 3: Annuities in Canada  | 
  
   144  | 
 
| 
   Annuity Terminology  | 
  
   144  | 
 
| 
   General Policy Provisions  | 
  
   148  | 
 
| 
   Planning for Increased Life Spans  | 
  
   149  | 
 
| 
   Longevity Risk  | 
  
   150  | 
 
| 
   Variable Annuities (Segregated Funds)  | 
  
   150  | 
 
| 
   Maturity Guarantees  | 
  
   151  | 
 
| 
   Death Benefit Guarantees  | 
  
   151  | 
 
| 
   Performance of Funds is not Guaranteed  | 
  
   151  | 
 
| 
   Types of Contracts  | 
  
   152  | 
 
| 
   Registered Retirement Savings Plans (RRSP)  | 
  
   153  | 
 
| 
   Section 146 of the Income Tax Act  | 
  
   153  | 
 
| 
   Non-Registered Annuities  | 
  
   154  | 
 
| 
   Prescribed Treatment/Non-Prescribed Treatment  | 
  
   155  | 
 
| 
   RRSP Types  | 
  
   156  | 
 
| 
   Contributions  | 
  
   157  | 
 
| 
   Spousal RRSP / Taxation of Deferred Annuities  | 
  
   158  | 
 
| 
   Taxation of Deferred Annuities  | 
  
   158  | 
 
| 
   The Decision to Buy  | 
  
   158  | 
 
| 
   Life Income Funds  | 
  
   159  | 
 
| 
   Immediate Annuities  | 
  
   160  | 
 
| 
   Payout Options  | 
  
   160  | 
 
| 
   Single Life Payout Option  | 
  
   161  | 
 
| 
   Joint-and-Survivor Payout Option  | 
  
   162  | 
 
| 
   Installment Refund Life Payout Option  | 
  
   162  | 
 
| 
   Variable Annuity Payout Option  | 
  
   163  | 
 
| 
   Term Certain Payout Option  | 
  
   163  | 
 
| 
   Other Products  | 
  
   163  | 
 
| 
   Dollar Cost Averaging  | 
  
   164  | 
 
| 
   Annuity Beneficiary Designations  | 
  
   164  | 
 
| 
   Annuity Contingent Beneficiaries  | 
  
   165  | 
 
| 
   The Insurance Contract  | 
  
   166  | 
 
| 
   Deposits  | 
  
   167  | 
 
| 
   Surrender Penalties  | 
  
   167  | 
 
| 
   Retirement Savings Plan (RSP) Endorsements  | 
  
   168  | 
 
| 
   Switches  | 
  
   169  | 
 
| 
   Investment Options  | 
  
   169  | 
 
| 
   Product Suitability  | 
  
   170  | 
 
| 
   Saving Adequately  | 
  
   170  | 
 
| 
   The Reason for the Goal (the reward)  | 
  
   171  | 
 
| 
   Determining Goals  | 
  
   174  | 
 
| 
   Basic Product Information Requirements  | 
  
   175  | 
 
| 
   Determining Product Suitability  | 
  
   176  | 
 
| 
   Product Replacement  | 
  
   178  | 
 
| 
   Twisting  | 
  
   178  | 
 
| 
   Churning  | 
  
   178  | 
 
| 
   Identifying Suitability Issues  | 
  
   179  | 
 
| 
   It is About Suitability for the Buyer, Not Liquidity  | 
  
   179  | 
 
| 
   A Comprehensive Financial Plan  | 
  
   181  | 
 
| 
   Suitability in the Retail Sale of Financial Products (report)  | 
  
   183  | 
 
| 
   Determining Suitability According to the Report  | 
  
   188  | 
 
| 
   Annuity Surrender Values and Penalties  | 
  
   189  | 
 
| 
   Financially Sound Insurers  | 
  
   190  | 
 
| 
   
  | 
  
   
  | 
 
| 
   Chapter 4: Anti-Money Laundering  | 
  
   191  | 
 
| 
   Abbreviations  | 
  
   192  | 
 
| 
   Client Due Diligence  | 
  
   193  | 
 
| 
   Determining Identification in a Face-to-Face Interview  | 
  
   193  | 
 
| 
   Identification of New Business Clients  | 
  
   194  | 
 
| 
   Confirming the Client’s Business  | 
  
   195  | 
 
| 
   Collection of Beneficial Owner & Director Information  | 
  
   195  | 
 
| 
   Not-for-Profit Organizations  | 
  
   195  | 
 
| 
   Exceptions to Requirements for Business Clients  | 
  
   196  | 
 
| 
   Third-Party Determination  | 
  
   197  | 
 
| 
   Politically Exposed Foreign Person Requirement  | 
  
   197  | 
 
| 
   Retention of Client Records  | 
  
   198  | 
 
| 
   Suspicious Transactions  | 
  
   198  | 
 
| 
   “Red Flag” Indicators  | 
  
   198  | 
 
| 
   Tipping Off  | 
  
   199  | 
 
| 
   Large Cash Transaction Reporting  | 
  
   199  | 
 
| 
   The Proceeds of Crime & Terrorist Financing Administration Monetary Penalties Regulations  | 
  
   199  | 
 
| 
   Terrorism Produces Insurer Risk  | 
  
   199  | 
 
| 
   FATF  | 
  
   200  | 
 
| 
   Proceeds of Crime and Terrorism Financing Act  | 
  
   201  | 
 
| 
   Objective of the Act  | 
  
   201  | 
 
| 
   Know-Your-Client (KYC)  | 
  
   203  | 
 
| 
   Prevention  | 
  
   208  | 
 
| 
   Policy Application  | 
  
   208  | 
 
| 
   Restricted Businesses and Entities  | 
  
   208  | 
 
| 
   Education is Always the Best Defense  | 
  
   209  | 
 
| 
   A Change in Thinking  | 
  
   209  | 
 
| 
   Product Identification  | 
  
   210  | 
 
| 
   Typologies  | 
  
   211  | 
 
| 
   1. Single Premium Life Insurance Contracts  | 
  
   211  | 
 
| 
   2. Early Policy Redemption  | 
  
   211  | 
 
| 
   3. Claim Fraud  | 
  
   212  | 
 
| 
   4. Cash Premium Payments  | 
  
   212  | 
 
| 
   5. “Free Look” Periods on Newly Issued Policies  | 
  
   212  | 
 
| 
   6. Collusion of Customer Intermediary and/or Insurer Employee  | 
  
   213  | 
 
| 
   7. Third-Party Premium Payments  | 
  
   213  | 
 
| 
   8. Risks Involved in International Transactions  | 
  
   213  | 
 
| 
   9. Fraudulent Customers, Insurers, or Reinsurance Companies  | 
  
   213  | 
 
| 
   Money Laundering Indicators Not Unique to Insurance Products  | 
  
   214  | 
 
| 
   Cash Transactions  | 
  
   214  | 
 
| 
   Use of False Addresses and Other Information  | 
  
   214  | 
 
| 
   Overseas Business from Higher Risk Jurisdictions  | 
  
   214  | 
 
| 
   Characteristics of the Money Launderer  | 
  
   214  | 
 
United Insurance Educators, Inc.