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Critical Illness Insurance

Critical Illness Insurance

Voluntary Critical Illness Insurance

You can’t predict the future, but you can plan for it. BorgWarner offers Voluntary Critical Illness insurance through Allstate that provides financial support in the form of a cash lump sum if you are diagnosed with a qualifying critical illness, such as:

Heart Attack
Heart Attack

Stroke
Stroke

Cancer
Cancer

Organ Transplant
Organ Transplant

Coverage is also is available for your spouse and children. Child(ren) are covered at no additional cost, but will end when the child reaches age 26, unless he or she continues to meet the requirements of an eligible dependent. By providing financial protection, this coverage allows you to focus on recuperating rather than coping with the stress of how to cover bills related to treatment or everyday living expenses.

Exclusions
We will not pay benefits for a critical illness that is, or caused by, contributed to, or results from: 1. War, declared or undeclared, participation in a riot, insurrection or rebellion. 2. Intentionally self-inflicted injury or action. 3. Illegal activities or participation in an illegal occupation. 4. Suicide while sane, or self-destruction while insane, or any attempt at either. 5. Substance abuse, to include abuse of alcohol, alcoholism, drug addiction or dependence upon any controlled substance.
Pre-existing condition limitations

Benefits are not payable for any critical illness diagnosed prior to the effective date. Benefits are subject to the Pre-Existing Condition Limitation (if included), as well as other limitations and exclusions. All critical illness must meet the definitions and dates of diagnoses stated in the policy and be diagnosed by a physician while coverage is in effect. Cancer critical illness benefits are payable for a diagnosis of a new or a recurrence of cancer, as long as the insured is diagnosed after the effective date of coverage, and has been free of any symptoms and treatment of cancer for 12 consecutive months immediately preceding the effective date of coverage, or any 12 consecutive months thereafter. The date of the diagnosis for each illness must be separated by 90 days. Emergency situations while outside the U.S. will be considered the insured returns to the U.S.

Allstate Benefits is the marketing name used by American Heritage Life Insurance Company (Home Office, Jacksonville, FL), a subsidiary of The Allstate Corporation.

Voluntary Critical Illness Insurance Benefit Amounts

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Voluntary Critical Illness Insurance Benefit Amounts

REPRESENTATION. I have read or had read to me the completed application and understand that any misstatement or misrepresentation in the application may result in loss of coverage. I represent that statements and answers given on this application are true, complete, and correctly recorded. UNDERSTANDING. I understand that: if premiums for the coverage(s) is (are) to be paid by payroll deductions, these deductions may start before the "effective date" of coverage(s) and that this does not change the effective date of coverage; and the “effective date” for health insurance coverages will be the date recorded on the policy/certificate/benefit statement, not the date the application is signed. If the coverage(s) is (are) not issued, American Heritage Life will refund any deductions it receives. I also understand that no producer (agent) has authority to waive any answer or otherwise modify this application, or to bind AHL in any way by making any promise or representation that is not set out in writing in this application. I understand that if I refuse any coverage for which I am eligible, satisfactory proof of insurability may be required, at my own expense, should I desire to apply for it at a later date. Any such application may be declined on the basis of such proof. PREMIUM DEDUCTION AUTHORIZATION. I AUTHORIZE my employer to deduct from my salary or wages, if applicable, the necessary premium for the coverages requested. AUTHORIZATION TO OBTAIN AND DISCLOSE CERTAIN DATA (FOR SI LIFE AND CRITICAL ILLNESS). I authorize any physician, medical practitioner, hospital, clinic or other medical facility, Pharmacy Benefit Managers, insurance company, MIB, Inc. or other organization, institution or person, that has records or knowledge of me or my health including my prescription medication history to give to AHL, its subsidiaries or its reinsurers any information. I also authorize AHL, or its reinsurers, to make a brief report of my health information to MIB, Inc. I understand that there is a possibility of redisclosure of any information disclosed pursuant to this authorization and that information, once disclosed, may no longer be protected by federal rules governing privacy and confidentiality. I acknowledge receipt of the Important Notice About Privacy and MIB Notice form. A copy of this authorization is as valid as the original. This authorization applies to any dependent on whom insurance is requested. This authorization is valid for 24 months from the date signed. I understand that I may revoke this authorization at any time by notifying AHL in writing of my desire to do so.

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