Certificate of Insurance – Group Policy CC001002
Issued to CashCo ADM Inc (the “Lender”) by Western Life Assurance Company (the “Insurer”)
The Promissory Note and the Certificate of Insurance are your insuring documents. This Certificate of Insurance describes the following benefits available under the Payroll Loan Insurance Plan.
• Death Benefit • Injury or Sickness Benefit • Critical Illness Benefit • Involuntary Unemployment Benefit
Not all of these insurance benefits necessarily apply to you. Coverage is provided in consideration of your eligibility, your request for coverage and payment of premium. You must read your Promissory Note and your Certificate of Insurance together to determine which insurance you are eligible for and which benefits apply to you.
The following words, when used in this Certificate of Insurance have the following meanings:
“Administrator” means, IWS Creditor Group, at 495 Richmond St., Suite 300, London, ON N6A 5A9, the administrator appointed by the Insurer to administer the Group Policy on their behalf.
“Date Insurance Begins” means, for a standard loan, the earliest of the date of your Promissory Note or the date funds are advanced OR for a mini loan (line of credit), the later of the date funds are initially advanced or the first of the month following a zero balance.
“Doctor” means a Doctor of Medicine (M.D.) duly licensed to practice medicine, or any other practitioner recognized by the College of Physicians and Surgeons in the Province or Country in which the Treatment is rendered. The Doctor must be someone other than yourself or a member of your immediate family. Immediate family includes any of your spouse, parent or stepparent, child or stepchild, brother or sister, stepbrother or stepsister, brother-in-law or sister-in-law, father-in-law or mother-in-law, and son-in-law or daughter-in-law.
“Employed Person” means a person who is working, for a salary or another form of remuneration, on a full-time basis for one or more employers, at least 20 hours per week immediately prior to the date your Involuntary Unemployment commenced. The 20-hour work requirement is continuous and must not be calculated through averaging.
“Hospital” means a licensed institution that is operated for the care and treatment of sick and injured people and:
1. provides organized facilities for diagnosis and major surgery;
2. provides 24-hour nursing services by registered nurses and has a Doctor in regular attendance;
3. is not primarily operated as a rest home, a nursing home or a place for the care and treatment of the blind, the deaf, or the mentally ill;
4. is not primarily operated as a treatment centre for drug addicts or alcoholics unless the institution is eligible to receive payments under a provincial hospital plan.
“Hospitalization” means confined in a Hospital as an inpatient.
“Injury” means bodily injury resulting directly and independently of all other causes from an accident that is caused by external, violent and visible means. We define accident as a sudden, unforeseen event that occurs while you are insured under the Group Policy with respect to the loan.
“Involuntary Unemployment” means
1. termination of employment without cause; or
2. layoff; or
3. termination of employment due to Sickness.
“Insurer” means Western Life Assurance Company.
“Job” means the work You are doing as an Employed Person on the date Your Sickness began or Your Injury occurred.
“Lender” means CashCo ADM Inc..
“Pre-Existing Condition” means any medical condition, symptom, or disease, diagnosed or undiagnosed, for which you received medical advice, consultation, investigation, diagnosis, or for which treatment was required or recommended by a Doctor, during the 12 months prior to the Date Insurance Begins.
“Promissory Note” means the Lender’s loan agreement signed by you and attached to this Certificate of Insurance.
“Seasonal Employee” means an insured person whose normal employment is subject to seasonal conditions wherein a lay-off or work suspension is a regular and anticipated part of the work schedule.
“Sickness” means illness or disease which first manifests itself while you are insured under the Group Policy with respect to the loan. “Sickness” includes mental, nervous, psychological, emotional or behavioural disorders, disease, or conditions.
“We”, “us”, “our” and “Company” mean Western Life Assurance Company, the insurer of Group Policy CC001002.
“You” and “your” mean the insured person named on the Promissory Note you have signed with the Lender when premium has been indicated and has been paid.
You are covered on the Date Insurance Begins under the Creditors’ Group Insurance Policy (the Group Policy) issued by us to the Lender, subject to the terms and conditions of coverage described in this Certificate of Insurance. This Certificate of
Insurance is intended to provide a summary of the provisions of the Group Policy. However, in the event of a dispute, we pay benefits according to the wording in the Group Policy. You may review the Group Policy at the Executive Offices of the Lender. This Certificate of Insurance replaces any and all certificates of insurance previously issued to you with respect to the Group Policy.
OUR AGREEMENT WITH YOU
If your premium is shown on your Promissory Note and has been paid and the information you provided when you enrolled is complete and accurate, we agree to pay the following benefits to the Lender, subject to the applicable terms, conditions and exclusions of this insurance:
1. the Death Benefit described below, if you die while covered for this benefit under the Group Policy;
2. the Injury or Sickness Benefit described in the Injury or Sickness Benefit Schedule below, if you suffer a specified loss while covered for this benefit under the Group Policy;
3. the Critical Illness Benefit, if you suffer a specified loss while covered for this benefit under the Group Policy;
4. the Involuntary Unemployment Benefit described below, if you become involuntarily unemployed while covered for this benefit under the Group Policy.
WHO MAY ENROLL IN THIS INSURANCE PLAN
If you are named on the Lender’s Promissory Note, you may enrol in Payroll Loan Balance Insurance subject to the General Eligibility Requirements listed below. With respect to enrolment in, cancellation of, or changes to this insurance coverage, we are entitled to rely on information and instructions provided by you. All notices and other correspondence relating to this insurance shall be sent to your address on the Lender’s records. Payroll Loan Balance Insurance is voluntary. You do not have to buy Payroll Loan Balance Insurance to obtain a loan.
DATE INSURANCE BEGINS
The Date Insurance Begins for a standard loan is the earlier of the date of your Promissory Note or the date funds are advanced. The Date Insurance Begins for a mini loan (line of credit) is the later of the date funds are initially advanced or the first of the month following a zero balance. All periods of coverage begin and end at 12:01 a.m. at your last address as it appears on the Lender’s records.
Method of Payment
You have agreed that we can charge the premium shown on your Promissory Note for coverage under the Payroll Loan Balance Insurance plan. We have the right to change the premium from time to time. Premiums are payable for each Promissory Note you sign.
GENERAL ELIGIBILITY REQUIREMENTS
There are specific conditions that apply to each of the specific benefits available under this insurance plan. Please refer to the applicable benefit description below for those specific conditions. The following general eligibility requirements apply to all benefits under the Payroll Loan Balance Insurance plan. You must satisfy all of the following conditions to be covered for or eligible to receive any benefits under this insurance:
1. You must be a resident of Canada on the date you apply.
2. You must be under age 70 at the date you apply
3. You must have agreed to the terms and conditions of the Promissory Note.
We do not pay benefits under this insurance if your death, Injury, Sickness, Critical Illness or Involuntary Unemployment resulted directly or indirectly from:
1. a Pre-existing Condition (we will waive this exclusion if your death, Injury, Critical Illness, Sickness or Involuntary Unemployment occurs more than 3 months after the Date Insurance Begins.)
2. intentionally self-inflicted Injury;
3. suicide or attempted suicide, while sane or insane (for the Death Benefit this exclusion is only applicable within the first 24-month period following the Date Insurance Begins);
4. the commission or attempted commission by you of any act which if adjudicated by a court would be an illegal act under the laws of the jurisdiction where the act was committed;
5. travel or flight in any vehicle or device for aerial navigation except as a fare paying passenger aboard a licensed scheduled airline;
6. an accident, Injury or illness sustained where you consumed, used, or had administered any drug, medication, narcotic, toxic substance or any other substance, except for any drug or medication used in strict accordance with the prescription of a licensed Doctor or dentist;
7. operating a vehicle either under the influence of any intoxicant or if your blood alcohol concentration is in excess of the legal limit in the jurisdiction where the accident occurred;
8. declared or undeclared war, or any nuclear, chemical or biological contamination due to any act of terrorism.
MAXIMUM BENEFIT PAYMENT
The Maximum Benefit Amount under any of the benefit provisions of this Group Policy is $1,800 per loss, and $3,000 is the Maximum Benefit Amount in any twelve (12) month period.
DEATH BENEFIT (LIFE INSURANCE) OR CRITICAL ILLNESS BENEFIT
The Death Benefit or the Critical Illness Benefit is equal to the LESSER of the following amounts:
1. the amount of the unpaid balance due under your Promissory Note on the date of your death or the date you are diagnosed with a Critical Illness, or
2. $1,800.00; the maximum amount we pay in the event of death or Critical Illness.
Specific Benefit Conditions
1. The Death Benefit will only be paid, if you die before you attain age 70.
2. The Critical Illness Benefit will only be paid if, while you are insured for the Critical Illness Benefit, you are diagnosed with life-threatening cancer; suffer a stroke, heart attack or kidney failure; or receive a major organ transplant, for the first time in your life and before you attain age 70. We will not pay the Critical Illness Benefit more than once.
3. If we pay the Critical Illness Benefit we will not pay the Death Benefit.
We do not pay the benefit if your death or Critical Illness resulted directly or indirectly from any of the exclusions listed under the General Exclusions section.
INJURY OR SICKNESS BENEFIT
If you suffer an Injury or Sickness we will pay the LESSER of the following amounts:
1. the amount of your unpaid account balance due under your Promissory Note on the date you suffered a specified loss described in the Injury or Sickness Benefit Schedule.
2. $1,800.00 per insured account; the maximum amount we pay in the event of Injury or Sickness.
Injury or Sickness Benefit Schedule
If you suffer an Injury, we will pay the lesser of the following amounts:
1. 100% of the Injury or Sickness Benefit if, due to Injury only, you suffered a fracture of one or more bones or a fracture of two or more fingers in respect to the same Injury, excluding toes, and such fracture requires fixation, open operation grafting or metallic fixation; or
2. 50% of the Injury or Sickness Benefit if:
(a) due to Injury only, you were Hospitalized within 24 hours after your Injury, on the recommendation of your Doctor, and remained Hospitalized for more than 24 hours; or
(b) due to Injury or Sickness, you were unable to work at Your Job for five (5) consecutive working days and You visited a Doctor for treatment of Your Injury or Sickness during the period of time Your were unable to work.
We will make an additional payment of the amount for which You qualify in part 2 of this section if You were unable to work at Your Job for thirty (30) consecutive days from the date Injury or Sickness began and You visited a Doctor for treatment of Your Injury or Sickness during the period of time You were unable to work.
Specific Benefit Conditions
The Injury or Sickness Benefit will only be paid if you suffered a specified loss described in the Injury or Sickness Benefit Schedule while covered for this benefit under the Group Policy.
We do not pay the Injury or Sickness Benefit if your Injury or Sickness resulted directly or indirectly from any of the exclusions listed under the General Exclusions section.
Proof of Loss
In addition to the general proof of claim matters addressed in the Notice of Claim and Claim Forms and Proof of Claim sections of this Certificate of Insurance, the following specific requirements of proof apply. In support of your Injury or Sickness Benefit claim, we will require a written statement from your employer and your Doctor and/or the Hospital where you were treated, in a form satisfactory to us, certifying that you suffered a specified loss described in the Injury or Sickness Benefit Schedule above.
INVOLUNTARY UNEMPLOYMENT BENEFIT
The Involuntary Unemployment Benefit is equal to the LESSER of the following amounts:
1. 100% of the unpaid balance of your Promissory Note on the date Your Involuntary Unemployment commenced; or 2. $1,800 per insured; the Maximum Benefit Amount we pay in the event of Involuntary Unemployment.
Specific Benefit Conditions
The Involuntary Unemployment benefit is paid only if:
1. Your Involuntary Unemployment is due to lay-off or Your termination of employment without cause; and
2. You provide information from Your former employer(s) in support of Your Involuntary Unemployment claim; and
3. You are eligible to register with Human Resources Development Canada (“HRDC”) for Employment Insurance Benefits; and
4. You are under 70 years of age at the time You became Involuntarily Unemployed.
The day following Your last day of work as indicated on Your notification of layoff or termination of employment shall be the date we consider Your Involuntary Unemployment to commence, regardless of the effective date of layoff or termination provided in such notification.
We do not pay the Involuntary Unemployment Benefit:
1. for unemployment which resulted directly or indirectly from any of the exclusions listed under the General Exclusions section;
2. if You were an Employed Person for less than 60 consecutive business days immediately before Your Involuntary Unemployment commenced;
3. if you are a Seasonal Employee;
4. if you became Involuntarily Unemployed within one (1) business day of the Date Insurance Begins (unless you were insured under this Group Policy immediately prior to the Date Insurance Begins for a previous Promissory Note); or
5. if you knew that you were about to become involuntarily unemployed when you applied for coverage; or
6. if your Involuntary Unemployment is the direct or indirect result of
(a) resignation or retirement from your employment,
(b) dismissal from your employment for cause, or
(c) a Labour Dispute or Lockout.
7. if your Involuntary Unemployment was due to Injury or Sickness.
We define a “Labour Dispute” as any disruption of work by an employee group to which you belong, for the purpose of limiting the output of one or more employers. We define a “Lockout” as an act by your employer to temporarily close your place of employment, or suspend your employment without ending it.
Proof of Claim (Involuntary Unemployment)
In addition to the general proof of claim matters addressed in the Making a Claim section of this Certificate of Insurance, the following specific requirements of proof apply. If you were employed, we will require, in support of your Involuntary Unemployment claim:
1. information from your former employers; and
2. proof that, within 15 days after your Involuntary Unemployment commenced, you registered with the Human Resources Development Canada (HRDC) to receive employment insurance benefits or proof that you have received the maximum benefits available from the HRDC; and you must stay registered with the HRDC for as long as you are eligible for HRDC benefits. We may require you to provide us with proof of your continuing Involuntary Unemployment as often as reasonably necessary after payment of your Involuntary Unemployment Benefit begins.
ADDITIONAL PROVISIONS APPLICABLE TO ALL BENEFITS
Making a Claim
This policy contains a provision removing or restricting the right of the group person insured to designate persons to whom or for whose benefit insurance money is to be payable.
Notice of Claim and Claim Forms
You or someone acting on your behalf must notify us within 30 days of your death, Sickness, critical illness, Injury or Involuntary Unemployment. You or your representative may notify us by calling our customer service representatives at 1-800-862-7184 or by writing to us at the Administrators office:
IWS Creditor Group
495 Richmond Street, Suite 300, London, ON N6A 5A9
Any written notice must include the Group Policy number. We will send you or your representative a claim form and instructions on submitting a claim once we have received verbal or written notification of a claim.
Proof of Claim
You, or someone acting on your behalf, must send us, at the address indicated in the Notice of Claim and Claim Forms section, written proof of your claim within 90 days after your loss. Proof of claim includes the completed claim form and supporting documentation including a signed authorization form giving us permission to ask your employer, Doctor, Hospital or health care practitioner about your health or employment information) within 90 days of the date we receive proof of your death, diagnosis of a critical illness, Injury, Sickness or Involuntary Unemployment. If we do not receive proof of claim within the specified time, we will only process the claim if you can show reasonable cause for delay. However, we will not extend the deadline beyond one year from the date of the loss for which benefits are being claimed. Any cost for the completion of a claim form or any documentation submitted in support of a claim is at your or your representative’s expense. Benefits will not be paid if you or your representative refuse to provide a claim form or any documentation or proof we require, or may require, in support of a claim.
Rights of Examination
In the event of death, we have the right, where allowed by law, to ask for an autopsy.
Termination of Coverage
Your coverage under the Group Policy automatically terminates on the earliest of the following dates:
1. the date of your death;
2. your 70th birthday;
3. the date stated in any written notice of termination sent to your address as it appears in our records;
4. the date the maximum number of Benefit payments has been made;
5. the date the maximum Benefit amount has been paid;
6. the date we receive your request to cancel coverage;
7. the date the Group Policy ends; or
8. the date we have paid a combined total of $3,000, in benefit payments, in respect of any and all of your loans covered under Payroll Loan Insurance Group Policies issued by the Company, in any one 12-month period.
If we terminate the Group Policy, written notice of such termination will be mailed to you 31 days in advance of the termination date.
You can cancel your coverage at any time by calling our customer service representatives at 1-800-862-7184 or by writing to us at the Administrators office:
IWS Creditor Group
495 Richmond Street, Suite 300, London, ON N6A 5A9
Right to examine this insurance
If you provide us notice that you wish to cancel this insurance within 20 days after you receive this Certificate of Insurance, any premiums you have paid will be refunded through a credit to your account. If you provide us notice that you wish to cancel your insurance more than 20 days after receiving this Certificate of Insurance, any premiums you have paid will not be refunded.
OTHER IMPORTANT INFORMATION
The contract of insurance includes the Group Policy, any amendments to the Group Policy and any form of application used for enrolment, such as the branch application. Verbal statements cannot alter your coverage as described in this Certificate of Insurance and your Promissory Note and such statements are not legally binding. The Lender and the Company may agree from time to time to amend the Group Policy. No amendment is valid unless the authorized representatives of the Lender and the Company approve it. You will be given 30 days prior written notice of an amendment. You will be deemed to have received such notice on the third business day after it is mailed to the primary applicant’s address as it appears in our records. If the Lender or the Company make any clerical errors in maintaining any records concerning the Group Policy, such errors will not alter or invalidate your coverage or continue coverage that would otherwise be ended for valid reasons.
If, at any time, we waive any provision of the Group Policy, it does not mean we have waived that provision permanently. No waiver of any provision is binding on us, unless it is in writing and signed by the authorized representatives of the Lender and the Company.
Limitation of Action
Every action or proceeding against an insurer for the recovery of insurance money payable under the contract is absolutely barred unless commenced within the time set out in the Insurance Act (Alberta and B.C.). Every action or proceeding against an insurer for the recovery of insurance money payable under the contract is absolutely barred unless commenced within the time set out in The Insurance Act (Manitoba). Every action or proceeding against an insurer for the recovery of insurance money payable under the contract is absolutely barred unless commenced within the time set out in the Limitations Act, 2002 (Ontario). Otherwise, in Quebec every action must be brought within 3 years after the date evidence is furnished, and in all other provinces within 1 year from the date of loss or such longer period as may be required under the law applicable in such province.
Misstatement of Age
We will use your true age to determine whether to pay any benefit.
Who receives the benefit payments
Any benefits payable under the Group Policy will be paid to the Lender unless the Promissory Note has been paid in full.
Any payments to us or by us will be payable in Canadian currency.
Prohibition against assignment
You cannot give your rights and interests with respect to your coverage to anyone else.
This Certificate of Insurance and the Group Policy are non-participating. You do not share in our surplus or profits.
Protecting your Personal Information
At Western Life Assurance Company (Western Life), we recognize and respect the importance of privacy. When you apply for coverage, we establish a confidential file that contains your personal information. This file is kept in the offices of Western Life or the offices of an organization authorized by Western Life. You may exercise certain rights of access and rectification with respect to the information in your file by sending a request in writing to Western Life’s address listed in this certificate. The Insured Person and any claimant may request a copy of the Insured Person’s application, any written evidence of insurability and the Group Policy (other than confidential commercial information or other information exempted from disclosure by applicable law). We limit access to personal information in the Insured Person’s file to Western Life staff or persons authorized by Western Life who require it to perform their duties, to persons to whom the Insured Person has granted access, and to persons authorized by law. We collect, use and disclose the personal information to process this application and, if this application is approved, provide and administer the financial product(s) applied for, investigate and process claims, and create and maintain records concerning our relationship.
This is a certificate of insurance. If there is a discrepancy between this certificate and the master policy, the master policy will apply. To view a copy of the master policy please visit www.iwsinc.ca/CC001002 or request a copy from the Administrator at 1-800-862-7184 or in writing to:
IWS Creditor Group
495 Richmond Street, Suite 300, London, ON N6A 5A9
Loan Balance Insurance provided by:
Western Life Assurance Company
Mailing Address: P.O. Box 3300, Winnipeg, MB R3C 5S2
Administrative Office: 717 Portage Avenue, Winnipeg, MB
Tel: 204-784-6900 Fax: 204-783-6913