Guardian Critical Illness Protection Plus Gold

Coverage Summary
(see your policy for further details)
How it Works

Critical Illness Protection Plus is a lump sum benefit that can supplement your existing medical coverage. It can help with expenses that medical insurance typically does not cover. Upon diagnosis of a covered critical condition, you will be eligible to receive a lump sum payout as described in the schedule below. That lump sum can be used in any way you choose, including to offset deductibles, other out-of-pocket costs, or services such as experimental treatments.
Your Plan Benefits
Guardian Pays
% of $20,000 lump sum plan benefit
(see Certain Plan Limitations below)
Heart & Vascular Conditions
Heart Attack
100% 1st occurrence, 50% recurrence
Stroke
(acute cerebrovascular event)
100% 1st occurrence, 50% recurrence
Heart Failure
(requiring a transplant)
100% 1st occurrence, 50% recurrence
Arteriosclerosis
(with need for intervention)
30% 1st occurrence, recurrence not covered
(see policy for full list of coverage)
Cancer Related Conditions

Invasive Cancer is a cancer that has spread from its site of origin to adjacent tissues

Non-Invasive Cancer or Carcinoma in Situ is a cancer that is confined to the location from which it started, and has not spread to adjacent tissues
Invasive Cancer
100% 1st occurrence, 50% recurrence
Non-Invasive Cancer

30% 1st occurrence, recurrence not covered

Skin Cancer
Not Covered
(see policy for full list of coverage)
 
 
 
 
Major Organ Failure

Other Major Organ Failure is the irreversible failure of both lungs, liver, pancreas, or bone marrow
Kidney Failure
(requiring dialysis or transplant)
100% 1st occurrence, 50% recurrence
Other Major Organ Failure
(requiring a transplant)
100% 1st occurrence, 50% recurrence
(see policy for full list of coverage)
Certain Plan Limitations
Multiple Critical Illness Conditions at the Same Time

When one Critical Illness condition causes or contributes to another Critical Illness condition, the plan benefit is limited to only one Critical Illness condition. The plan pays the greater benefit of the two Critical Illness conditions
Multiple Critical Illness Conditions in the Same Category

Plan benefit for multiple Critical Illness conditions in the same category (e.g., Heart Attack and Stroke) is limited to occurrences separated by at least 3 months
Recurrence

Plan benefit for a 2nd occurrence of the same condition is limited to an occurrence separated from the 1st occurrence by at least 6 months, during which you have not exhibited symptoms or received treatment (excluding preventive medications). Additional occurrences beyond the 2nd occurrence are not covered
Pre-Existing Conditions

A pre-existing condition includes any condition for which you, during the 6-month period prior to coverage in this plan, consulted with a physician, received treatment, or took prescribed drugs

Plan benefit for pre-existing conditions is limited to occurrences at least 6 months following the coverage start date
Deductibles
What you pay out-of-pocket before your plan pays benefits
You Pay
There is no deductible

$0
Maximum Payouts
The maximum amount Guardian will pay per occurrence diagnosis
Maximum Guardian Pays
Lump Sum Benefit Amount $20,000
Ongoing Eligibility Requirements
Renewability

Coverage is guaranteed renewable. Premiums will not change because of a change in your health.

Premiums may occasionally change, however, for all members of a class. If premiums change, you will receive at least 30 days advance notice
Age-Related Termination Coverage will be terminated at age 75
Exclusions
(see your policy for further details)

This Policy will not pay benefits for any Critical Illness caused by, or related to, directly or indirectly, any of the following:

  • Participating in a felony, riot or insurrection.
  • Suicide or attempted suicide or Intentional self-inflicted Injury
  • Caused by, alcohol or drug usage, unless administered under the advice of a Doctor.
  • Declared or undeclared war, or act of war.
  • For which Diagnosis is made outside the United States, its possessions,or the countries of Canada and Mexico, unless the Diagnosis is confirmed in the United States.  In that case, the Specified Disease will be deemed to occur on the date the Diagnosis was made outside the United States.
  • That is diagnosed while the person is not covered by this Policy.
  • For which Diagnosis is made by a Doctor who is the Policyowner, his or her Spouse, child, parent, sibling or business associate.
  • For which Diagnosis is made while the You are not alive, unless otherwise specified under Covered Specified Disease.

 

Critical Illness Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Please refer to your plan documents for a complete list of limitations and exclusions.  Plan documents are the final arbiter of coverage.

Policy Form # IP-CI-16-NY