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What is a Critical Illness Rider for Life Insurance?

critical illness rider
Insurance Quotes 2 Day Team

Written By Doug Mitchell

Doug Mitchell, CLU holds a BA degree in Finance from Auburn University as well as having obtained a Chartered Life Underwriter (CLU) designation from The American College in Bryn Mahr, PA.  Doug has spent close to 30 years in the insurance and financial planning industry and has held licenses to sell securities, long-term care insurance, health.  Doug is also a financial blogger addressing the topics of life insurance, annuities and retirement income planning.

Holly Mitchell  &

Holly Mitchell’s background in life insurance insurance goes back to 1985 when she worked for her father who was a New York Life agent. Holly has a marketing degree from Auburn University and has had a life insurance license since 2008. In addition to advising life insurance for customers all around the country, Holly is our website fact checker.

Rob Pinner   &

Rob Pinner is the founder and CEO of Pinner Financial Services servicing all 50 states. Rob started his insurance career in 2002.

Louis LaBash

Results-driven and innovative life insurance professional with 30 plus years of life insurance industry sales and marketing experience. Recognized as a pioneer in the field, leveraging phone and internet channels to exceed personal sales of over $100 million during the first decade of the 21st century. Creator of a highly effective intuitive IUL life insurance sales software that facilitated the sale of millions of dollars of indexed universal policies by numerous life insurance agents. Proven track record as a Managing General Agent (MGA), Life Agent, IUL Life Insurance Sales Software developer, and leading-edge creator of insurance marketing tools, educational content, and delivery systems.

 11 minute read

If you were to be diagnosed with a chronic or critical illness would you have the resources available to make certain that you and your family can manage your disease financially?

Even if you have the best health insurance in the marketplace, have you thought about the related financial costs that come with a debilitating illness?

How about a quick review of the cost?  Take a minute to view them here:

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What if you could add a chronic or critical illness rider to your life insurance policy at a very low cost? 

Would this be valuable to you?

It seems logical that having chronic and critical illness rider life insurance would be beneficial to anyone.

What if you could have peace of mind knowing that if you became so ill that you could not work but you still needed to remodel your home to accommodate your illness, would that be important to you? If so, keep reading to learn about getting life insurance with critical illness insurance or chronic illness insurance riders.

Anyone who has been through being diagnosed with a chronic or critical illness will typically testify that the experience is devastating. Fortunately, most of the life insurance policies that we sell today include chronic illness insurance and critical illness insurance benefits that will pay a lump sum or monthly benefits for these types of disasters.

How much critical illness life insurance do I need and is it possible to buy critical illness rider life insurance with pre-existing conditions?

The truth of the matter is, we all have family, friends, neighbors, and co-workers that have experienced this at some point during their lives. Certainly, It is hard to imagine that it can happen to us and nobody can imagine the toll such a diagnosis can take on our lives and the lives of our family. The physical and emotional aspects of a debilitating diagnosis are bad enough, but have you ever considered the ramifications of the financial aspects? One of the most important things I have learned in life is that you can never have too much insurance to help cover you in the case of the unimaginable.

The Critical Illness Rider Life Insurance

When you’re shopping for life insurance and any critical illness rider to go with it, it can be a confusing process trying to understand all of the different terms and conditions that go along with these plans. Fortunately, we are here to help you ensure that you’re getting the perfect coverage for you and your loved ones. If something tragic were to happen to you, and you didn’t have life insurance coverage, then your family could be left with a massive amount of bills and other final expenses which can easily result in financial devastation, especially if they do not have the resources to cope with this medical trauma.

There is no question that the cost of a critical or chronic illness can be staggering when you don’t have chronic illness insurance or critical illness insurance. In a time when you should be concentrating on getting healthy or spending your precious remaining days with your loved ones, you can be crippled with medical bills that are staggering.

Even with exceptionally good medical insurance, the cost of treatment can far exceed your benefits. In fact, it has been estimated that a year of treatment for certain diseases could cost upwards of $1 million, a number that exceeds the maximum paid by most health insurance companies. Fortunately, you can purchase riders for your life insurance that can help with these expenses.  Most of the indexed universal life insurance policies today automatically add these types of coverage to the policy at no cost.  These benefits offer you more flexibility and enable you to realize some of the positives of life insurance without having to die.

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What Exactly is Covered Under These Riders?

If you are diagnosed as chronically ill and consequently become unable to perform simple daily activities such as bathing, eating or dressing, or if you are diagnosed as chronically ill because of cognitive impairment, you may be eligible for a chronic illness insurance benefit.  Generally, if your policy has been in place for at least two years, a chronic illness rider will pay you a lump sum or monthly benefit up to a certain percentage of your death benefit.

You do not have to be terminally ill to get these benefits. There is a lot of flexibility with these policies and for those who do need cash now, there is peace of mind in knowing that their life insurance can do that without them having to die.

Critical Illness insurance coverage will generally pay a lump sum if you suffer from a covered illness. Serious injuries or major diseases are typically included. Also, you do not have to be totally disabled to collect the benefit and you do not have to be employed to collect it either. The diagnosis of the critical illness does have to be made by a qualified physician, generally an expert in the field. Specific tests confirming the diagnosis may also be ordered.

Examples of triggering illnesses generally include:

  • Heart attack: In most cases, a heart attack occurs as a result of blood not bringing enough oxygen to the heart muscle which results in the heart muscle being severely reduced or even cut off altogether. Many people have heard or are familiar with a condition call Ischemia. Ischemia happens when your heart muscle is deprived of oxygen and nutrients. This typically results in damage to the heart muscle or even death to part of it. This ischemia can result in a heart attack or what physicians refer to as myocardial infarction (MI).
  • Cancer: The term “Cancer” is a name given to a large collection of related diseases. In every case, cancer is the result of a person’s cells in their body that begin to divide and multiply without coming to a stop and thus will spread into the surrounding tissues in the body. Cancer cells in the body differ greatly from normal cells because of the out-of-control growth that allows them to become invasive to other tissue and organs. Cancer is a genetic disease. This means that it’s caused by changes to your genes that have control over how your cells actually function, meaning how they should grow and divide normally. There is good news, however, the death rate from cancer has steadily gone down over the last twenty years. Although cancer diagnoses have increased each year, innovative treatments have reduced the death rate attributed to cancer.
  • Stroke: A stroke is an attack on a person’s brain and unfortunately, stroke can happen to anyone. A stroke will occur when the blood flow to an area in your brain is completely cut off. When the blood flow stops, your brain cells become deprived of their needed oxygen and begin to die. Unfortunately for a stroke victim, the body’s abilities which are controlled in the affected area of the stroke. Examples of this would be memory loss and the loss of muscle control.

Here are some startling facts about stroke victims:

>> About 800,000 people are affected by a new or recurrent stroke each year.

>> Someone has a stroke about every 40 seconds every day

>> Stroke has become the fifth leading cause of death in the United States

>> In the U.S. someone will die from stroke every 4 minutes

>> When it comes to disabled adults, stroke is the leading cause

>> The surprising statistic about stroke is, about 80% of them could have been prevented

  • Severe burns: Severe burns can easily incapacitate the victim and death will typically result from infection. The CDC (Centers for Disease Control and Prevention), publish an annual report regarding severe burns and any resulting deaths. The statistics are likely to surprise the reader:

>> During the year 2000, someone was injured every 23 minutes by a severe burn and someone died every 2 hours as a result

>> The American Burn Association reports that each year 1.1 million injuries resulting from a burn require medical attention.

>> In the United States, about 10,000 people die each year as a result of burn-related infections.

>> The cost for treating severe burns and the resulting infection can cost the burn victim in the neighborhood of $38,000 to $107,000 depending on the severity of the burn and resulting infection. [National Business Group on Health]

  • Kidney failure: According to the American Kidney Fund, kidney disease has become the 9th leading cause of death in the U.S. and over 30 million people in the U.S. have chronic kidney disease. More importantly, however, 9 out of 10 people in the U.S. who have stage three chronic kidney disease and don’t even know it. There are two leading causes of chronic kidney failure: Diabetes and High Blood Pressure.

  • Organ transplant: According to the American Transplant Foundation, organ transplant occur or need to occur much more than most people might imagine. There are many organs in the human body that can fail and the only treatment may be a transplant. The organs that are currently being transplanted are:
    • heart
    • liver
    • kidney
    • lungs
    • pancreas
    • small intestines
    • various tissues including heart valves, tendons, skin, veins, tendons, and ligaments
    • The most common tissue transplant is the cornea with over 40,000 transplants a year.

  • Alzheimer’s disease: Anyone who has had a friend or family member with Alzheimer’s disease understands how cruel this disease can be and how devastating it can be for the patient, friends, and loved ones. This horrible disease is irreversible and it is progressive as it slowly obliterates the patient’s memory and thinking skills. Eventually, the victims of Alzheimer’s disease lose the ability to perform the simplest tasks. Today, Alzheimer’s symptoms typically begin to appear in people in their mid-60s. Estimates of our population with Alzheimer’s disease vary, but many experts in the field of Alzheimer’s study believe that more than 5 million Americans likely have this terrible disease.

  • Loss of sight or hearing: Although few people die as a result or sight or hearing loss, the treatment for either has become more expensive than most people can imagine. And in some cases, there is no treatment, only the cost of learning how to live a productive life when you cannot see or hear. People who go through sight or hearing loss experience psychological trauma that can easily remove them from the workplace and in some cases affect them in a way that makes dealing with normal daily activities extremely difficult.

  • Paraplegia: Certainly, paraplegia is not something you get, it is always the result of some form of trauma to the body. The trauma can be the result of damage to the brain, spinal cord, or both but it can also be the result of infection, cancer, or other problems experienced by the victim. Most paraplegics struggle with movement below the waist and they can experience an intense loss of sensation and feeling in the waist and legs until there may be no feeling whatsoever from the waist down. The expenses associated with Paraplegia are extensive since the patient can lose the ability to take care of themselves and perform the skills needed to go through life.

  • Heart valve surgery: The valves in your heart are miraculous. They work non-stop to control the blood flow through each chamber of your heart. Each valve in your heart is supposed to completely close after the blood flows through its chamber, but if the valve is diseased and not working correctly, your blood can flow backward and cause severe problems. Some of the symptoms a person with a damaged heart valve might experience include:
    • fatigue
    • dizziness
    • being lightheaded
    • having shortness of breath
    • chest pain
    • fluid retention
    • cyanosis

According to the American Heart Association patients without health insurance will typically pay between $80,000 and $200,000 if there are no significant complications. Needless to say, having a chronic illness insurance rider on your life insurance policy is a great way to supplement your health insurance and provide for those services not normally covered under health insurance or Medicare.

  • Aortic surgery: Aortic surgery is not uncommon for many in the U.S. because it typically involves repairing or replacing the aortic valve when it becomes diseased and cannot function properly. Aortic surgery is called for to repair an enlarged aorta (an aortic aneurysm) and typically involves one or more of the following:

  • Aortic Valve repair
  • Aortic aneurysm
  • Repair any tears or holes in the valve
  • Aortic valve replacement

Some patients with Coronary Artery Disease (CAD) can be treated with various drugs like nitrates, beta blockers, and calcium blockers which reduce the demand for oxygen by the heart muscle. If the patient still experiences angina after treatment, the doctor may elect to perform a coronary artery bypass graft which can re-establish the needed blood flow in order to carry oxygen and nutrients to the heart muscle.

  • Multiple Sclerosis: Multiple Sclerosis (MS) is a chronic illness that affects the central nervous system. With MS, your immune system will attack your myelin, a protective layer around the nerve fibers. This attack results in scar tissue and/or lesions which makes it difficult for the brain to signals to your body. There are several different types of MS:
    • Relapsing-remitting MS
    • Clinically isolated syndrome
    • Primary-progressive MS
    • Secondary-progressive MS

    Currently, there are multiple treatments for MS but sadly no cure is currently available.

  • Parkinson’s disease: Parkinson’s is a disorder that affects dopaminergic neurons in the part of the brain known as substantia nigra. The symptoms of Parkinson’s typically develop slowly over many years and affect people differently. Most Parkinson’s patients develop tremors in the hands, limb rigidity, balance problems, and slowness in their movement (Bradykinesia). Although Parkinson’s is not fatal, complications from the disease can be deadly. In fact, the CDC rates complications from Parkinson’s as the 14th highest cause of death in the U.S.

  • HIV contracted from an operation or a blood transfusion: HIV (human immunodeficiency virus) is a retrovirus that infects the organs and cells of your immune system. Unless an antiretroviral therapy is undergone the virus will typically develop into AIDS. HIV is transmitted from an infected person to an uninfected person through blood and other bodily fluids. The symptoms of HIV are similar to flu symptoms but more severe.

This is not a comprehensive list…

Can I Choose how to Spend my Critical Illness Benefits?

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The benefit from the insurer for a critical illness diagnosis can be used however the recipient chooses. It can be used for medical bills obviously, but could also be used for things like a wheelchair, or redesigning your home to accommodate your new circumstances.

Imagine the peace of mind from knowing that if you need to adapt your home to be handicapped accessible you could have the money required to do it. If you need the money for paying your mortgage or other bills, you can use it. You could even use the money to take a dream vacation or add to your savings for future generations.

There are, of course, exclusions and limitations to critical life insurance benefits. Usually, if you are diagnosed during the policy waiting period, you may not be covered. Suicide, self-inflicted injury or an injury that occurs because of an illegal activity may also be excluded.

Most policies are good for a minimum of two years and up to 20 or 25 years. The cost for the policies is varied. Obviously, age and health at the time of purchase are considered when getting the best rates. Family history will also be considered. The older you are when you purchase a rider, the more expensive it will be.


 Call us for a detailed quote at 1-800-712-8519.  


Frequently Asked Questions

Do I have to be terminally ill to collect benefits?

You do not have to be terminally ill to get these benefits. There is a lot of flexibility with these policies and for those who do need cash now, there is peace of mind in knowing that their life insurance can do that without them having to die.

What types of illnesses usually qualify for this benefit?

Although insurance companies differ as to what illness are included in this benefit, the most common are:
Heart Attack
Cancer (not skin cancer)
Severe Burns
Kidney Failure
Serious conditions such as Parkinson’s, MS, Alzheimer’s

Is there a list of expenses that I have to use the money for?

The benefit from the insurer for a critical illness diagnosis can be used however the recipient chooses. It can be used for medical bills obviously, but could also be used for things like a wheelchair, or redesigning your home to accommodate your new circumstances.

Is it worth the extra cost?

no exam life insurance

Choosing to add this rider to your life insurance will have a minor impact on your monthly premium and with some companies, there is no additional cost for the benefit.


author avatar
Doug Mitchell, CLU Independant Advisor
Doug Mitchell, CLU holds a BA degree in Finance from Auburn University as well as having obtained a Chartered Life Underwriter (CLU) designation from The American College in Bryn Mahr, PA. Doug has spent almost 30 years in the life insurance industry and has also held licenses to sell securities, long-term care insurance and home and auto insurance. Doug is a Top of the Table Million Dollar Round Table member (MDRT).  MDRT is a global, independent association of the world's leading life insurance advisors.  For two years, Doug served as President of the Auburn Opelika Association of Financial Advisors and has been a member of the Million Dollar Round Table. He obtained Life Millionaire status at Horace Mann Insurance Company and was awarded the Life Agent of the Year Award. Later in his career with New York Life he was an Executive Council Member. Doug currently serves as President of Ogletree Financial, a managing general agency serving life insurance agents and clients in all parts of the United States. Today, Doug’s main focus is servicing 1000s of policyholders and growing the agency through the reach of

2 Responses

  1. I appreciate that you point out that you don’t have to be disabled or employed to collect on a critical illness claim. I can see why some people might believe this because of the nature of it’s name. My grandpa has been told by his doctor that he is at a high risk of having a heart attack. I’ll have to talk with my mother about getting them this kind of coverage in case it does happen.

  2. Pingback: What Michael Phelps and Life Insurance Have in Common

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