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The Advisor’s Guide:Financial and Medical Underwriting Requirements

PERSONAL ACCIDENT DISABILITY INSURANCE AND CASH HOSPITAL

Information Included in this Guide

Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

General. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Language . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Landed Immigrants/Permanent Residents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Foreign Residence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Cash Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

Pre-screening for Personal Accident Disability Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

What is a physical impairment?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

Physical Impairment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

Not a Physical Impairment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

Personal Accident Disability Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

Benefit Minimum & Maximums and Age Eligibility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

Employment Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

Limited/Rated Occupations for 24 Hour Compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

Financial Underwriting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

1. Determine Employment Status. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

2. Determine Insurable Income .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

3. Calculate Maximum Allowable Monthly Benefit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

4. Integrating Monthly Benefits From Other Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

Sickness Disability Rider & Medical Underwriting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

The Application Medical Questionnaire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

Pre-Qualifying . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

Height & Weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

Automatic Medical Requirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

Underwriting Requirements – Q & A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

Conditions and Probable Underwriting Actions for Sickness Disability – Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

Conditions and Probable Underwriting Actions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Appendix – Limited/Rated/Ineligible Occupations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21

2

Clients who reside outside ofCanada are ineligible for PADI.

You may now be able to offercoverage to your clientswhom have only lived inCanada for 3 months.

Before accepting anapplication, be confident thatyour client is a reasonablerisk. The Advisor’s Reportprovides us with yourappraisal of your client’s risk.

Applications that have altereddates, white-out, are filledout in pencil, more than onewriter or pen will not beaccepted.

3

Introduction

GeneralLanguage

Clients must be able to understand English and/or French.

Landed Immigrants/Permanent Residents If you have clients who are not yet Canadian citizens or Permanent Residents, you may be able to offer them Personal Accident – 24 Hour Compensation insurance under our expanded criteria.

If your client has been living in Canada, for a minimum of 3 months, is in the process of applying for residency and is in the following groups, they may now qualify for insurance coverage up to $4,000 per month:

• Married to a Canadian or Permanent Resident • Domestic Workers • Skilled Workers (Provincial Nomination) • Foreign-Trained Physicians

Eligible coverage is restricted to 24 Hour Compensation Accident insurance (2 Year Benefit), AD&D Rider, Non-Occupational Loss of Income (2 Year Benefit), Accident Excess Medical, Return of Premium, Return of Premium on Death, and Accidental Death. Extension riders, Sickness Disability, Cash Hospital or Sickness Hospital coverage are currently not available to these clients.

Details of their intention to settle in Canada (purchase of a home, employment letter etc), a copy of their application for permanent residency status (for example, a copy of a letter from Immigration confirming receipt of their application) and any available documentation on their current immigration status should be submitted with a letter from the Advisor.

They must also be able to speak, read and write English and/or French. They must also be able to provide acceptable financial documentation of their earned Canadian income.

Coverage is not available to individuals applying for refugee status, foreign students on student visas, or people in Canada on a temporary work visa.

Foreign Residence To be eligible for coverage, clients must have a full-time Canadian residence. Clients who intend to reside outside Canada are ineligible for coverage. Temporary foreign residence, for no more than twelve months, may be considered on an individual basis if a Canadian residence and Canadian banking are being retained, all other risk factors are favourable, and the country is economically,socially, and politically stable. In such a case, we may consider coverage with a limitation that is designed to allow claimpayments to be made when the person has returned to either Canada or the U.S. Please discuss the details of the case withyour underwriter prior to taking an application.

4

Cash Hospital coverage isGuaranteed to Issue – nomedical or financial questions.

For your field assessmentwhen taking an application,think of 'Assumed (orPresumptive) Disability' as a quick determination of physical impairment. Has that ? Not insurable.

Cash Hospital

• Available 18 to 80 (if couple/family, age is eldest spouse)

• Minimum $20 per day up to $100 per day, $10 increments

• Primary Insured, Couple, Primary + Children and Family CoverageNote: Family coverage insures dependents 31 days to age 21 (or 25 if student full-time)

Cash Hospital is a guaranteed issue plan. There are no qualification questions and no medical or financial underwriting. There isno integration of benefits with other plans: Cash Hospital is available in addition to any other disability coverage (including GHIPor any other travel or health insurance).

Cash Hospital can be used as an alternative to sickness insurance or travel insurance for medically uninsurable people.

Preface

Pre-screening For Personal Accident Disability Insurance

1. Must be from 5 to 80 years of age on last birthday

2. Must be a permanent resident of Canada (or meets the criteria under landed immigrant/permanent resident on page 3)

3. Must not be totally or partially disabled or receiving disability benefits or a disability pension

4. Must not have any physical impairments that limit their ability to perform their normal occupation and/or engage in all of the functions of normal daily routine

What is a physical impairment?

An applicant must NOT have any physical impairment that limits their ability to perform their normal occupation or engage intheir normal activities. Here's a helpful guide:

Physical Impairment (not eligible) • Condition which results in a significant physical limitation. For example:

• loss of speech, • loss of sight in both eyes, • loss of hearing in both ears, • loss of use of both hands, or • loss of use of both feet.

• Spinal disc fusion, amputated limb, or missing finger (only if limits ability to perform regular occupation/activities; otherwise, eligible)

Not a physical impairment (eligible to apply) • Undergoing chiropractic treatment

• Diabetes or high blood pressure (only if it does not limit their ability to perform their normal occupation and/or engage in all of the function of their normal daily routine; otherwise, ineligible).

If an applicant is unsure if they have a physical impairment, we recommend they have a discussion abouttheir personal situation with their physician to best determine their appropriate application response.

IMPORTANTIf a pre-existing physical impairment is not disclosed on the application, coverage may be rescinded or cancelled at the time of claim.

5

The application is a legaldocument. Make sure theapplication is completed fullyand accurately includingoccupation, medical andfinancial history whereappropriate to ensure accurateunderwriting.

Clients with limitedoccupations can apply for amaximum monthly benefit of $1,000.

Clients must work 30 hoursper week in a stableoccupation to be eligible formore than $1,000 of coverage.

Clients in rated occupationscan apply for benefit amountsexceeding $1,000 on a ratedpremium basis.

Personal Accident Disability Insurance

Benefit Minimum & Maximums and Age Eligibility

For detailed minimum and maximum benefit details and age eligibility, please consult the 'Advisor’s Product and Rate Guide for Personal Accident Disability Insurance and Cash Hospital on www.Repsource.com

Employment Status

1. Non-working and those with part-time employment can qualify for 24 Hour Compensation Accident and Sickness rider monthly benefits of $1,000 or less.

2. Clients must work 30 hours per week in a stable occupation to be eligible for more than $1,000 of coverage.

3. All new business owners are eligible, even at ‘start up’. Those new to consulting or working from home are also eligible.

Limited/Rated Occupations for 24 Hour Compensation

The following is a list of occupations limited to $1,000 per month of Personal Accident 24 Hour Compensation Coverage: • Acrobat or Gymnast • Actor or Actress • Crop Dusters • Divers • Driller – oilfield and offshore • Entertainers, Performers, Singers • Explosives Handlers • Gas – pipeline construction • Jockeys • Log Boomers • Mining – underground workers • Parking Lot Attendants • Police on Bomb Squad • Powerline Workers • Rodeo Performers • Racers – driver & crew – cars, boats, all types • Taxi/Limo Drivers unless Owner

The following is a list of occupations rated at 50% extra for Personal Accident 24 Hour Compensation Coverage: (No rating applies to benefits of $1,000 per month or less)

• Equestrian workers • Firemen – including Forestry • Fishermen • Glaziers • Hunting Guide • Logging – except truckers (excluding Ontario) • Miners – above ground workers • Police – except bomb squad • Sawmill & Pulp Workers • Taxi/Limo Owners only • Nursing Home or Convalescent Centre Nurses & Employees • Prison and security guards

Note: See Appendix for Rated/Limited Occupation lists for optional coverage and riders

Financial Underwriting

These guidelines apply to all Total Disability benefit amounts over $2,000.

1. Determine Employment Status

Is your client an:• Employee? • Sole Proprietor/Partner? • Business Owner of an incorporated company?

2. Determine Insurable Income

3. Calculate Maximum Allowable Monthly Benefit Based on Insurable Income

Employee (Personal Income only)

Personal Income:

Gross Annual Personal Earned Income / 12 X 75% = Insurable Monthly Benefit

Example: Gross Annual Earned Income = $91,800Divided by 12 = $7,650 monthly gross earned incomeMultiply by 75% = $5,700 eligible monthly income (rounded down to nearest $100)

Proof of income required at the time of claim: T1 Prior Year

6

Employment Status Definition of Income Source of Proof

Employee Gross Annual PersonalEarned Income

T1 – Lines 101 & 104

Self-Employed Gross Annual Personal/Business Earned Income

T1 – Lines 135 to 143

Sole Proprietor Gross Annual BusinessIncome*

T2124A Statement of Bus.Activities Line A of the IncomeSection less lines 8300 to 8515and 9060

Partner Gross Annual BusinessIncome* X % Share


Business Owner – Incorporated

Gross Annual BusinessIncome* X % Share


* Gross Annual Business Income includes the value of Overheard Expenses, but does not include Purchases,Sub-Contracts, Wages & salaries, Investment, Interest, and Rental & Government Plan Incomes. Do notdeduct line 8300 (Opening Inventory)

You will need a copy yourclient’s T1 General Tax Form to determine the benefitamount they are eligible foramounts greater than $1,000.

Projected earnings are notinsurable.

Gross personal income isdefined as salary, wages,dividends, bonuses,commissions, fees, drawsfrom a business or otherearned income.

Benefits applied for shouldnot exceed 75% of earnedincome or 1% of businessincome. It is the Advisor’s jobto determine a consistentpattern of earned income.

If self employed for less than3 months, use a combinationof income earned in the newbusiness and prior earningsto determine qualifyingincome. If longer than 3months, income earned willbe pro-rated.

Proof of income is onlyrequired at time of claim.

Self-Employed with no Employees Includes Business Expense Coverage

Sole Proprietors/Partners

[(Gross Annual Business Income X % of ownership) X 75%] / 12 = Insurable Monthly Benefit

Example: Gross Annual Business Income = $100,000 X share partner 50% = $50,000Multiply X 75% = $37,500Divided by 12 = $3,100 eligible monthly income (rounded down to nearest $100)

Proof of income required at the time of claim: Not Incorporated: T1 Prior YearIncorporated: T2124A Prior Year

Business Owner – Incorporated (includes Overhead Expenses)

[(Gross Annual Business Income X 1%] = Insurable Monthly Benefit

Example: with employeesGross Annual Business Income = $600,000 x 1% = $6,000

Applicant is eligible for $6000 based on Gross Annual Business Income.

Proof of income required at the time of claim: T2124A Prior Year

Self Employed with Employees (includes Business Expense Coverage)

Sole Proprietors/Partners

Method A: Determine Using Gross Annual Business Income Onlyor Method B: Determine Using Gross Annual Personal Earned Income and

Gross Annual Business Income (the personal income must first be deducted from the business income as follows:

Example: Sole ProprietorGross Annual Personal Earned Income = ($14,000 ÷ 12) x 75% = $800 Gross Annual Business Income = $250,000 - $21,000 = 229,000 x 1%

= $2,290 (round down) = $2,200= $3,000

Applicant is eligible for $800 based on Gross Annual Personal Earned Income and $2,200 based on Gross Annual Business Income for a total monthly benefit amount of $3,000.

Example: Partnership (50% - 50%)Gross Annual Personal Earned Income = ($14,000 ÷ 12) x 75% = $800 Gross Annual Business Income = $600,000 x 50% = (300,000 -21,000) x 1%

= $2,790 (round down) = $2,700= $3,500

Applicant is eligible for $800 based on Gross Annual Personal Earned Income and $2,700 based on Gross Annual Business Income for a total monthly benefit amount of $3,500.

Proof of income required at the time of claim: Not Incorporated: T1 Prior YearIncorporated: T2124A Prior Year

Business Owner – Incorporated (includes Overhead Expenses)

[(Gross Annual Business Income X 1%] = Insurable Monthly Benefit

Example: with employeesGross Annual Business Income = $600,000 x 1% = $6,000

Applicant is eligible for $6000 based on Gross Annual Business Income.

Proof of income required at the time of claim: T2124A Prior Year

7

For the self employed,business income and personalincome can be used asqualifying income.

Business income is defined asgross business income lessthe cost of goods sold,salaries, wages & personalincome, investment income,income from governmentplans, interest income andrental income.

Benefit amounts should bereassessed after 1 year forclients who recently changeoccupations or become self-employed.

8

4. Integrating Monthly Benefits from Other Sources

Benefit amounts less than $2,000 will not be integrated at time of application or claim.

For all monthly benefit amounts over $2,000, you must deduct your client’s WSIB coverageand any existing disability coverage to calculate their total eligible monthly benefit.

Sickness Disability Rider & Medical Underwriting

The Application Medical Questionnaire

To apply for Sickness Disability coverage, the Medical Questionnaire on the Application for Insurance must be completed.

No proof of overhead costs is required at time ofapplication or claim.

For benefit amounts greaterthan $2,000, any otherdisability coverage and WSIBshould be deducted from theeligible monthly benefit.

Rider coverage is notintegrated and is fullyavailable.

Employment Status Employed Individuals

Coverage to bededucted

1. WSIB/Workers Compensation**2. Any other disability benefit amount

(salary continuance, coverage with other companies, group coverage etc.)

Example Gross Monthly Income= 8,000 x 75% = 6,000

(eligible monthly income calculated in Step 3)

Less integration from all sources - 776 (WSIB/WCB)- 2,000 (existing coverage, Personal DI, LTD)= 3,224 eligible monthly benefit

(round down to nearest $100)

= 3,200 Total eligible monthly benefit***

** For more information on WSIB, go to http://www.awcbc.org/en/*** Note: Your Client may select an amount less than $2,000 with no integration with WSIB/WC

Key Information

1. Applicant must be eligible for the 24 Hour Compensation plan in order to apply for Sickness Disability coverage.

2. Benefit amounts and benefit periods must not exceed (they can be less) the benefit amounts and benefit periods applied for under the 24 Hour Compensation, Non-Occupational Loss of Income and Accident Disability Extension coverage.

3. To qualify for more than a $2,000 monthly benefit under any Sickness Disability rider, the Financial Underwriting Guidelines will apply.

Sickness Disability coverage issubject to medical eligibilityand financial underwritingfor amounts over $2,000.See sections 4 and 5 on theapplication.

Please ensure that yourclient’s height and weightfalls within the acceptablerange.

Pre-qualifying

Any applicant that has any of the following conditions is not eligible for Sickness Disability or Sickness Disability Extensioncoverage:

• Active Hepatitis • AIDS or AIDS-related disease • Alzheimer’s disease • Any heart condition or heart trouble • Coronary bypass surgery • Diabetes • Huntington’s Chorea • Lou Gehrig’s disease (ALS)• Multiple Sclerosis • Stroke• Heart Attack • Alcohol abuse in the past 5 years • Lupus • Cancer – except basal cell skin • Transient Ischemic Attack

Height & Weight

9

Height & Weight Table – Males & Females Age 18-65

Imperial Measure Metric Measure

Height(ft/in)

Minimum Weight

(lbs.)

Maximum Weight

(lbs.)

Height(cm)

Minimum Weight

(kg)

Maximum Weight

(kg)

4' 10" 76 183 147 34 83

4' 11" 79 189 150 36 86

5' 0" 82 196 152 37 89

5' 1" 85 202 155 39 92

5' 2" 87 209 157 40 95

5' 3" 90 216 160 41 98

5' 4" 93 223 163 42 101

5' 5" 96 230 165 44 104

5' 6" 99 237 168 45 108

5' 7" 102 244 170 46 111

5' 8" 105 252 173 48 114

5' 9" 108 259 175 49 117

5' 10" 111 267 178 50 121

5' 11" 114 274 180 52 124

6' 0" 118 282 183 54 128

6' 1" 121 290 185 55 132

6' 2" 124 298 188 56 135

6' 3" 128 306 191 58 139

6' 4" 131 315 193 59 143

6' 5" 135 323 196 61 147

6' 6" 138 331 198 63 150

10

Automatic Medical Requirements

Important:

When ordering requirements, indicate they are for Manulife Affinity Personal Accident

Approved Service Providers:• www.hooperholmes.ca, by fax or by phone • www.medysis.ca

Indicate in “Advisor’s Comments” which medical requirements have been ordered, the supplier, the date they were ordered andthe reference number.

Additional requirements may be necessary depending upon the client’s medical history.

Issue Age Monthly Benefit Amount Requirements

18 to 50 Up to $2,400 Application & MIB

$2,500 to $6,000 Application, MIB, Blood Profile & Urinalysis

51 to 64 Up to $1,000 Application & MIB

$1,100 to $2,400 Application, MIB, Paramedical

$2,500 to $4,900 Application, MIB, Paramedical, Blood Profile & Urinalysis

$5,000 to $6,000 Application, MIB, Paramedical, Blood Profile, Urinalysis & ECG

11

Underwriting Requirements – Questions and Answers

What requirements are necessary and what do they mean?

What is an MIB? It is a report from the Medical Information Bureau (MIB), a nonprofit company used for sharing information between memberinsurance companies. Manulife Financial will send an inquiry to MIB to check if your client is included in their data base. If theyhave information, MIB will provide Manulife with a report. If the MIB report is inconsistent with information your client providedon his/her application, further investigation may be required.

What is a Paramedical Examination? A paramedical examination is performed by a registered nurse. During the examination, your client will be asked questionsregarding their medical history. The nurse will take your client’s blood pressure, pulse and record their height and weight. Yourclient will also be asked to provide a urine sample.

What is the Paramedical process? The Paramedical Company will contact the applicant to arrange an appointment to complete any required tests at their home orplace of business.

Blood Profile If a blood profile is required, your client will need to sign a consent form authorizing the registered nurse or technician to take ablood sample. Your client’s blood and/or urine samples will be sent to a laboratory for processing by qualified lab technicians.Please advise your client to notify the nurse if he/she is taking any medication or if they have any problems such as blood clotting,fainting, and nausea or if they bruise easily.

What is an ECG?Depending on your client’s age and the amount of coverage he/she has applied for, they may be asked to undergo anelectrocardiogram (ECG). An electrocardiogram is a test that records the electrical activity of your heart.

What is an Attending Physician Statement (APS)?An Attending Physician Statement (APS) is a report provided by your client’s personal physician(s) which outlines their medicalhistory. It can include copies of test results and reports from other medical specialists.

Who pays for these tests?Manulife Financial will assume the cost of these test/examinations if they are performed by the facility of our choice.

Preparing for the Paramedical: Helpful hints for your Applicant

• Have the name, address and telephone number of personal physician(s) available

• Notify the nurse of any illness or injuries

• Avoid any strenuous exercise for 24 hours before your appointment

• Avoid alcohol consumption at least 8 hours before your appointment

• Avoid the following items at least 1 hour prior to your appointment:• coffee, tea • beverages or food containing caffeine • food high in salt and cholesterol content.

Provide your client withhelpful hints prior to theirparamedical exam to ensureoptimum results.

12

Conditions and Probable Underwriting Actions For Sickness Disability – Index

Addison’s Disease. . . . . . . . . . . . . . . . . . . . . . . .13

Adjustment Disorder . . . . . . . . . . . . . . . . . . . .13

AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Albuminuria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Alcoholism.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Allergies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Alzheimer’s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Amnesia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Amputation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Anemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Arteriosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Asthma.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Aneurysm .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Ataxia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Back Conditions . . . . . . . . . . . . . . . . . . . . . . . . .13

Bell’s Palsy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Blindness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Brain Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Breast Disorders. . . . . . . . . . . . . . . . . . . . . . . . . .13

Bronchiectasis . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Bronchitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Bursitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Calculus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Cancer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Carpal Tunnel . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Cataract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Cerebrovascular Stroke . . . . . . . . . . . . . . . . .14

Cervix Disorders . . . . . . . . . . . . . . . . . . . . . . . . .14

Chest Pains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Cholecystitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Cholesteatoma.. . . . . . . . . . . . . . . . . . . . . . . . . .14

Chronic Obstructive Lung Disease. . . .14

Chronic Fatigue Syndrome.. . . . . . . . . . . .14

Cirrhosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Colitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Convulsions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Crohn’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . .15

Cyst . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Cystic/Polycystic Kidneys . . . . . . . . . . . . . . .15

Cystic Fibrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Cystitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Deafness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Diabetes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Discoid Lupus . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Diverticuliis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Diverticulum of Stomach. . . . . . . . . . . . . . .15

Drug Addiction . . . . . . . . . . . . . . . . . . . . . . . . . .15

Emotional Disorders. . . . . . . . . . . . . . . . . . . . .15

Empyema .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Endometriosis . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Epilepsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Esophagitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Eye Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Fatty liver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Fibrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Gallbladder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Gastritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Glomerular Disorders . . . . . . . . . . . . . . . . . . .16

Glycosuria, Hematuria . . . . . . . . . . . . . . . . . .16

Gout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Headache (migraine) . . . . . . . . . . . . . . . . . . . .16

Heart Disorders . . . . . . . . . . . . . . . . . . . . . . . . . .16

Hemorrhoids . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Hepatitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Hiatus Hernia. . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

High Blood Pressure. . . . . . . . . . . . . . . . . . . . .16

Hypoglycemia . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Hypethyroidism .. . . . . . . . . . . . . . . . . . . . . . . . .17

Hyporthyroidism .. . . . . . . . . . . . . . . . . . . . . . . .17

Hysterectomy. . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

Indigestion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

Intracranial Hemorrhage . . . . . . . . . . . . . . .17

Kidney Disorder . . . . . . . . . . . . . . . . . . . . . . . . . .17

Knee Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . .17

Labyrinthitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

Liver Enlargement . . . . . . . . . . . . . . . . . . . . . . .17

Lupus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

Major Organ Transplant . . . . . . . . . . . . . . . .17

Malignant Hyperthermia . . . . . . . . . . . . . . .17

Marfan’s Syndrome .. . . . . . . . . . . . . . . . . . . .17

Meniere’s Disease. . . . . . . . . . . . . . . . . . . . . . . .17

Meningitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

Menstrual Disorders. . . . . . . . . . . . . . . . . . . . .17

Multiple Sclerosis . . . . . . . . . . . . . . . . . . . . . . . .17

Muscular Dystrophy . . . . . . . . . . . . . . . . . . . . .17

Myalgia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

Myelitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Nervous System Disorders. . . . . . . . . . . . . .18

Osteitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Osteoarthritis. . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Osteochondritis . . . . . . . . . . . . . . . . . . . . . . . . . .18

Osteomyelitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Otitis Externa. . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Otitis Media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Palsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Paranoid Disorders . . . . . . . . . . . . . . . . . . . . . .18

Parkinson’s Disease. . . . . . . . . . . . . . . . . . . . . .18

Personality Disorder . . . . . . . . . . . . . . . . . . . . .18

Phlebitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Pneumothorax . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Poliomyelitis (Polio). . . . . . . . . . . . . . . . . . . . . .18

Polymyalgia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Polyps. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Pregnancy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Prostate Enlargement . . . . . . . . . . . . . . . . . . .19

Psychosexual Disorders . . . . . . . . . . . . . . . . .19

Pyelonephritis . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Raynaud’s Syndrome .. . . . . . . . . . . . . . . . . . .19

Renal Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Retinal artery & Vein Occln. . . . . . . . . . . .19

Retinal Detachment . . . . . . . . . . . . . . . . . . . . .19

Sarcoidosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Schizophrenic Disorders . . . . . . . . . . . . . . . .19

Sciatica . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Shingles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Sinusitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Sleep Disorders . . . . . . . . . . . . . . . . . . . . . . . . . .19

Spinal Curvature . . . . . . . . . . . . . . . . . . . . . . . . .19

Spina Bifida. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

Suicide Attempt . . . . . . . . . . . . . . . . . . . . . . . . .20

Syncope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

Thyroid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

Tumour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

Ulcers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

Urinary Tract Infection . . . . . . . . . . . . . . . . . .20

Uterus Prolapse . . . . . . . . . . . . . . . . . . . . . . . . . .20

Uveitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

Varicose Veins . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

Vertigo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

13

Conditions and Probable Underwriting Action

Condition Qualification Probable Underwriting Action

Addison’s Disease Individual Consideration

Adjustment Disorder a) Present or Recurrentb) 2 years post recovery

a) Declineb) Individual Consideration

AIDS or AIDS related condition Decline

Albuminuria (protein in urine) Decline

Alcoholism or alcohol abuse a) 0 - 8 years after treatment or no use of alcoholb) Thereafter


Allergies Non-respiratory Standard

Alzheimer’s Disease Decline

Amnesia Decline

Amputation Submit trial application for individual consideration a) Exclusionb) Decline

Anemia (blood deficiency) a) Pernicious (primary)b) Others


Aneurysm (sac formed in blood vessel)

Decline

Arteriosclerosis Decline

Arthritis a) Osteoarthritisb) Rheumatoid

a) Exclusionb) Decline

Asthma a) Mildb) Moderatec) Severe

a) Approveb) Exclusionc) Decline

Ataxia Decline

Back Conditions (Lumbago,Whiplash, Muscle Spasm)

a) No disc involvement;– one attack, complete recovery, one week

or less off work, 0-2 years– as above, +2 years– as above, more than one attack and more

than one week off work, 0-4 years– +4 years

b) With disc involvement, all cases

a)– Exclusion

– Approve– Exclusion

– Approveb) Exclusion

Bell’s Palsy SEE PALSY

Blindness a) Blindness in both eyesb) One eye

a) Declineb) Exclusion

Brain disorder Decline

Breast Disorders Breast Tumor, Cyst, Fibrocystic Disease, Mastectomy, Mastitisa) If benign, over 2 years complete recovery

following sugeryb) Otherwise

a) Approve/Exclusion

b) Individual Consideration

Bronchiectasis Individual Consideration

14


Bronchitis a) Acute – After Recoveryb) Chronic

a) Approveb) Decline

Bursitis, Synovitis, Tendinitis,Tenosynovitis

a) One episode – over 1 yearb) Present or Current

a) Approveb) Exclusion

Calculus (Kidney Stone) a) Current– unilateral– bilateral or single kidney

b) History– stone removed, one episode, 0-1 yr– +1 year– more than one episode, 0-3 yrs– +3 years

a)– Exclusion– Decline

b)– Exclusion– Approve– Exclusion– Approve

Cancer a) Skin (except malignant melanoma)b) Otherwise

a) Approve/Excludeb) Usually Declined

Carpal Tunnel Syndrome a) Currentb) History

– unoperated– operated, 0-1 year– operated, +1 year

a) Exclusionb)

– Exclusion– Exclusion– Approve

Cataract a) Unoperatedb) Operated, complete recovery

a) Exclusionb) Approve

Cerebrovascular Accident,Stroke, Transient Ischemic Attack

Decline

Cervix Disorders Individual Consideration

Chest Pains Non cardiac Individual Consideration

Cholecystitis (Gall Bladder) a) Unoperated, complete recovery– current - 0-6 months– +6 months

b) Recurrent episodes, recovered– current - 5 yrs– +5 yrs

c) Operated, complete recovery, Cholecystectomy

a)– Exclusion– Approve

b)– Exclusion– Approve

c) Approve

Cholesterol (elevated) a) Over 2 years treated & controlledb) Reocurrence


Cholesteatoma a) Present or surgery within 1 yearb) One year post surgery and no residual hearing

impairment


Chronic Obstructive Lung Disease Decline

Chronic Fatigue Syndrome a) Within 2 years or presentb) Following 2 years recovery


Cirrhosis Hardening of liver Decline

Colitis (Inflammation of the colon)

a) Spastic or mucousb) Ulcerative

– single mild attack - over 3 years recovery– recurrent with 5 years– recurrent over 5 years recovery

a) Approveb)

– Exclusion– Decline– Exclusion

15


Convulsions (Seizures) Decline

Crohn's Disease a) Single mild attack – over 3 yrs recoveryb) Recurrent within 5 yearsc) Recurrent – over 5 years recovery

a) Exclusionb) Declinec) Exclusion

Cyst a) Benign

b) Malignant

a) Approve/Exclusion, depending on the location

b) Decline

Cystic or Polycystic Kidneys Decline

Cystic Fibrosis Decline

Cystitis a) Acute – recoveredb) Chronic

– 0-1 yr, specimen normal– +1 yr, specimen normal

a) Approveb)

– Exclusion– Approve

Deafness Both ears progressive sustained exposure to noise Exclusion

Depression a) Current use of medicationb) Recovered 2 years +


Diabetes Type 1 or 2 Decline

Discoid Lupus a) Current to five yearsb) +5 yrs, definite diagnosis, no SLE

a) Declineb) Exclusion

Diverticulitis a) Symptomaticb) Asymptomatic


Diverticulum of Stomach Approve/Exclusion

Drug addiction or abuse a) 0 - 8 years after treatment/recoveryb) Thereafter


Emotional Disorders Individual Consideration

Empyema(accumulation of pus in a cavityof lung)

a) Currentb) History

– single attack, 0-2 yrs– single attack, +2 yrs– more than one attack, 0-5 years

a) Declineb)

– Decline– Exclusion– Decline

Endometriosis a) Current– non-disabling– severe or recurring

b) Operated, no treatment– 0-6 mths– +6 mths



Epilepsy Over 10 years since last attack Individual Consideration

Esophagitis a) Mild symptomsb) Moderate to Severe symptoms


Eye Disorders a) Cataractsb) Glaucoma

a) Exclusionb) Exclusion

Fatty Liver Individual Consideration

Fibrosis Decline

16


Fibrositis, Fibromyositis,Myositis

a) Current– single attack

b) History– 0-1 yr– +1 yr

c) Recurrent attacks– 0-3 yrs– +3 yrs

a)– Decline


c)– Exclusion– Approve

Fracture Hip, pelvis, neck, shoulder blade, skull, spine on recovery

Approve/Exclusion

Gallbladder a) Surgery, 1 attack, 0 – 3 monthsb) Multiple attacks


Gastritis a) Acute, single attackb) Chronic or Recurrent

– no attacks for +2 yrs


– Exclusion

Glomerular Disorders Decline

Glycosuria, Hematuria, Pyuria Individual Consideration

Gout a) Current, no cardiovascular or renal abnormalities– mild, infrequent– moderate to severe

b) History, single attack, complete recovery– 0-1 yr– +1 yr



Headache (Migraine) a) Mild, occasionalb) Moderate, severe, disabling


Heart or Ciculatory Disorders Angina, Coronary Insufficiency or Occlusion,Endocaarditis, Heart Attack, Murmur, (exceptfunctional heart murmur), Irregular Heart Beat,Myocarditis, Palpitations, Pericarditis

Decline

Hemorrhoids (piles) a) Over 1 year complete recoveryb) Otherwise


Hepatitis a) Present, chronic or carrierb) In history with studies indicative of cure

a) Declineb) Approve

Hernia a) Unoperated – irreducibleb) Operated – complete recovery


Hiatus Hernia a) Current – small– no symptoms– with symptoms

b) Surgery – complete recovery, no sequels– 0-6 mths– +6 mths

a)– Approve– Exclusion


High Blood Pressure a) Well controlled with no associated impairmentsb) Others


Hypoglycemia (low blood sugar) Individual Consideration

17


Hyperthyroidism a) Untreatedb) Surgery/favorable treatment 6 mos.-2 yrsc) Thereafter

a) Declineb) Exclusionc) Approve

Hypothyroidism a) Untreatedb) Treated & regulated


Hysterectomy a) Non-malignant, no sequels, 0-6 mthsb) History, as above


Indigestion a) Acute, single attackb) Chronic or Recurrentc) As above, no attacks for +2 yrs

a) Approveb) Exclusionc) Approve

Intracranial Hemorrhage Decline

Kidney disorder Decline

Knee disorders a) Disabled up to one week, no ligament or cartilage damage, complete recovery– 0-1 yr– +1 yr

b) Disabled more than one week– 0-3 yrs– +3 yrs

c) Unoperated, disabled more than one week or torn cartilage – 0-3 yrs– +3 yrs

d) Operated, complete recovery– 0-1 yr – + 1 yr

a)



c)


d)– Exclusion– Approve

Labyrinthitis a) Single episode, recoveredb) Chronic or recurrent


Liver Enlargement Liver function normal Individual Consideration

Lupus a) Discoid lupus– Current to 5 years– +5 years

b) Systemic lupus erythematosus

a)– Decline– Exclusion

b) Decline

Malignant Hyperthermia Decline

Major Organ Transplant Decline

Marfan’s Syndrome Decline

Meniere’s Disease a) Current – 5 yrsb) History – +5 yrs


Meningitis Individual Consideration

Menstrual Disorders Individual Consideration

Multiple Sclerosis Decline

Muscular Dystrophies Decline

Myalgia a) Within 3 yearsb) Recovered more than 3 years

a) Declineb) Approve/Exclusion

18


Myelitis Individual Consideration

Nervous System disorder Decline

Osteitis Decline

Osteoarthritis a) Mild, no disabilityb) Severe, disabled


Osteomyelitis a) Currentb) History, one bone, single attack, full recovery

– 0-3 yrs– +3 yrs

c) As above, more than one bone, chronic\recurrent– 0-2 yrs– 2-5 yrs– +5 yrs

a) Declineb)


c)– Decline– Exclusion– Approve

Otitis Externa Benign Approve

Otitis Media a) Single episode, recoveredb) Recurrent – 0-2 yearsc) Chronic

– current, 3 yrs– history, +3 yrs

a) Approveb) Exclusionc)


Palsy (Paralysis) a) Bells Palsy– current– history fully recovered

b) Others

a)– Decline– Approve

b) Decline

Pancreatitis No alcohol criticism Individual Consideration

Paranoid Disorders Decline

Parkinson’s Disease Decline

Personality Disorder Decline

Phlebitis a) Within 3 years, no edemab) Over 3 years, no edemac) With persisting edema

a) Exclusionb) Approvec) Individual Consideration

Pneumonia a) Currentb) History

– single episode– 2+ episodes within 12 months

a) Declineb)

– Approve– Decline

Pneumothorax a) Traumatic – currentb) Spontaneous – currentc) History, complete resolutiond) History, more than one attack

a) Declineb) Declinec) Approved) Exclusion

Poliomyelitis (Polio) a) No residual disabilityb) Minimal disability, good work recordc) Severe Disability

a) Approveb) Exclusionc) Decline

Polymyalgia Recovered Individual Consideration

Polyps a) Cervical, Uterine, Nasal, Rectal –following surgery

b) Otherwise

a) Approve

b) Exclusion

19


Pregnancy(Note: No benefits are payablefor normal pregnancy)

a) Up to the 6th monthb) From 7th monthc) History

– no complications– with complications

a) Exclusion for complicationsb) Postponec)


Prostate Enlargement a) Current, asymptomatic, no malignancyb) History, operated, no sequels, no malignancy

– 0-6 months– +6 months

a) Individual Considerationb) Exclusion

– Decline– Approve/Exclusion

Psychosexual Disorders Decline

Pyelonephritis a) Single attack, recoveredb) Recurrent attacks or chronic


Raynaud’s Syndrome a) Present – 5 yrsb) History, medical treatment, no symptoms +5 yrs


Renal Failure Decline

Retinal artery and Vein Occlusion Decline

Retinal Detachment Exclusion

Sarcoidosis a) Current – 4 yrsb) History, +4 yrs, stabilized, no steroid treatment

in the last year


Schizophrenic Disorders Decline

Sciatica a) Current or within 3 yearsb) More than 3 years

– no disc involvement– with disc involvement

c) Surgery – within 2 yearsd) 2 years post surgery – no symptomse) Symptoms post surgery

a) Exclusionb)


c) Exclusiond) Approvee) Exclusion

Shingles a) Recovered, no residualsb) With residuals

a) Approveb) Individual Consideration

Sinusitis a) No complicationsb) Otherwise


Sleep Disorders Individual Consideration

Spinal Curvature – Lordosis,Kyphosis, Scoliosis

a) Mild, unoperatedb) Moderate to Severec) Operated, full recovery

– 0-1 yr– 1-3 yrs– +3 yrs

a) Approveb) Declinec)

– Decline– Exclusion– Exclude/Approve

Spina Bifida – Occulta a) Current– no symptoms– with symptoms

b) History, operated– 0-6 months– +6 months– With residual symptoms


b)– Decline– Exclusion– Decline/Exclusion

20


Spina Bifida – Cystica a) Currentb) History, operated, full recovery

– 0-1 yr– +1 yr– with residual symptoms

a) Declineb)

– Decline– Exclusion – Decline

Stroke Decline

Suicide Attempt a) 0 – 12 years b) After – no continuing treatment


Syncope (Fainting) Individual Consideration

Thyroid Non-Toxica) Current, no symptoms, no malignancyb) History, no symptoms, no malignancyToxica) Current, uncontrolledb) History, operated, good control

– 0-2 yrs– +2 yrs

Non-Toxica) Exclusionb) ApproveToxica) Declineb)


Tuberculosis a) Presentb) Mild to Moderate within 2 yearsc) Mild to Moderate over 2 yearsd) Severe

a) Declineb) Exclusionc) Approved) Decline

Tumour a) Benignb) Cancerous

a) Individual Considerationb) Decline

Ulcer – Peptic, Duodenal a) Unoperated– Present or within 2 years– over 2 years

b) Operated

a)– Exclusion– Approve

b) Individual Consideration

Urinary Tract Infection a) Single attack, recoveredb) Recurrent attack


Uterus Prolapse a) Present or surgery within 6 monthsb) 6 months post surgery


Uveitis No underlying Disease Individual Consideration

Varicose Veins a) Abdomen, Esophagus, Thoraxb) Legs

Current– mild, moderate or severe, no complications– with complicationsHistory, surgery, complete recovery– 0-6 months– +6 months

a) Declineb)

– Exclusion– Decline


Vertigo (Dizziness) Individual Consideration

Appendix – Limited/Rated/Ineligible Occupations for Optional Coverage and Riders

24 Hour Compensation Extension

Occupations not insurable for coverage under the 24 Hour Accident Disability Extension:

• Acrobat or Gymnast • Actor or Actress • Crop Dusters • Divers • Driller – oilfield and offshore • Entertainers, Performers, Singers • Explosives Handlers • Gas – pipeline construction• Jockeys • Log Boomers• Mining – underground workers • Parking Lot Attendants • Police on Bomb Squad • Powerline Workers • Retired Persons • Racers – driver & crew – cars, boats, all types • Students/Unemployed • Rodeo Performers • Taxi/Limo Drivers unless Owner

Rated occupations for 24 Hour Accident Disability Extension if benefit amount exceeds $1,000:

• Equestrian workers • Firemen – including Forestry • Fishermen • Glaziers • Hunting Guide • Logging – except truckers • Miners – above ground workers • Police – except bomb squad• Sawmill & Pulp Workers • Taxi/Limo Owners only• Prison & Security Guards • Nursing Home or Convalescent Centre Nurses & Employees

Non-Occupational Loss of Income

Limited occupations not eligible for more than $1,000 of coverage under the Non-Occupational Loss of Income are:

• Actor or Actress • Entertainers, Performers, Singers • Parking Lot Attendants • Taxi & Limo Drivers

Non-Occupational Accident Disability Extension

Limited occupations not eligible for coverage under the Non-Occupational Accident Disability Extension coverage are:

• Acrobat or Gymnast • Actor or Actress • Crop Dusters • Divers • Driller – oilfield and offshore • Entertainers, Performers, Singers • Explosives Handlers • Gas – pipeline construction• Jockeys • Log Boomers• Mining – underground workers • Parking Lot Attendants • Police on Bomb Squad • Powerline Workers • Retired Persons • Racers – driver & crew – cars, boats, all types • Students/Unemployed • Rodeo Performers • Taxi/Limo Drivers unless Owner

21

Accidental Death

The following occupations are not covered for the Accidental Death Rider:

• Acrobat or Gymnast • Logging – all except truckers • Crop Dusters • Mining – all • Divers • Police • Driller – oilfield and offshore • Powerline Workers• Explosive Handlers • Prison & Security Guards• Firemen – including Forestry • Racers & crew – any type • Gas – pipeline construction • Rodeo Performers • Glaziers • Sawmill & Pulp Workers • Hunting Guide

Accidental Death and Dismemberment

The following occupations are not insurable for Accidental Death & Dismemberment:

• Acrobat or Gymnast • Logging – all except truckers • Crop Dusters • Mining – all • Divers • Police • Driller – oilfield and offshore • Powerline Workers• Explosive Handlers • Prison & Security Guards• Firemen – including Forestry • Racers & crew – any type • Gas – pipeline construction • Rodeo Performers• Glaziers • Sawmill & Pulp Workers • Hunting Guide

PA 06/10 INTENDED FOR ADVISOR USE ONLY – NOT TO BE REPRODUCED OR DISTRIBUTED WITHOUT AUTHORIZATION

Personal Accident Disability Insurance and Cash Hospital is offered through Manulife Financial (The Manufacturers Life Insurance Company). Underwritten by The Manufacturers Life Insurance Company. Manulife Financial and the block design are registered service marks and trademarks of The Manufacturers Life Insurance Company and are used by it and its affiliates including Manulife Financial Corporation. ®†/™Trademarks of The Manufacturers Life Insurance Company. © 2010 The Manufacturers Life Insurance Company. All rights reserved.

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