Critical Illness Care Plus

Product Description

  • Critical Illness Care Plus provides more comprehensive financial support to cover the costs of treatment or loss of income to help you and your family focus on your recovery, if diagnosed with any of the covered illnesses
  • Worldwide Coverage

Insured / Spouse

Policy Term (in years)

Eligible Ages

5 21 - 70
10 21 - 65
15 21 - 60
20 21 - 55
25 21 - 50
30 21 - 45
35 21 - 40
Up to Age 75 21 - 39

Children

Age 0 - 20 years

US Dollar (USD) and Qatari Riyals (QR)

Policy Benefits

Insured / Spouse: Benefit payment will be severity-based and the amount payable (as a % of face amount) will vary depending on the critical illness category and tier of the claim (Refer Appendix 1). Once 100% of the face amount is paid (either as a single claim or accumulated through multiple claims), the benefit will be terminated.

Children: A lump sum of USD 20,000 (QR 70,000) will be paid (for each child) and for up to 5 children, upon diagnosis of any of the covered conditions. (Refer Appendix 2) Elimination Period of 90 days applies from the Policy Effective Date, for all Named Insureds. A survival period of 14 days also applies. Elimination Period for newborn Dependents, added at birth, will be 14 days from their date of birth. Policy Owner should update the Company with the details of newborn children.
MetLife will pay premiums due for six months, to guarantee that the policy remains in force, under the following conditions (of the main insured):
  • Total Temporary Disability due to Accident or Sickness - for self-employed and unemployed individuals;
  • Involuntary Loss of Employment - for public or private sector employees. A waiting period of 60 days will be applicable after Total Temporary Disability / Involuntary Loss of Employment event, before claim will be paid out.
  • Increase / Decrease in coverage is applicable only for main Insured & Spouse; not applicable for Children.
  • Increase in coverage will be subject to the eligibility of the insured or spouse.
  • Increase/Decrease in coverage is allowed after the first Policy year, provided no claims are submitted.
    Note: Request for increase / decrease in coverage can be accepted during policy anniversary only.
Critical Illness Care benefit will continue even after the Named Insureds become non-residents of Gulf. * Sanctioned countries and High Risk Countries are excluded from coverage.
Waiver of Premium benefit will only be available for residents in Gulf countries.

Minimum / Maximum Coverage

Insured / Spouse

Benefit

Minimum Coverage

Maximum Coverage

Critical Illness USD 50,000 USD 1,000,000
QR 200,000 QR 3,500,000

Policy Fee

USD 55 / QR 205



Premium Payment Modes

Annual, semi-annual, quarterly and monthly.

Premium


Premium Frequency

Minimum Premium (USD)

Minimum Premium (QR)

Annual 250 918
Semi-annual 130 477
Quarterly 68 248
Monthly 23 83

Premiums are not guaranteed. Company reserves the right to review premium on yearly basis.

Discount in Premium
Spouse will be offered a discount in premium, provided the spouse applies along with the main Insured under the same policy.

Modal Loads
  • Semi-annual: 0.52
  • Quarterly: 0.27
  • Monthly: 0.09


Cancellation

Policy is non-cancellable.



Renewability & Expiry
  • Renewable up to age 75;
  • Expiration: at policy anniversary immediately following the 5, 10, 15, 20, 25, 30 or 35-year term selected; or immediately following the seventy fifth (75th) birthday of the Insured / Spouse, if term up to age 75 is selected.
  • Dependent's coverage will terminate on the policy anniversary date immediately following his/her twenty first (21st) birthday; or upon termination of coverage of Insured & Spouse; or upon payout of 5 claims for Dependents, whichever is earlier;
  • Policy coverage renewal is guaranteed without medical examination.
  • Premium rates are however subject to change.

  • Note: The policy continues as long as either the insured's or spouse's benefit remain active and will only terminate when both become inactive.



Termination of the Policy:
The coverage under this policy shall automatically terminate on the earliest of the following dates:
a)  Any premium on this policy remains unpaid at the end of the Grace Period;
b)  On the policy anniversary date of this policy immediately following the 5, 10, 15, 20, 25, 30 or 35 years term; or immediately following seventy fifth (75th) birthday of the Insured / Spouse, if term up to age 75 is selected.
c)  Death of the Insured and Spouse;
d)  The "Lump Sum " has been paid for both Insured & Spouse.

Reinstatement
    Reinstatements shall be allowed within one year from the premium due date, subject to the following:
  • A written application for reinstatement;
  • Satisfactory long health form or medical if required due to age and/or sum assured;
  • Production of evidence of insurability satisfactory to the Company;
  • New elimination period of 90 days and pre-existing conditions exclusion will commence from the reinstatement date.
  • Payment of the applicable premium (based on attained age) at the time of reinstatement;
    Reinstatement will not be allowed after one year from the premium due date.
    Lapsed policies shall be reinstated with a new effective date defined as the latest of:
    • The date of payment of the premium; or
    • The date of the long health form or medical (if applicable).


Exclusions
  • Suicide, war, terrorist acts, pre-existing conditions, hazardous sports etc.
  • Please refer the policy document for more details.
  • If Insured resides in any of the sanctioned countries*
    *Sanctioned countries as of September 2022: Crimea region, Cuba, Iran, North Korea and Syria (subject to changes).


Grace Period

A Grace Period of sixty (60) days shall be allowed for the payment of premiums, during which period the policy will remain in force. If loss occurs during these 60 days grace period, the outstanding premium shall be deducted in settlement of this policy. After the expiry of the 60 days, the policy will be cancelled without value.



Day Free Look Period

MetLife offers a 15-day free trial following the issuance date, during which time you may cancel the plan by writing to Customer Service Department at MetLife. You are entitled to a refund of premium. No refund will be made if a claim has already been paid.

Claims Processing
  • Claims are only payable by the Company upon delivery of the policy together with satisfactory proof of: (a) the occurrence of the assured event as stated in the Policy Specification Schedule;
    (b) the age of the Named Insured; and
    (c) the title of the claimant.

  • Claims must be sent to:
    Claims Department - MetLife
    P.O. Box 913, Doha, Qatar
    Tel. +974 44405444
    Fax. +974 44405445
    E-mail: gulflifeclaims@metlife.com
For more than a century, MetLife has a reputation as a company that believes in fair dealing, integrity and trustworthiness. That’s why we pride ourselves on always striving to deliver the highest standard of customer service.
If you feel that we have not lived up to these standards we would like to hear about it, so we can put it right for you.
How you can get in touch
Email us on: Complaints@metlife.qa
Providing:
  • Your full name
  • Policy number
  • Contact telephone number
Call us on toll free number: 8009711
Visit us:
Airport Road, Jaidah Square Building
3rd floor, Office # 304A
PO Box 913, Doha- Qatar

What happens next?
    After you get in touch, we will:
  • Acknowledge your feedback within two (2) working days, and advise who will be investigating it for you;
  • Endeavour to complete our investigation and issue our response within ten (10) working days;
  • Inform you if for any reason we are not able to respond within ten (10) working days, and keep you updated as to our progress.

We are committed to providing our customers and partners with products and services of the highest standards. If you feel our response did not completely satisfy your request, under QCB referral rights, you may refer your complaint to QCB by filling in “E-compliant form” and attaching a copy of the supporting documents, accordingly:

bcsu@qcb.gov.qa

Phone: 0097444222441
Disclaimer
Please note that a portion of the premiums you pay for this product will be used to cover the administration and distribution expenses including commissions payable to intermediaries/distributors (as applicable).

 

Category Tier Critical Illness Conditions Amount payable
Cancer Tier 1 Benefits Cancer - advanced 100%
Tier 2 Benefits Cancer - excluding specified early stage cancers 50%
Tier 3 Benefits Cancer - early stage cancers 25% (capped at QR 100,000 or relevant currency equivalent)
Heart Tier 1 Benefits Heart Condition - significantly impaired heart function 100%
Tier 2 Benefits Angioplasty - triple vessel
Cardiomyopathy
Coronary Artery Bypass Surgery
Heart Attack - with specified clinical evidence
Heart Surgery - open heart surgery
Pulmonary Arterial Hypertension
50%
Tier 3 Benefits Angioplasty - single or double vessel
Heart Valve Surgery - keyhole procedure
25% (capped at QR 50,000 or relevant currency equivalent)
Neurological Tier 1 Benefits Neurological Condition - permanent neurological deficit 100%
Tier 2 Benefits Dementia including Alzheimer's Disease
Motor Neurone Disease
Multiple Sclerosis
Muscular Dystrophy
Parkinson's Disease
Stroke - with persisting clinical symptoms
50%
Tier 3 Benefits Bacterial Meningitis or Viral Encephalitis
Benign Brain Tumour
Hydrocephalus - requiring surgery
25% (capped at QR 250,000 or relevant currency equivalent)
Vital Organ and Digestive System Disorders Tier 1 Benefits Vital Organ or Digestive System Disorder - end stage 100%
Tier 2 Benefits Lung Removal - excluding donors 50%
Tier 3 Benefits Aplastic Anaemia
Crohn's Disease - severe
Diabetes - insulin dependent
Ulcerative Colitis - severe
25% (capped at QR 250,000 or relevant currency equivalent)
Disability Conditions and Accidental Tier 1 Benefits Blindness
Loss of Independence
Loss of Use of Limb - two or more limbs
100%
Tier 2 Benefits Burns - full thickness
Deafness
50%
Tier 3 Benefits Blindness - partial loss
HIV Infection - acquired medically, at work, or from an assault
Loss of Use of Limb - single limb
25% (capped at QR 250,000 or relevant currency equivalent)

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