Life Insurance and Medically Assisted Death

Canada is one of a few countries (listed below) where medically assisted death and/or euthanasia are legal (more on both definitions further below). This poses additional questions on the topic of life insurance and how Canadian life insurance companies treat physician-assisted death.

Below you’ll find detailed information on this topic in the context of Canadian life insurance, with material from multiple life insurance companies. Should you have additional questions, please do not hesitate to contact our life insurance professionals.

What is medically assisted death?

Medically assisted death is a situation where a qualified/licensed doctor or physician provides a patient with the information and means to end their life. Typically, there is reason to do so such a thing: relieving the suffering of terminally ill individuals or, as the Assisted Dying Bill puts it,” ending a grievous and irremediable condition” where the death is “reasonably foreseeable.”

There are many other terms for medically assisted death, and they all basically mean the same thing:

  • Medical Assistance in Dying (MAID)
  • Doctor-Assisted Death
  • Physician-Assisted Death
  • Doctor-Assisted Suicide
  • Physician-Assisted Suicide
Is medical assistance in dying different from euthanasia?

Yes. There is a difference between euthanasia and medically assisted death. Euthanasia assumes that a doctor/physician is actively involved in providing dying assistance, e.g. via a lethal injection. Physician-assisted death or physician-assisted suicide means that a doctor provides the means for the suicide but does not execute it personally.

This difference, though, is not relevant for life insurance providers. As long as the health and legal conditions for the medically assisted death are fulfilled, life insurers treat euthanasia and medically assisted death in the same way.

What other countries have physician assisted death?

Currently, there are only few countries that legally allow medical assistance in dying and/or euthanasia. Here is a brief overview:

  Country Details
Canada All provinces in Canada allow euthanasia and all but Quebec allow medical assistance in dying.
United States Not all states in the U.S. treat doctor-assisted death in the same way. It is legal in California, Colorado, Montana, Oregon, Vermont and Washington State.
Switzerland It is the only country providing medical assistance in dying not only to its own citizens, but also to foreigners.
The Netherlands Individuals are not legally required to be terminally ill to request euthanasia or medical assistance in dying. Also, children age 12 years or older can request euthanasia, given they have a parental consent.
Belgium Euthanasia can be performed both to terminally ill and not terminally ill people, but there is a waiting period of one month in the second case.
Columbia Unlike most other countries where medically assisted death is legal, a special panel must approve it.
Luxembourg Euthanasia has been legalized here since 2009.
Does life insurance pay for death by suicide in Canada?

It depends on how long a policy has been in place. In general, if a policy has been in place for less than two years, insurers WILL NOT pay for a death by suicide, and will only return paid premiums.

If a policy has been in place for at least two years, insurers will typically treat suicide cases like any other death and WILL pay the death claim.

It is important to know that insurers investigate most claims and will try to determine if misrepresentations were made when getting the policy. For example, if a policyholder had a history of depression or mental instability and did not reported it, the insurer may decide not to pay the claim.

Life insurance and medically assisted death: Overview

It is interesting to note that nearly all life insurers treat physician-assisted death/euthanasia in a similar way. If there is a clear case of MAID (medical assistance in dying) where both health preconditions (terminal disease/palliative condition) AND legal requirements are met, life insurance companies will pay claims in full – it does not matter how long the policy was in place.

It is different for a suicide death – if it happens in the first two years while the policy is in place, insurance companies do not pay the claim and only return paid premiums. After two years, suicide is treated as a usual death and insurers will pay.

  Scenario 1 Scenario 2 Scenario 3 Scenario 4
How does the situation look like? Medically Assisted Death/Euthanasia Medically Assisted Death/Euthanasia SUICIDE SUICIDE
How long was policy in place? Policy in place for LESS than 2 years Policy in place for MORE than 2 years Policy in place for LESS than 2 years Policy in place for MORE than 2 years
What do insurers do? Paid in full, treated as a usual death case Paid in full, treated as a usual death case No claim is paid, only paid premiums will be returned Paid in full but insurer will thoroughly investigate the case to make sure there were no special pre-conditions like mental instability

It is important to mention that all claims are typically subjected to thorough investigation and, if an insurer suspects misrepresentation, can be voided. A typical example could be a previously known mental disorder or pre-condition that has not been disclosed to an insurer. A suicide claim, even after the policy has been in place for two years in this case, will not be paid.

That’s in line with CLHIA (Canadian Life and Health Insurance Association) guidelines on Medical Assistance in Dying: “The industry’s position is that member companies would not treat deaths resulting from MAID as a “suicide” for policy purposes provided the legislated process has been followed. Other defences (such as misrepresentation or other exclusions) would remain open. As it will be important to be aware of the underlying cause of death in the circumstances, we continue to recommend to provincial governments that they implement requirements that the underlying cause of death be recorded on death certificates issued in the circumstances of a MAID death…”

CLHIA guidelines on Medical Assistance in Dying as PDF  
Life insurance and assisted death: a detailed perspective

Here are how various insurers see medical assistance in dying – these are verbatim responses of insurance companies.

 

Life Insurance Company #1 and Medically Assisted Death

“We do not treat doctor-assisted death the same way as suicide, therefore we do not consider the 2-year period.

Typically, in these doctor-assisted death situations, it’s to relieve the suffering of terminally ill individuals. Doctors are still required to respect certain criteria and laws for these situations. The laws are really strict in where people would be eligible to receive doctor assisted deaths.

We do adhere to the CLHIA (Canadian Life and Health Insurance Association) guidelines on Medical Assistance in Dying: The CLHIA also affirmed its position that life insurance claims in cases of physician assisted dying should not be denied as long as the processes set out in the law are followed. We also indicated that the industry will work towards complying with any changes in the legislation when the time comes.

In saying this, at time of claim, like all of our claims, there may be additional information that would be required, example a completed Physician Statement or supporting medical documents. These are done on a case by case basis.”

 

Life Insurance Company #2 and Medically Assisted Death

“Our position regarding a death that occurs due to medically assisted suicide is as follows. If a death occurs while the suicide and contestable clauses are in effect, the claim will be reviewed for material misrepresentation, which if found, may render the policy contract voidable.

If no material misrepresentation was found and the loss did not meet the MAID definition, the suicide benefit would be paid.

If no material misrepresentation is found and the death meets the definition of medical assistance in dying, at this time and based on current legislation, the death would not be considered a suicide, and thus the claim would be paid accordingly.

This response is not meant to be a waiver of any of our company’s rights to investigate future claims.”

 

Life Insurance Company #3 and Medically Assisted Death

“The CLHIA has stated that carriers will not enforce the suicide provisions in a policy if the life insured dies as a result of medically assisted death.  Our company has not made a similar statement.

While we are anticipating changes to provincial insurance legislation to address medically assisted death in relation to suicide provisions in a life insurance contract, it is not known when this will occur or how the changes will be worded.

We would adjudicate the claim to ensure there was no non-disclosure or misrepresentation as we normally would.

This is a TENTATIVE assessment only and is subject to full underwriting review and decision.  In our company, any and all underwriting opinions on inquiries will be subject to review of a fully completed application within 30 days of this message, as well as routine age and amount requirements requested by the Underwriting Department to finalize.”

 

Life Insurance Company #4 and Medically Assisted Death

“To be eligibility to request assisted dying, the person must –
  • Be covered under a government health plan
  • Be 18 years and capable of making health care decision
  • Have a grievous and irremediable medical condition
  • Give written voluntary request for assisted dying with no external pressure – (complete and sign the required forms)
  • Give consent after informed of other means available to relieve pain, e.g. palliative

Providing all of the criteria outlined in the Criminal Code (noted above) are met, at claim time

  • The cause of death should not be considered suicide
  • If the policy is in force for more than 2 years and the suicide exclusion period has expired then the claim would be treated the same as any other cause of death
  • If the Insured person received medical assistance in dying within 2 years of the policy effective date or date of reinstatement the claim will be reviewed in accordance with the contestable policy review
  • Any underlying condition and/or any excluded condition will be taken into consideration.”

 

Life Insurance Company #6 and Medically Assisted Death

“Where an insured person dies as a result of a medically assisted death in accordance with the rules and processes set out by the appropriate government in relevant legislation, we will not consider the medically assisted death to be a “suicide” for the purposes of life insurance.

We will also need to know the medical cause that led up to the MAID.

Please note, that our company will still adjudicate any claim in accordance with other contract provisions that may be applicable. For example,

  • Any misrepresentation (innocent or fraudulent as those terms are interpreted under applicable provincial insurance legislation) that may have been made in connection with the coverage, or
  • Any exclusions that were specifically included in the policy at the time the coverage was issued.”

 

Life Insurance Company #7 and Medically Assisted Death

“The process of a file with the cause of death “medically assisted death” will be as a normal file. It means that we will process with the same criteria, requirements and standards for a death claim as the other file.”
Doctor-assisted death and life insurance: other things to know

Not being able to sign the consent: If the insured is unable to sign the consent, then the person signing on their behalf or acting as an independent witness cannot be a beneficiary to the policy or in their will.  In other words, they cannot benefit financially from the death in any way.

Misrepresentation: Any insurance company will very likely investigate any claims for misrepresentations to find out if a policyholder had known health preconditions but did not report them to the insurance company when buying the policy. This can void the policy.

Should you have any further questions, our licensed life insurance brokers are happy to advise you and your family in these important matters.