Critical Illness Care Plus

• 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)

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

Dependent's coverage will be USD 20,000 / QR 70,000

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.

Address: P.O.Box 913, Doha, Qatar
Qatar toll free number: 8009711
Email: CustomerCare.QA@metlife.qa

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).

 

Appendix 1- Covered Critical Illnesses (Insured & Spouse)

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 Heart Attack - 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)

Appendix 1- Covered Critical Illnesses (children)

Category	Tier	Critical Illness Conditions	Amount payable
Cancer	Tier 1 Benefits	Cancer – advanced	100%
	Tier 2 Benefits	Cancer – excluding specified early stage cancers	100%
Heart	Tier 1 Benefits	Heart Condition - significantly impaired heart function Heart Attack - 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	100%
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	100%
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	100%
Disability	Tier 1 Benefits	Blindness Loss of Independence Loss of Use of Limb - two or more limbs	100%
	Tier 2 Benefits	Burns - full thickness Deafness	100%
Child specific conditions	Tier 1 Benefits	Cerebral Palsy Cystic Fibrosis Muscular Dystrophy	100%
	Tier 2 Benefits	Intensive Care Craniosynostosis – treated by surgery Hydrocephalus – treated with invasive surgery to the brain tissue	100%

The above are the key features of the product.
Please refer to policy contract for further clarifications and complete coverage conditions/exclusions; in case of discrepancy between the conditions mentioned above and the policy itself, the latter shall supersede.
I have read and understood the above key facts of the product on all pages in this document.