Assuris Protection and Calculations

Protection responds to member failure

Assuris protects eligible policyholders if a member life and health insurer fails. It is an industry-funded policyholder protection organization, not the agent licensing authority, a general investment-return guarantee, or the insurer's ordinary claims department.

Assuris' member information explains mandatory membership for authorized life and health insurers, with opt-in treatment for fraternal benefit societies and prepaid medical services companies. Check the actual issuing member rather than assume every organization using an insurance-related name participates.

Protection applies separately to member companies. The current protection overview also describes separate application to individual and group products. Use current product-specific guidance and the Assuris calculator for complex holdings rather than importing older aggregation assumptions.

Current benefit thresholds

As checked October 10, 2026, the published protection is the higher of the stated threshold or 90% of the relevant benefit, capped at the actual benefit:

The actual-benefit cap is essential. A $200,000 death benefit does not become $1 million merely because that threshold appears in the table. The floor preserves a smaller benefit in full.

Compare the two alternatives

For a hypothetical $900,000 death benefit, 90% is $810,000. The $1 million threshold is higher, but the benefit itself is only $900,000. The protected amount is therefore $900,000.

For a $1.2 million death benefit, 90% is $1.08 million. That exceeds the $1 million floor, so the protection calculation gives $1.08 million.

For monthly income of $5,200, 90% is $4,680. The $5,000 floor is higher, so the protected monthly amount is $5,000. A monthly benefit of $4,000 would be protected only to its actual $4,000 amount.

These examples apply the published formula to isolated qualifying benefits. They do not establish the final result for a complicated contract with loans, riders, multiple accounts, or unusual ownership.

Investment guarantees and assets

An accumulated-value promise differs from a segregated fund guarantee. A GIA may create a contractual accumulated-value obligation. A segregated fund holds market-linked assets separately, with a specified insurer guarantee.

Assuris protection of that guarantee does not turn every market decline into an insolvency claim. If an equity fund loses value while its insurer remains solvent, ordinary investment and maturity rules apply.

Likewise, a 75% contractual maturity guarantee and Assuris' 90% failure-protection formula concern different obligations. Identify the guaranteed obligation first. Do not tell the client that 90% of every segregated fund deposit is always payable on demand.

Failure resolution and continued coverage

Assuris works within the resolution process to preserve protection, commonly through transfer of policies or benefits to another insurer. The aim is continuity and minimizing loss, rather than automatically sending every policyholder an immediate cheque for the entire face amount.

The client should follow official instructions during a failure. Unplanned surrender can remove useful protection or create tax consequences. The agent should obtain current information and avoid spreading rumors about an insurer's solvency.

A policy's ordinary exclusions, entitlement requirements, and payment conditions still matter. Failure protection does not create a valid claim where the underlying contract had no payable benefit.

Accurate disclosure is permitted

Assuris' financial-adviser toolkit supports adviser communication and use of approved information. A blanket statement that mentioning Assuris in sales material is prohibited is wrong.

The agent should use accurate current wording and avoid suggesting complete protection without limits. A statement that Assuris makes insurer financial strength irrelevant would also be misleading.

A suitable explanation identifies the issuing member, relevant benefit category, formula, and any need for product-specific confirmation. It complements product and solvency analysis rather than replacing them.

A qualifying hypothetical health expense benefit of $300,000 illustrates the same comparison: 90% is $270,000, higher than the $250,000 threshold, so the simplified protected amount is $270,000. The category matters; a monthly disability benefit should use the monthly-income rules instead. Before calculating, identify the obligation and units, verify member status and consult current product-specific guidance. A large policy face amount or a familiar insurer brand does not tell the agent which protection category applies.

Keep the roles distinct

Assuris addresses member insurer failure. OLHI addresses eligible life and health complaints. Regulators address licensing and conduct within their powers. E&O insurance concerns covered professional liability.

Choosing the correct organization depends on the loss event. An agent's negligent beneficiary change is not automatically an Assuris claim, and a disputed disability definition is not automatically evidence of insurer insolvency.