In Canada, a stroke occurs every five minutes, with nearly half of all stroke events in Canada never resulting in a hospital admission, ending instead at the emergency department (ED).
Most Canadians assume that TIAs (mini strokes) do not change their insurance profile. However, life insurance underwriters treat all documented stroke events as a permanent shift in your health profile. That’s why waiting to secure coverage until after a “warning sign” can result in doubled premiums or a total loss of eligibility for traditional plans. MyChoice analyzed the growing gap between hospitalizations and ED-only events to understand how this shift in the Canadian healthcare landscape is impacting the insurance industry.
Key Stroke Statistics in Canada
An estimated 108,707 stroke events were recorded in Canada in 2017–18, which is about one stroke every five minutes. Those total events were split almost perfectly between:
- 54,357 stroke events led to hospitalizations
- 54,350 stroke events were ED-only events (no hospitalization). This includes TIAs.
That near-even split is the real story for insurance. If you only look at hospitalizations, you miss the ED-only half of this risk picture, where people had symptoms serious enough to get triaged, assessed, and coded as stroke/TIA, but weren’t admitted. That can happen for a few reasons:
- Symptoms resolved
- Imaging didn’t show any large injury
- The event was labelled a TIA
- The hospital’s admission threshold and pathways routed the case to rapid outpatient follow-up.
From an underwriting perspective, this still signals future risk. TIAs may not cause permanent brain damage, but they are the single most significant predictor of a major stroke that can lead to more health complications or even death.
According to the most recent CIHI data, stroke hospitalization rates vary substantially across provinces, reflecting differences in population age, underlying health risk factors, and the delivery of stroke care within each provincial health system. Atlantic provinces such as Newfoundland and Labrador (148 per 100,000) and Nova Scotia (135) report among the highest hospitalization rates, whereas British Columbia (110) and Ontario (112) are below the national average. Prairie provinces such as Manitoba (141) and Saskatchewan (138) also exhibit elevated rates relative to central Canada.
It’s important to note that these figures capture hospital admissions only. Provinces with lower hospitalization rates may still experience a similar overall burden of stroke-related events if more cases are managed through emergency departments and outpatient pathways rather than inpatient admission.
Why ED-Only Strokes Matter for Life Insurance
In healthcare, a “minor” stroke or TIA is often treated very differently from a major stroke. In life insurance underwriting, that difference mostly disappears. What matters is that a stroke-related event happened at all, because:
- It signals an underlying blood vessel or circulation risk
- The risk of a full stroke is highest in the days, weeks, and months after a TIA, which is why doctors treat it seriously.
In short, even a mild event can permanently change how insurers assess your risk, regardless of how quickly you recovered.
While every insurer’s rules differ, even ED-only strokes can lead to:
- Higher premiums
- Coverage exclusions (more common in disability/critical illness than life)
- A waiting period before you can qualify (often a few years)
- A decline, especially for a fully underwritten term life policy
Around 1 in 20 strokes occur in Canadians under age 45, and many ED-only cases occur in working years. This life stage is typically when families still have mortgages, child-related expenses, and income dependence, and when coverage gaps hurt most.
How Life Insurance Underwriting Changes After a Stroke or TIA
| Coverage Type | Typical Impact After Stroke/TIA |
|---|---|
| Term Life Insurance | This is often the most restrictive soon after the event. Many insurers postpone for a period after the last event; offers may return later with a rating depending on stability and risk factor control. |
| Permanent Life Insurance | This can be more flexible than term in some cases, but still fully underwritten and may come with ratings. Depending on their risk appetite, this is offered by insurers despite declining to offer term life insurance. |
| Disability Insurance | Underwriting is usually strict because stroke/TIA directly affects the risk of future disability claims. Exclusions (e.g., neurological/cerebrovascular) are common if coverage is offered. |
| Critical Illness Insurance | This can be challenging as stroke is typically a covered core condition. If offered, it may include exclusions related to stroke/TIA or may be declined if risk is considered high. |
| Group Insurance | This is usually easier to access because it’s not individually underwritten at the same depth, especially for basic coverage. But limits may be lower and portability/conversion rules matter. |
When applying for any type of insurance after a stroke, remember that insurers don’t just look at the event. Approval and rates will depend heavily on why your stroke happened and evidence of how you’ve been managing the underlying factors since, such as:
- Blood pressure control
- Quitting smoking, if applicable
- Following up with a cardiologist and/or neurologist
- Cholesterol management
Key Advice from MyChoice
- Don’t apply blindly for life insurance. Every time an application is declined, it’s recorded in the MIB (Medical Information Bureau), which other insurers can see.
- Never minimize a “minor” ED-only stroke visit in your application. If an underwriter discovers a TIA or “dizziness” episode in your records that you didn’t disclose, it’s often viewed as “non-disclosure”. This is considered misrepresentation and can lead to an automatic decline of your application or payout.
- If you’re a stroke survivor and need a medical check-up for a policy application, avoid caffeine, high-sodium foods, and strenuous exercise for 24 hours prior. A single high blood pressure reading during this exam, combined with your history, can trigger higher premiums or even an application denial.