Occupational HIV Infection

fully covered

Definition

A definite diagnosis of infection with human immunodeficiency virus (HIV) resulting from accidental injury during the course of the Policyholder’s normal occupation, which exposed the Policyholder to HIV contaminated body fluids. The accidental injury leading to the infection must have occurred after the later of:

  • The Effective Date; or
  • The most recent Effective Date of Reinstatement.

Payment under this Covered Critical Illness Condition requires satisfaction of the following:

  • The accidental injury must be reported to us within 14 days of the accidental injury;
  • A serum HIV test must be taken within 14 days of the accidental injury and the result must be negative;
  • A serum HIV test must be taken between 90 days and 180 days after the accidental injury and the result must be positive;
  • All HIV tests must be performed by a duly licensed laboratory in Canada or the United States; and
  • The accidental injury must have been reported, investigated, and documented in accordance with current workplace guidelines in Canada or the United States.

The diagnosis of Occupational HIV Infection must be made by a Specialist.

Waiting Period

Until the criteria outlined above for this condition have been met.

Exclusions

We will not pay a Critical Illness Benefit under this condition if:

  • The Policyholder has elected not to take any available licensed vaccine offering protection against HIV;
  • A licensed cure for HIV infection has become publicly available prior to the accidental injury; or
  • HIV infection has occurred as a result of non-accidental injury including, but not limited to, sexual transmission and intravenous (IV) drug use.

Multiple Sclerosis

fully covered

Definition

A definite diagnosis of at least one of the following occurring after the later of the Effective Date, or the most recent Effective Date of Reinstatement Policy:

  • Two or more separate clinical attacks, confirmed by at least one magnetic resonance imaging (MRI) of the nervous system, showing multiple lesions of demyelination;
  • A single attack, with objective Neurological Deficits lasting more than 6 months, confirmed by MRI of the nervous system, showing multiple lesions of demyelination; or
  • A single attack, confirmed by repeated MRI of the nervous system, which shows multiple lesions of demyelination which have developed at intervals at least one month apart.

The diagnosis of Multiple Sclerosis must be made by a Specialist.


Waiting Period

Until the criteria outlined above for this condition have been met.

Exclusions

We will not pay a Critical Illness Benefit under this condition for the following:

  • Solitary sclerosis;
  • Clinically isolated syndrome;
  • Radiologically isolated syndrome;
  • Neuromyelitis optica spectrum disorders; or
  • Suspected multiple sclerosis or probable multiple sclerosis.

‍1-year exclusion:

We will not pay a Critical Illness Benefit under this condition if, within the first year of the later of: (i) the Effective Date; and (ii) the most recent Effective Date of Reinstatement, the Policyholder has any of the following:

  • Signs, symptoms or investigations leading directly or indirectly to a diagnosis of multiple sclerosis (covered or not covered under the Policy), regardless of when the diagnosis is made; or
  • A diagnosis of multiple sclerosis (covered or not covered under the Policy).

Medical information about the diagnosis and any signs, symptoms or investigations leading to the diagnosis must be reported to us within six months of the date of the diagnosis. If this information is not provided within this period, we have the right to deny any claim for Multiple Sclerosis or any critical illness caused by multiple sclerosis or its treatment.

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Aplastic Anaemia

fully covered

Definition

Aplastic Anaemia is defined as a definite diagnosis of a chronic persistent bone marrow failure, confirmed by biopsy, which results in anaemia, neutropenia and thrombocytopenia requiring blood product transfusion, and treatment with at least one of the following:

  • Marrow stimulating agents;
  • Immunosuppressive agents; or
  • Bone marrow transplantation.

The diagnosis of Aplastic Anaemia must be made by a Specialist.

Waiting Period

There is no Waiting Period for this condition.

Exclusions

None