PolicyMe Critical Illness Insurance Covered Conditions

PolicyMe Life, Critical Illness, and Health & Dental insurance plans are underwritten by Canadian Premier Life Insurance Company of Canada and sales are conducted by PolicyMe Corp. The insurance transaction is between the client and Canadian Premier Life Insurance Company. Securian Canada is the brand name used by Canadian Premier Life Insurance Company to do business in Canada. PolicyMe Corp., doing business as PolicyMe, a licensed Life and Accident & Sickness insurance agency, acts as the administrator and technology provider of PolicyMe Life, Critical Illness and Health & Dental insurance plans on behalf of Securian Canada. PolicyMe is compensated by way of commissions by Securian Canada for sales of insurance.

Definition 


A definite diagnosis of new damage to brain tissue caused by traumatic head injury, resulting in a newly developed significant Neurological Deficit (defined in Section 3 – Definitions) that:

• Results from an external trauma severe enough to have prompted the Policyholder to seek a medical consultation in less than a week after the occurrence of the trauma;
• Is present and verifiable on clinical examination;
• Is corroborated by abnormal magnetic resonance (MR) and/or computed tomography (CT) brain imaging studies, that confirm brain trauma; and
• Persists for more than 180 consecutive days following the date of diagnosis.


The diagnosis of Acquired Brain Injury must be made by a Specialist.



Waiting Period 
‍

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

‍

Exclusions

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

• An abnormality seen on imaging studies of the brain without corresponding clinical impairment;
• Neurological deficit without corresponding imaging study lesions; and
• A concussion that does not have abnormal imaging studies.

Definition 


The undergoing of surgery for disease of the aorta requiring excision and surgical replacement of any part of the diseased aorta with a graft. Aorta means the thoracic and abdominal aorta but not its branches.


The surgery must be determined to be medically necessary by a Specialist.



Waiting Period 


30 days following the date of surgery.



Exclusions

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

• Angioplasty (this is a Covered Early Condition);
• Intra-arterial procedures;
• Percutaneous trans-catheter procedures; or
• Non-surgical procedures.

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

Definition 

A definite diagnosis of meningitis, confirmed by cerebrospinal fluid showing the presence of pathogenic bacteria. The presence of pathogenic bacteria must be confirmed by culture or other generally medically accepted microbiological testing. The Bacterial Meningitis must result in objective Neurological Deficits persisting for at least 90 days from the date of diagnosis.

The diagnosis of Bacterial Meningitis 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 viral meningitis.

Definition 
‍

A definite diagnosis of a non-malignant tumour located in the cranial vault and limited to the brain, meninges, cranial nerves or pituitary gland. The tumour must require surgical or radiation treatment or cause irreversible objective Neurological Deficit(s).

These deficits must be corroborated by diagnostic imaging showing changes that are consistent in character,location, and timing with the Neurological Deficit(s).

The diagnosis of a Benign Brain Tumour must be made by a Specialist.
‍
Waiting Period 
‍

There is no Waiting Period for this condition.
‍
Exclusions‍

Please see Section 1.7 for terms that apply to all cancer-related conditions covered under this Policy.
‍We will not pay a Critical Illness Benefit under this condition for:

• Pituitary adenomas less than 10 mm;
• Vascular malformations;
• Cholesteatomas; or
• Infectious or inflammatory tumours.

Definition 


A definite diagnosis of the total and irreversible loss of vision in both eyes, evidenced by:

• The corrected visual acuity being 20/200 or less in both eyes; or
• The field of vision being less than 20 degrees in both eyes.
  
  The diagnosis of Blindness must be made by a Specialist.

Waiting Period 


There is no Waiting Period for this condition.



Exclusions

None

Definition 


A definite diagnosis of a malignant tumour as evidenced by the uncontrolled growth and spread of malignant cells and the invasion of tissue. The term cancer includes carcinoma, melanoma, leukemia, non-cutaneous lymphoma, and non-cutaneous sarcoma.


The diagnosis of cancer must be made by a Specialist and must be confirmed by a final pathology report.
‍Waiting Period 


There is no Waiting Period for this condition.
Exclusions

Please see Section 1.7 for terms that apply to all cancer-related conditions covered under this Policy.

No Critical Illness Benefit will be payable under this condition for the following:

• Lesions described as benign, non-invasive, pre-malignant, of low and/or uncertain malignant potential, borderline, carcinoma in-situ, or tumours classified as Tis or Ta;
• All grades of dysplasia, all grades of squamous intraepithelial lesions (HSIL and LSIL), and all grades of intra-epithelial neoplasia;
• Malignant melanoma of skin that is less than or equal to 1.0 mm in thickness, unless it is ulcerated or is accompanied by lymph node or distant metastasis;
• All ocular (uveal) melanomas confined to the eye unless treatment with resective surgery, brachytherapy, external beam radiotherapy, chemotherapy, or targeted systemic therapy has been undertaken;
• Any non-melanoma skin cancer, without lymph node or distant metastasis. This includes but is not limited to, cutaneous lymphoma, dermatofibrosarcoma, basal cell carcinoma, squamous cell carcinoma or Merkel cell carcinoma, all of which are confined to the skin (which includes the epidermis, dermis and hypodermis/subcutaneous tissue);
• Prostate cancer classified as T1a or T1b, without lymph node or distant metastasis;
• Papillary thyroid cancer or follicular thyroid cancer, or both, that is less than or equal to 2.0 cm in greatest diameter and classified as T1, without lymph node or distant metastasis
• All bone marrow malignancies and non-cutaneous lymphomas (including, but not limited to, leukemia, myeloproliferative neoplasms, essential thrombocythemia, primary myelofibrosis, polycythemia vera, and myelodysplastic syndrome), unless the bone marrow malignancy or non-cutaneous lymphoma requires treatment with systemic chemotherapy, targeted cancer therapies, bone marrow transplant or hematopoietic stem cell transplant, or a permanent reliance on blood product replacement or therapeutic phlebotomies;
• All neuroendocrine tumours (including carcinoid tumours) and gastrointestinal stromal tumors that are AJCC prognostic Stage I or less;
• Thymomas (stage 1) confined to the thymus, without evidence of invasion into the capsule or spread beyond the thymus; or
• All cancers only identified from tumour cells, genetic material, or any other biomarkers, any of which may be present in the blood, saliva, urine, or other bodily fluids, including, but not limited to, tests known as “liquid biopsies”.

For the purposes of this Policy:

• T1a or T1b prostate cancer means a clinically inapparent tumour that was not palpable on digital rectal examination and was incidentally found in resected prostatic tissue;
• The terms Tis, Ta, T1a, T1b, T1, Stage 1 and AJCC prognostic Stage 1 are as defined in the American Joint Committee on Cancer (AJCC) Staging Manual, 8th Edition, 2018; and
• The term Rai stage 0 is as defined in KR Rai, A Sawitsky, EP Cronkite, AD Chanana, RN Levy and BS Pasternack: Clinical staging of chronic lymphocytic leukemia. Blood 46:219, 1975.

Definition 


A definite diagnosis of a non-alcohol related dilated, ischemic, hypertrophic and restrictive forms of cardiomyopathy. Cardiac imaging must show permanent left ventricular dysfunction as evidenced by one of the following:

• Left ventricular ejection fraction of ≤35%;
• Severe Grade III restrictive left ventricular diastolic dysfunction; or
• Heart failure due to one of the above forms of cardiomyopathy which has required cardiac resynchronization therapy (CRT) upon the advice of an accredited electrophysiologist. CRT refers to biventricular pacing for the purposes of resynchronizing cardiac contractility in heart failure. This criterion does not apply to devices deployed purely for the treatment of electrical conduction system disease of the heart.


The Cardiomyopathy must result in permanent functional impairment to at least Class III of the New York Heart Association (NYHA) Classification which has persisted for at least six months while on optimal therapy. NYHA Class III means the Policyholder has marked limitation of physical activity and less than ordinary activity such as walking across a room causes fatigue, rapid/irregular heartbeat (palpitations) or shortness of breath (dyspnea).

The diagnosis of a Cardiomyopathy 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 any form of Cardiomyopathy that is causeddirectly or indirectly by alcohol use.

Definition 


A definite diagnosis of a state of unconsciousness, with no reaction to external stimuli or response to internal needs for a continuous period of at least 96 hours, and for which period the Glasgow Coma Score must be 4 or less.


The diagnosis 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 for the following conditions:

• A medically induced coma;
• A coma which results directly from alcohol or drug use; or
• A diagnosis of brain death.

Definition 


The undergoing of heart surgery to correct narrowing or blockage of one or more coronary arteries with bypass graft(s).


The surgery must be determined to be medically necessary by a Specialist.
‍Waiting Period 


30 days following the date of your surgery.
‍Exclusions

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

• Angioplasty (this is a Covered Early Condition);
• Intra-arterial procedures;
• Percutaneous trans-catheter procedures; or
• Non-surgical procedures.

Definition 


A definite diagnosis of the total and irreversible loss of hearing in both ears, with an auditory threshold of 90 decibels or greater within the speech threshold of 500 to 3,000 hertz.


The diagnosis of Deafness must be made by a Specialist.
‍Waiting Period 


There is no Waiting Period for this condition.
‍Exclusions

None

Definition 


A definite diagnosis of Dementia characterized by a progressive deterioration of memory and at least one of the following areas of cognitive function:

• Aphasia (a disorder of speech);
• Apraxia (difficulty performing familiar tasks);
• Agnosia (difficulty recognizing objects); or
• Disturbance in executive functioning (e.g. inability to think abstractly and to plan, initiate, sequence, monitor, and stop complex behaviour), which is affecting daily life.

The Policyholder must exhibit:

• Dementia of at least moderate severity, which must be evidenced by a Mini Mental State exam of 20/30 or less, or equivalent score on another generally medically accepted test or tests of cognitive function; and
• Evidence of progressive worsening in cognitive and daily functioning either by serial cognitive tests or by history over at least a six-month period.

For purposes of this Policy, reference to the Mini Mental State exam is to Folstein MF, Folstein SE, McHugh PR, J Psychiatr Res 1975;12(3):189.

The diagnosis of Dementia 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 affective or schizophrenic disorders, or delirium.

Definition 


A rise and fall of biochemical cardiac markers to levels considered diagnostic of myocardial infarction, with atleast one of the following:

• Heart attack symptoms;
• New electrocardiogram (ECG) changes consistent with a heart attack; or
• Development of new pathological Q waves on ECG following an intra-arterial cardiac procedure including, but not limited to, coronary angiography and/or coronary angioplasty


The diagnosis of Heart Attack must be made by a Specialist.

‍Waiting Period 


30 days following the date the condition was diagnosed.
‍Exclusions

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

• ECG changes suggestive of a prior myocardial infarction;
• Other acute coronary syndromes, including angina pectoris and unstable angina; or
• Elevated cardiac biomarkers and/or symptoms that are due to medical procedures or diagnoses other than heart attack.

Definition 


The undergoing of surgery to replace any heart valve with either a natural or mechanical valve, or to repair heart valve defects or abnormalities.

The surgery must be determined to be medically necessary by a Specialist.
Waiting Period 


30 days following the date of surgery.
‍Exclusions

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

• Angioplasty (this is covered as an Covered Early Condition);
• Intra-arterial procedures;
• Percutaneous trans-catheter procedures; or
• Non-surgical procedures.

Definition 


A definite diagnosis of chronic irreversible failure of both kidneys to function, as a result of which regular hemodialysis, peritoneal dialysis or renal transplantation is initiated.

The diagnosis of Kidney Failure must be made by a Specialist.


Waiting Period 


There is no Waiting Period for this condition.
‍Exclusions

None

Definition 


A definite diagnosis of chronic irreversible failure of both kidneys to function, as a result of which regular hemodialysis, peritoneal dialysis or renal transplantation is initiated.A definite diagnosis of the total inability, due to disease or injury, to perform independently:

• With or without the aid of assistive devices;
• At least 3 of 6 Activities of Daily Living (ADL) listed below;
• For a continuous period of at least 90 days;
• With no reasonable chance of recovery; and
• The diagnosis must be made by a physician and supported by an independent home care assessment made by an occupational therapist or equivalent.

Activities of Daily Living are:

• Bathing – the ability to wash oneself in a bathtub, shower or by sponge bath;
• Dressing – the ability to put on and remove necessary clothing, braces, artificial limbs or other surgical appliances;
• Toileting – the ability to get on and off the toilet and maintain personal hygiene;
• Bladder and Bowel Continence – the ability to manage bowel and bladder function with or without protective undergarments or surgical appliances so that hygiene is maintained;
• Transferring – the ability to move in and out of a bed, chair or wheelchair; and
• Feeding – the ability to consume food or drink that already has been prepared and made available.


Waiting Period 


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

None

Definition 


A definite diagnosis of the complete severance of two or more limbs at or above the wrist or ankle joint as the result of an accident or medically required amputation.

The diagnosis of Loss of Limbs must be made by a Specialist.

Waiting Period 


There is no Waiting Period for this condition.

Exclusions

None

Definition 


A definite diagnosis of the total and irreversible loss of the ability to speak as the result of physical injury or disease, for a period of at least 180 days.

The diagnosis of Loss of Speech must be made by a Specialist.


Waiting Period 


There is no Waiting Period for this condition.

Exclusions

None

Definition 


A definite diagnosis of the irreversible failure of the heart, both lungs, liver, both kidneys or bone marrow, and transplantation must be medically necessary. To qualify under Major Organ Failure (on Waiting List), the Policyholder must become enrolled as the recipient in a recognized transplant centre in Canada or the United States that performs the required form of transplant surgery.

The diagnosis of the Major Organ Failure must be made by a Specialist.

Waiting Period 


There is no Waiting Period for this condition.

Exclusions

None

Definition 


A definite diagnosis of the irreversible failure of the heart, both lungs, liver, both kidneys or bone marrow, and transplantation must be medically necessary. To qualify under Major Organ Transplant, the Policyholder must undergo a transplantation procedure as the recipient of a heart, lung, liver, kidney or bone marrow and limited to these entities.

The diagnosis of the major organ failure must be made by a Specialist.

Waiting Period 


There is no Waiting Period for this condition.

Exclusions

None

Definition 


A definite diagnosis of one of the following:

• Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease);
• Primary lateral sclerosis;
• Progressive spinal muscular atrophy;
• Progressive bulbar palsy; or
• Pseudo bulbar palsy.

The diagnosis of Motor Neuron Disease must be made by a Specialist.


Waiting Period 


There is no Waiting Period for this condition.

Exclusions

None

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.

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.

Definition 


A definite diagnosis of the total loss of muscle function of two or more limbs as a result of injury or disease tothe nerve supply of those limbs, for a period of at least 90 days following the precipitating event.

The diagnosis of Paralysis must be made by a Specialist.

Waiting Period 


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

Exclusions

None

Definition 


A definite diagnosis of primary Parkinson’s Disease, a permanent neurologic condition which must becharacterized by bradykinesia (slowness of movement) and at least one of muscle rigidity; or rest tremor.

The Policyholder must exhibit objective signs of progressive deterioration in function for at least one year, for which the treating neurologist has recommended dopaminergic medication or other generally medically accepted equivalent treatment for Parkinson’s Disease.

Specified Atypical Parkinsonian Disorders are defined as a definite diagnosis of progressive supranuclear palsy,corticobasal degeneration, or multiple system atrophy.

The diagnosis of Parkinson’s Disease or a Specified Atypical Parkinsonian Disorder must be made by aneurologist.

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 any other types of Parkinsonism.

1-year exclusion:

We will not pay a Critical Illness Benefit under this condition if, within the first year following 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 Parkinson’s Disease, a Specified Atypical Parkinsonian Disorder or any other type of parkinsonism, regardless of when the diagnosis is made; or
• A diagnosis of Parkinson’s Disease, or a Specified Atypical Parkinsonian Disorder or any other type of parkinsonism.

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 Parkinson’s Disease or Specified Atypical Parkinsonian Disorders or any critical illness caused by Parkinson’s Disease or Specified Atypical Parkinsonian Disorders or its treatment.

Definition 


A definite diagnosis of third-degree burns over at least 20 percent of the body surface.

The diagnosis of Severe Burns must be made by a Specialist.

Waiting Period 


There is no Waiting Period for this condition.

Exclusions

None

Definition 


A definite diagnosis of an acute cerebrovascular event caused by intra-cranial thrombosis or hemorrhage, or embolism, with:

• Acute onset of new neurological symptoms; and
• New objective Neurological Deficits on clinical examination,

persisting continuously for more than 30 days following the date of diagnosis. These new symptoms and deficits must be corroborated by diagnostic imaging testing showing changes that are consistent in character, location and timing with the new Neurological Deficits.

The diagnosis of Stroke 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:

• Transient Ischemic Attacks;
• Intracerebral vascular events due to trauma;
• Ischaemic disorders of the vestibular system;
• Death of tissue of the optic nerve or retina without total loss of vision of that eye; or
• Lacunar infarcts which do not meet the definition of stroke as described above

Definition 


A definite diagnosis of aortic aneurysm, where the aorta is enlarged to at least 55 mm in diameter for males or 50 mm for females.

For the purposes of this definition, "aorta" means the thoracic and abdominal aorta, but not its branches.

The diagnosis of aortic aneurysm must be evidenced by appropriate imaging technique and confirmed by a Specialist.

Waiting Period 


30 days after the date of diagnosis.

Exclusions

None

Definition 


Carcinoma in-Situ is defined as any tumour histologically confirmed to be a carcinoma in-situ (superficial cancer which has not invaded the organ of origin) and that is classified as (Tis).


The diagnosis of cancer must be made by a Specialist and must be confirmed by a final pathology report.

Waiting Period 


There is no Waiting Period for this condition.

Exclusions

Please see Section 1.7 for terms that apply to all cancer-related conditions covered under this Policy.

No benefit will be payable under this condition for:

• All tumours which are histologically described as benign, pre-malignant; borderline malignant, low malignant potential; all grades of dysplasia, all grades of squamous intraepithelial lesions (HSIL and LSIL), and all grades of intra-epithelial neoplasia unless considered to be Tis;
• Carcinoma in-situ of the skin;
• Melanoma in-situ;
• Ductal Carcinoma in-Situ of the Breast or Lobular Carcinoma in-Situ of the Breast (covered elsewhere);
• Stage TaN0M0 papillary urothelial carcinoma of the bladder; or
• All cancers only identified from tumour cells, pieces of DNA, or any other biomarkers, any of which may be present in the blood, saliva, urine, or other bodily fluids, including, but not limited to, tests known as “liquid biopsies”.

For the purposes of this exclusion, the terms “Tis and carcinoma in-situ as per AJCC classification” are to be applied as defined in the American Joint Committee on Cancer (AJCC) Staging Manual, 8 th Edition, 2018.

Definition 


The actual undergoing of a mastectomy to totally remove one or both breast(s) due to a diagnosis of carcinoma in-situ of the breast (CIS).

The surgery must be considered medically necessary, be supported by appropriate pathology reports and performed by a Specialist.

Waiting Period 


There is no Waiting Period for this condition.

Exclusions

Please see Section 1.7 for general conditions that apply to all cancer conditions covered under this Policy.

No Early Condition Benefit will be payable under this condition for Carcinoma In-Situ (CIS) of the breast treated by any other means other than total mastectomy.

Definition 


A definite diagnosis of Chronic Lymphocytic Leukemia Rai stage 0.

The diagnosis of Chronic Lymphocytic Leukemia Rai stage 0 must be confirmed by blood tests or other clinically approved diagnostic tests and made by a Specialist.

For the purposes of this definition, the term “Rai stage 0” is to be applied as set out in KR Rai, A Sawitsky, EPConkite, AD Chanana, RN Levy and BS Pasternack: Clinical staging of chronic lymphocytic leukemia. Blood46:219, 1975.

Waiting Period 


There is no Waiting Period for this condition.

Exclusions

Please see Section 1.7 for terms that apply to all cancer-related conditions covered under this Policy.

Definition 


The undergoing of any interventional procedure to widen a narrowed or obstructed coronary artery which supplies blood to the heart.

The procedure must be considered medically necessary and performed by a Specialist.

Waiting Period 


30 days following the date of your surgery.

Exclusions

None

Definition 


A definite diagnosis of Dermatofibrosarcoma which is confined to the skin (which includes the epidermis, dermis and hypodermis/subcutaneous tissue), without lymph node or distant metastasis.

The diagnosis of Dermatofibrosarcoma must be made by a Specialist and must be confirmed by a final pathology report.

Waiting Period 


There is no Waiting Period for this condition.

Exclusions

Please see Section 1.7 for terms that apply to all cancer-related conditions covered under this Policy.

Definition 


A definite diagnosis of Ductal Carcinoma in-Situ of the Breast or Lobular Carcinoma in-Situ of the Breast.

The diagnosis of Early-Stage Breast Cancer: Ductal Carcinoma in-Situ of the Breast or Lobular Carcinoma in-Situ of the Breast must be made by a Specialist and must be confirmed by a final pathology report.

Waiting Period 


There is no Waiting Period for this condition.

Exclusions

Please see Section 1.7 for terms that apply to all cancer-related conditions covered under this Policy.

Definition 


A definite diagnosis of Gastrointestinal Stromal Tumour, classified as AJCC prognostic Stage 1 tumour.

The diagnosis of Early-Stage Gastrointestinal Stromal Tumour must be made by a Specialist and must be confirmed by a final pathology report.

For the purposes of this Policy:

• The term AJCC prognostic Stage 1 is as defined in the American Joint Committee on Cancer (AJCC) Staging Manual, 8 th Edition, 2018.

Waiting Period 


There is no Waiting Period for this condition.

Exclusions

Please see Section 1.7 for terms that apply to all cancer-related conditions covered under this Policy.

Definition 


A definite diagnosis of Malignant Melanoma of the skin that is less than or equal to 1.0 mm in thickness, without ulceration, lymph node or distant metastasis.

The diagnosis of Early-Stage Malignant Melanoma must be made by a Specialist and must be confirmed by a final pathology report.

Waiting Period 


There is no Waiting Period for this condition.

Exclusions

Please see Section 1.7 for terms that apply to all cancer-related conditions covered under this Policy.

Definition 


A definite diagnosis of an Early-Stage Neuroendocrine Tumours classified as AJCC prognostic Stage 1 tumour.

The diagnosis of Early-Stage Neuroendocrine Tumours must be made by a Specialist and must be confirmed by a final pathology report.

For the purposes of this Policy:

• The term AJCC prognostic Stage 1 is as defined in the American Joint Committee on Cancer (AJCC) Staging Manual, 8th Edition, 2018.

‍Waiting Period 


There is no Waiting Period for this condition.

Exclusions

Please see Section 1.7 for terms that apply to all cancer-related conditions covered under this Policy.

Definition 


A definite diagnosis of Papillary Thyroid Cancer or Follicular Thyroid Cancer, or both, that is less than or equal to 2.0 cm in greatest diameter and classified as T1, without lymph node or distant metastasis.

The diagnosis of Early-Stage Papillary Thyroid Cancer or Follicular Thyroid Cancer must be made by a Specialist and must be confirmed by a final pathology report.

Waiting Period 


There is no Waiting Period for this condition.

Exclusions

Please see Section 1.7 for terms that apply to all cancer-related conditions covered under this Policy.

Definition 


A definite diagnosis of Prostate Cancer that is either T1a or T1b tumour of the prostate, without lymph node or distant metastasis.

The diagnosis of stage T1a or T1b Prostate Cancer must be made by a Specialist and must be confirmed by a final pathology report.

For the purposes of this Policy:

• T1a or T1b prostate cancer means a clinically inapparent tumour that was not palpable on digital rectal examination and was incidentally found in resected prostatic tissue; and
• The terms T1a and T1b are as defined in the American Joint Committee on Cancer (AJCC) Staging Manual, 8 th Edition, 2018.

Waiting Period 


There is no Waiting Period for this condition.

Exclusions

Please see Section 1.7 for terms that apply to all cancer-related conditions covered under this Policy.

Definition 


The actual undergoing of a radical prostatectomy to totally remove the entire prostate gland for the diagnosis of Early-Stage Prostate Cancer which is defined as a T1a or T1b tumour of the prostate.

The surgery must be considered medically necessary, be supported by appropriate pathology reports and performed by a Specialist.

Waiting Period 


There is no Waiting Period for this condition.

Exclusions

Please see Section 1.7 for general conditions that apply to all cancer conditions covered under this Policy.

No Early Condition Benefit will be payable under this condition for Early-Stage Prostate Cancer (T1a or T1b) treated by any other means other than radical prostatectomy.

Definition 


The actual undergoing of a percutaneous trans-vascular, catheter-based procedure to repair or correct an aneurysm, narrowing, obstruction or dissection of the aorta. For the purposes of this definition, "aorta" means the thoracic and abdominal aorta, but not its branches.

The surgical procedure must be considered medically necessary, evidenced by appropriate investigations and performed by a Specialist.

Waiting Period 


30 days following the date of your surgery.

Exclusions

None

Definition 


The actual undergoing of the Implantation of a Permanent Cardiac Pacemaker for the treatment of electrical conduction system disease of the heart.

The procedure must be supported by appropriate investigations and be both deemed medically necessary and performed by a Specialist.

Waiting Period 


30 days following the date of your surgery.

Exclusions

No Early Condition Benefit will be payable under this condition for:

• Implantation of a non-permanent cardiac pacemaker; or
• The use of a temporary cardiac pacemaker.

Definition 


The actual undergoing of the Implantation of a Permanent Implantable Cardioverter-Defibrillator (ICD).

This definition covers for two types of permanent implantable cardioverter-defibrillator (ICD) systems: the conventional transvenous implantable cardioverter-defibrillator (TV-ICD) and the subcutaneous implantable cardioverter-defibrillator (S-ICD).

The procedure must be supported by appropriate investigations and be both deemed medically necessary and performed by a Specialist.

In addition, based on the opinion of an expert electrophysiologist, there must have been the deployment of a permanent implantable cardioverter-defibrillator for one of the following reasons:

• Documented arrhythmias; or
• Presumed arrhythmogenic syncope; or
• As a primary prevention strategy where there is an expert view that the claimant is at a high risk of a lethal arrhythmia.

30 days following the date of your surgery.

Exclusions

No Early Condition Benefit will be payable under this condition for:

• Implantation of a non-permanent implantable cardioverter-defibrillator (ICD);
• Use of a wearable (temporary) cardioverter-defibrillator.

No Early Condition Benefit will be payable under this condition if the Policyholder has received a payout for the Implantation of a Permanent Cardiac Pacemaker.

Definition 


A definite diagnosis of primary cutaneous T-cell, NK-cell, or B-cell lymphoma which are confined to the skin (which includes the epidermis, dermis and hypodermis/subcutaneous tissue), without lymph node or distant metastasis.

The diagnosis of cutaneous lymphoma without distant metastasis must be made by a Specialist and must be confirmed by a final pathology report.

Waiting Period 


There is no waiting period for this condition.

Exclusions

Please see Section 1.7 for terms that apply to all cancer-related conditions covered under this Policy.