Kidney failure – requiring dialysis

Chronic and end stage failure of both kidneys to function, as a result of which regular dialysis is necessary.

Loss of speech – permanent and irreversible

Total permanent and irreversible loss of the ability to speak as a result of physical injury or disease.

Loss of hands or feet – permanent physical severance

Permanent physical severance of any combination of 2 or more hands or feet at or above the wrist or ankle joints.

Major organ transplant

The undergoing as a recipient of a transplant of bone marrow or of a complete heart, kidney,liver, lung, or pancreas, or inclusion on an
official UK waiting list for such a procedure.

For the above definition, the following is not covered:

• Transplant of any other organs, parts of organs, tissues or cells.

Motor neurone disease [before age x] – resulting in permanent symptoms

A definite diagnosis of motor neurone disease (before age x) by a Consultant Neurologist. There must be permanent clinical impairment
of motor function.

Multiple sclerosis – with persisting symptoms

A definite diagnosis of Multiple Sclerosis by a Consultant Neurologist. There must be current clinical impairment of motor or sensory
function, which must have persisted for a continuous period of at least 6 months.

Paralysis of limbs – total and irreversible

Total and irreversible loss of muscle function to the whole of any 2 limbs.

Parkinson’s disease [before age x] – resulting in permanent symptoms

A definite diagnosis of Parkinson’s disease (before age x) by a Consultant Neurologist. There must be permanent clinical impairment
of motor function with associated tremor,rigidity of movement and postural instability.

For the above definition, the following is not covered:

• Parkinson’s disease secondary to drug abuse.

Stroke – resulting in permanent symptoms

Death of brain tissue due to inadequate blood supply or haemorrhage within the skull resulting in permanent neurological deficit with
persisting clinical symptoms.

For the above definition, the following are not covered:
• Transient ischaemic attack.
• Traumatic injury to brain tissue or blood vessels.

Terminal illness

Advanced or rapidly progressing incurable illness where, in the opinions of an attending Consultant and our Chief Medical Officer, the
life expectancy is no greater than 12 months.

Third degree burns – covering 20% of the body’s surface area

Burns that involve damage or destruction of the skin to its full depth through to the underlying tissue and covering at least 20% of
the body’s surface area.

Traumatic head injury – resulting in permanent symptoms

Death of brain tissue due to traumatic injury resulting in permanent neurological deficit with persistent clinical symptoms.

Coma – resulting in permanent symptoms

A state of unconsciousness with no reaction to external stimuli or internal needs which:

• requires the use of life support systems for a continuous period of at least 96 hours;

and

• results in permanent neurological deficit with persisting clinical symptoms.

For the above definition, the following is not covered:

• Coma secondary to alcohol or drug abuse.

Coronary artery by-pass grafts – with surgery to divide the breastbone

The undergoing of surgery requiring median sternotomy (surgery to divide the breastbone) on the advice of a Consultant Cardiologist to correct narrowing or blockage of one or more coronary arteries with by-pass grafts.

Deafness – permanent and irreversible

Permanent and irreversible loss of hearing to the extent that the loss is greater than 95 decibels across all frequencies in the better ear using a pure tone audiogram.

Heart attack – of specified severity

Death of heart muscle, due to inadequate blood supply, that has resulted in all of the following evidence of acute myocardial infarction:

• Typical clinical symptoms (for example, characteristic chest pain).
• New characteristic electrocardiographic changes.
• The characteristic rise of cardiac enzymes or Troponins recorded at the following levels or higher;
- Troponin T > 1.0 ng/ml
- AccuTnI > 0.5 ng/ml or equivalent threshold with other Troponin I methods.

The evidence must show a definite acute myocardial infarction.

For the above definition, the following are not covered:

• Other acute coronary syndromes including but not limited to angina.

Heart valve replacement or repair – with surgery to divide the breastbone

The undergoing of surgery requiring median sternotomy (surgery to divide the breastbone) on the advice of a Consultant Cardiologist to replace or repair one or more heart valves.

HIV infection – caught (in the UK) from a blood transfusion, a physical assault or at work in an eligible occupation

Infection by Human Immunodeficiency Virus resulting from:

• a blood transfusion given as part of medical treatment;
• a physical assault; or
• an incident occurring during the course of performing normal duties of employment (from the eligible occupations listed below);1

after the start of the policy and satisfying all of the following:

• The incident must have been reported to appropriate authorities and have been investigated in accordance  with the established procedures.

after the start of the policy and satisfying all of the following:

• The incident must have been reported to appropriate authorities and have been investigated in accordance  with the established procedures.
• Where HIV infection is caught through a physical assault or as a result of an incident occurring during the course of performing normal duties of employment, the incident must be supported by a negative HIV antibody test taken within 5 days of the incident.
• There must be a further HIV test within 12 months confirming the presence of HIV or antibodies to the virus.
• [The incident causing infection must have occurred in the UK] 2.

For the above definition, the following is not covered:
• HIV infection resulting from any other means, including sexual activity or drug abuse.
1Note: include specified occupations if applicable
2Note: include geographic limits as applicable

These definitions are openly available from the ABI or life assurance companies direct but just in case we thought that we would break them down for you into a few bite size chunks.

Alzheimer’s disease [before age x] – resulting in permanent symptoms

A definite diagnosis of Alzheimer’s disease[before age x] by a Consultant Neurologist,Psychiatrist or Geriatrician. There must be
permanent clinical loss of the ability to do all of the following:

• remember;
• reason; and
• perceive, understand, express and giveeffect to ideas.

For the above definition, the following are not covered:

• Other types of dementia.

Aorta graft surgery – for disease

The undergoing of surgery for disease to the aorta with excision and surgical replacement of a portion of the diseased aorta with a graft.  The term aorta includes the thoracic and abdominal aorta but not its branches.

For the above definition, the following are not covered:

• Any other surgical procedure, for example the insertion of stents or endovascular repair.
• Surgery following traumatic injury to the aorta.

Benign brain tumour – resulting in permanent symptoms

A non-malignant tumour or cyst in the brain, cranial nerves or meninges within the skull,resulting in permanent neurological deficit with persisting clinical symptoms.

For the above definition, the following are not covered:

• Tumours in the pituitary gland.
• Angiomas.

Blindness – permanent and irreversible

Permanent and irreversible loss of sight to the extent that even when tested with the use of visual aids, vision is measured at 3/60 or worse in the better eye using a Snellen eye chart

Cancer – excluding less advanced cases

Any malignant tumour positively diagnosed with histological confirmation and characterised by the uncontrolled growth of
malignant cells and invasion of tissue. The term malignant tumour includes leukaemia, lymphoma and sarcoma.
For the above definition, the following are not covered:

• All cancers which are histologically classified as any of the following:
– pre-malignant;
– non-invasive;
– cancer in situ;
– having either borderline malignancy;
or
– having low malignant potential.

• All tumours of the prostate unless histologically classified as having a Gleason score greater than 6 or having
progressed to at least clinical TNM classification T2N0M0.

• Chronic lymphocytic leukaemia unless histologically classified as having progressed to at least Binet Stage A.

• Any skin cancer other than malignant melanoma that has been histologically classified as having caused invasion
beyond the epidermis (outer layer of skin).