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| Cancer |
A disease manifested by the presence of a malignant tumor characterized by the uncontrolled growth and spread of malignant cells, and the invasion of tissue. The term cancer also includes leukemia and malignant disease of the lymphatic system such as Hodgkin’s Disease.
But excluding:
 | All tumors that are histological described as pre-malignant, non-invasive or carcinoma in situ, prostate tumors classified upto T1 (under the TNM classification). |
| Tumors treated by endoscopic procedures alone |
| Kaposi’s Sarcoma or any other malignant tumor in the presence of any Human Immuno-deficiency virus. |
| Any skin cancer other than invasive malignant melanoma (starting with Clark Level III) |
| T1N0M0 (under the TNM classification System) papillary carcinoma of the thyroid less than 1 cm in diameter |
| Tumors that pose no threat to life and for which no treatment is required |
| Tumors that are a recurrence of metastasis of a tumor that first occurred prior to 180 days following the policy start date |
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| Kidney Failure (End Stage Renal Failure) |
| End stage renal disease presented as chronic irreversible failure of both kidneys to function, as a result of which either regular renal dialysis (hemodialysis or peritoneal dialysis) is instituted or renal transplantation is carried out |
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| Multiple Sclerosis |
Unequivocal diagnosis of multiple sclerosis by a consultant neurologist holding such an appointment at a Government Hospital. The Insured must exhibit neurological abnormalities that have existed for a continuous period of atleast 6 months or must have had atleast two clinically documented episodes.
The above must be evidenced by the typical symptoms of demyelination and impairment of motor and sensory functions as well as by typical MRI findings |
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| Major Organ Transplant |
The receipt of a transplant of
| Human bone marrow using haematopoietic stem cells preceded by a total bone marrow ablation, or |
| One of the following whole human organs: heart, lung, liver, pancreas or kidney, as a result of irreversible end stage failure of the respective organ |
| A specialist Doctor confirms the requirement of same |
| Other stem cell transplants and transplants of part of an organ are excluded |
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| Heart Valve Replacement |
| The undergoing of medically necessary open heart surgery to replace a heart valve as a consequence of a heart valve defect. Surgeries using Balloon or catheter techniques are excluded |
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| Coronary Artery Bypass Graft |
| The actual undergoing for the first time of an open chest coronary artery bypass surgery to correct narrowing or blockage of one or more coronary arteries with bypass grafts provided it is recommended by cardiologist and supported with coronary angiographic evidence but excluding balloon angioplasty and/or any other intra-arterial procedures or laser relief. |
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| Stroke |
The first occurrence of any cerebrovascular incident producing neurological sequel lasting more than 24 hours and including infarction of brain tissue, haemorrhage and embolisation from an extra cranial source.
The following must evidence the diagnosis for the same:
| Finding on Magnetic Resonance Imaging, Computerised Tomography or any other reliable imaging techniques, demonstrate a lesion consistent with the acute haemorrhage, embolism or thrombosis. |
| Neurological deficit for atleast 3 months Transient Ischaemic Attacks and/or Brain damage due to an accident, infection, vasculitis or an inflammatory disease are excluded. |
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| Paralysis |
Complete and permanent loss of function of two or more limbs as a result of Injury or Illness of the brain or spinal cord. Permanent loss of function of two or more limbs shall be deemed to have occurred if:
| The condition has persisted for at least 6 months from the date it was first suffered in spite of the Insured properly implementing all medical advice related to its cure, and |
| A Doctor of central or a state government hospital confirms complete, irreversible and permanent loss |
Paralysis resulting directly or indirectly or as a consequence of any self- inflicted injury is excluded.
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| Myocardial Infarction (Heart Attack) |
The first occurrence of an acute myocardial infarction leading to the death of a portion of heart muscle (Myocardium) as a result of inadequate blood supply to the relevant area.
The diagnosis for the same must be evidenced by all of the following:
| An episode of typical chest pain. |
| The occurrence of a typical new acute infarction changes (ST-T elevation) on the electrocardiograph and progressing to development of pathological Q waves |
| Elevation of Cardiac Troponin (T or I) to atleast 3 times the upper limit of normal reference range or an elevation in CPK-MB to atleast 200% of the upper limit of the normal reference range |
But excluding non-STEMI with elevation of troponin I or T. Other acute coronary syndromes including but not limited to angina or chest pain are excluded from this definition. |
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Critical Care Glossary
