DEFINITIONS OF COVERED EVENTS 12-19

DEFINITIONS OF COVERED EVENTS 12-19

(12)“Heart Valve Surgery”:
The actual undergoing of open-heart surgery to replace or repair cardiac valves as a consequence of heart valve defects or abnormalities.
Repair via intra-arterial procedure, key-hole surgery or similar techniques are excluded.

(13)“Deafness / Total Loss Of Hearing ”:
Total and irreversible loss of hearing in both ears as a result of illness or accident. Total means “the loss of at least eighty (80) decibels in all frequencies of hearing”.
Medical evidence in the form of an audiometry and sound-threshold tests must be provided and certified by an Ear, Nose, and Throat (ENT) specialist.

(14)“Surgery To Aorta”:
The actual undergoing of surgery via a thoracotomy or laparotomy to repair or correct an aortic aneurysm, an obstruction of the aorta or a dissection of the aorta. For the purpose of this definition, aorta shall mean the thoracic and abdominal aorta but not its branches.
Angioplasty, other intra-arterial or catheter based techniques or keyhole or laser procedures are excluded.

(15)“Loss Of Speech”:
Total and irrecoverable loss of the ability to speak for a continuous period of twelve (12) months. Medical evidence to confirm injury or illness to the vocal cords to support this disability must be supplied by an Ear, Nose and Throat specialist.
All psychiatric related causes are excluded.

(16)“Alzheimer’s Disease / Irreversible Organic Degenerative Brain Disorders”:
Deterioration or loss of intellectual capacity or abnormal behavior as evidenced by the clinical state and accepted standardized questionnaires or tests arising from Alzheimer’s Disease or irreversible organic degenerative brain disorders resulting in significant reduction in mental and social functioning (such that continuous supervision is required). The diagnosis must be clinically confirmed by a Consultant Neurologist.
The following are excluded:
(a) Non organic brain disorders such as neurosis
(b) Psychiatric illnesses
(c) Drug or alcohol related brain damage

(17)“Major Burns”:
Third degree (i.e. full thickness) skin burns covering at least twenty percent (20%) of the total body surface area.

(18)“Coma”:
A state of unconsciousness with no reaction or response to external stimuli or internal needs, persisting continuously for at least ninety-six (96) hours, requiring the use of life support systems and resulting in a permanent neurological deficit, lasting more than thirty (30) days. Confirmation by a Consultant Neurologist must be present.
Coma resulting directly from self-inflicted injury, alcohol or drug abuse is excluded.

(19)“Severe Cardiomyopathy”:
An impaired function of the heart muscle, unequivocally diagnosed as Cardiomyopathy by a cardiologist, and resulting in permanent physical impairment of at least Class III of the New York Heart Association's classification of cardiac impairment. The diagnosis has to be supported by echocardiographic findings of compromised ventricular performance.The NYHA Classification of Cardiac Impairment for Class III and Class IV means the following:-
Class III: Marked limitation of physical activity. Comfortable at rest but less than ordinary activity causes symptoms.
Class IV: Unable to engage in any physical activity without discomfort. Symptoms may be present even at rest.
Cardiomyopathy directly related to alcohol or drug abuse is excluded

About the author :Kertar Singh has joint Great Eastern Life Assurance in August 1995 as a part time agent.

Became a full time agent in 2000 after retiring from the army after 22 years.

He deal with all kind of Insurance from Life Insurances to General Insurances and Will Writing.

Kertar.en@gmail.com

H.P 013-322 8582

Notes: Reference have been made from MII and Gela