FAQ - Critical Illness

What is the meaning of the Major Critical Illness Covered under the Policy?

Definition for the Major Critical Illness:-

FIRST HEART ATTACK: A Heart attack also known as myocardial infarction happens when part of the heart muscle dies as a result of inadequate blood supply or oxygen.

OPEN CHEST CABG: Open chest surgery is an operation in which the heart is opened by a surgical incision for a corrective procedure to be carried out. CABG is a type of surgery that improves blood flow to the heart.

STROKE RESULTING IN PERMANENT SYMPTOMS: Evidence of permanent neurological deficit lasting for at least 3 months has to be produced. Stroke is a medical condition when the blood flow to the brain is either interrupted or reduced. When this occurs, the brain does not get enough oxygen or nutrients which cause brain cells to die.

CANCER OF SPECIFIED SEVERITY: Cancer is also known as a malignant tumor is a disease where normal cells change and grow in an abnormal way.  If not treated on time they will destruct the normal tissues. The term cancer includes leukemia (Cancer of the bone marrow, blood), lymphoma (Cancer that affects the immune system) and sarcoma.

MAJOR ORGAN / BONE MARROW TRANSPLANT: It is a surgical procedure of undergoing a transplant of Human organs like – Heart, lung, liver, pancreas, kidney, etc. which resulted from the irreversible end-stage failure.

MULTIPLE SCLEROSIS WITH PERSISTING SYMPTOMS: Multiple Sclerosis is a nervous system disease that affects your brain and spinal cord. It damages the myelin sheath which protects your nerve cells. Neurological damage such as SLE (Systemic Lupus Erythematosis) and HIV are excluded.

PERMANENT PARALYSIS OF LIMBS: The total and irreversible loss of 2 or more limbs due to an injury or diseases of the brains or spinal cord.

ALZHEIMER’S DISEASE: It is a neurological disorder in which the death of the brain cells may cause memory loss, confusion, communication problem and cognitive decline. These conditions must be medically documented for at least 90days. The following needs to be Diagnosis before age 60 years as confirmed by a medical practitioner.

BLINDNESS: Blindness means a significant loss of both eyes which is Total, Permanent and Irreversible loss of sight for a continuous period of 6months as a result of sickness or accidents.

TOTAL LOSS SPEECH: Total loss of the ability to speak for a continuous period of 6months due to a tumor or serious injury which has led to the removal of vocal cords.

PROGRESSIVE SCLERODERMA: Scleroderma is a group of rare diseases that involves the hardening and tightening of the skin and connective tissues. This disease affects women more often than men between the age group of 30 to 50yrs.

AORTA GRAFT SURGERY: The Aorta is the body’s main artery carrying blood from the heart. An Aorta Graft surgery means, where a part of the aorta is removed and replaced with a graft/ valve. This procedure is required to correct a weakening or bulging in the artery.

APALLIC SYNDROME: It is a condition where the patient has severe brain damage leading to coma but has progressed to a stage of partial arousal, rather than true awareness. In such conditions, the patient will respond to stimulation in varying degrees, as compared to a person who is in a complete coma.

APLASTIC ANAEMIA: A condition where the body stops producing enough new blood cells is called as Aplastic Anemia. It leaves you with symptoms like fatigued, higher risk of infections and uncontrolled bleeding.

BACTERIAL MENINGITIS: Bacterial Meningitis is the most common form of meningitis i.e. infection of the membranes surrounding the brain and spinal cord. Such infection can cause the tissues around the brain to swell.

BENIGN TUMOUR IN BRAIN [RESULTING IN PERMANENT NEUROLOGICAL SYMPTOMS]: A benign Tumor is a non-cancerous abnormal growth of tissue that can increase in size and cause pressure in the brain. Some symptoms are headaches, seizures and blurred vision.

BRAIN SURGERY: Brain surgery is an operation to treat problems in the brain and surrounding structures. The actual undergoing of surgery to the brain under general anesthesia during which a craniotomy is performed A craniotomy is a surgical removal of part of the bone from the skull to expose the brain. Specialized tools are used to remove the section of bone called the bone flap. The bone flap is temporarily removed, then replaced after the brain surgery has been performed.

CARDIOMYOPATHY: Cardiomyopathy is a condition where the heart muscle is abnormal. It is a group of disorders affecting the muscles of the heart which function. Symptoms are shortness of breath, fainting and palpitations.

COMA OF SPECIFIED SEVERITY: A coma is a state of unconsciousness from which the patient cannot be aroused and has no control over bodily functions. It may be caused due to illness, stroke, infection, very low blood sugar or serious accident.

CREUTZFELDT-JAKOB DISEASE (CJD): It is a disease of the nervous system. It may be present without symptoms for many years. Once they appear, symptoms may include failing memory, problems with vision, immobility, loss of speech and coma in advanced stages.

DEAFNESS: This means permanent loss of hearing in both the ears.

ENCEPHALITIS: It is an inflammation of brain tissues which is caused due to infection. Symptoms might include a severe headache, nausea, vomiting, convulsions, and personality changes, problems with speech/hearing, confusions and disorientation.

END STAGE LIVER DISEASES OF SPECIFIED SEVERITY: It means liver failure at an advanced stage. A severely advanced liver diseases resulting in cirrhosis i.e. late stage of fibrosis (scarring) of the liver caused by many forms of liver diseases and conditions.

END STAGE LUNG DISEASES: It means advanced lung failure when breathing is severely affected and regular oxygen therapy is required.

GOODPASTURE`S SYNDROME: It is an autoimmune disease in which antibodies attack the lungs and kidneys, leading to permanent lung and kidney damage. It also leads to bleeding from the lung and kidney.

KIDNEY FAILURE REQUIRING REGULAR DIALYSIS: End stage renal diseases presenting as a chronic irreversible failure of both kidneys to function. In such situations, a regular dialysis may be required to do the filtering or a transplant.

MAJOR BURNS: These are third-degree burns which cover at least 20% of the surface of the insured’s body.

MAJOR HEAD TRAUMA: A physical head injury causing significant permanent functional impairment lasting for a minimum period of 3months from the date of trauma or injury.

MOTOR NEURON DISEASE WITH PERMANENT SYMPTOMS: It is a gradual weakening and wasting of the muscles, usually starting with the arms and legs. It may cause difficulty in walking or holding objects.

MULTIPLE SYSTEM ATROPHY: It is a progressive disease of the nervous system. It may lead to permanent clinical impairment. Symptoms include – Muscle weakness, swallowing difficulties and increasingly severe impairment of physical function.

OPEN HEART REPLACEMENT OR REPAIR OF HEART VALVE: Surgery related to Open Heart Valve to replace or repair one or more heart valves, due to defects in abnormalities or diseased affected heart valves.

PNEUMONECTOMY: It is a surgical procedure to remove a lung infected to disease or traumatic injury.

PRIMARY PARKINSON’S DISEASE: Parkinson disease is a condition in which part of the brain (central nervous system) becomes progressively damaged for many years. The main symptoms are – involuntary shaking of particular parts of the body, slow movement, stiff and inflexible muscles.

PRIMARY PULMONARY ARTERIAL HYPERTENSION: It is abnormally occurring of high blood pressure in the arteries of the lungs.

PROGRESSIVE SUPRANUCLEAR PALSY: It is a brain disease that develops slowly, which progresses to seriously affect vision and movement.

PULMONARY ARTERY GRAFT SURGERY: The undergoing of surgery requiring median sternotomy (surgery to divide the breastbone) on the advice of a Consultant Cardiologist for a disease of the pulmonary artery to excise and replace the diseased pulmonary artery with a graft.

SYSTEMIC LUPUS ERYTHEMATOSUS: Systemic lupus erythematosus (SLE), sometimes called ‘lupus’, involves chronic inflammation of body tissues caused by autoimmune disease. Autoimmune diseases are illnesses that occur when the body’s tissues are attacked by its own immune system, i.e. the body creates antibodies, which work against it.

TOTAL LOSS OF SPEECH: The total loss of the ability to speak. It’s often caused when the vocal cords need to be removed because of a tumor or a serious injury.

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