17. Definitions of medical conditions
Heart attack Heart attack resulting in permanent and irreversible left ventricular ejection fraction of less than 40% (two measurements at least six months apart) whilst on ongoing optimal therapy for a minimum of six months, and significant and irreversible physical impairment to the degree of at least Class III (3) of the New York Heart Association Functional Classification System of cardiac impairment. Heart attack means the death of a portion of the heart muscle (myocardium) as a result of inadequate blood supply to the relevant area, confirmed by a cardiologist or general physician and evidenced by: Typical rise and/or fall of cardiac biomarkers with at least one value above the 99 th percentile of the upper reference limit;
Cancer
The life assured has suffered or undergone one of the following conditions :
Cancer
Any metastatic cancer classified as, Stage III (3) based on TNM classification, where all treatment modalities have failed and been exhausted and where no other therapies are available and where progression of the cancer can be identified, or Stage IV (4) based on TNM classification; or Advanced lymphoma classified as, Ann-Arbor Stage III (3) where all treatment modalities have failed and been exhausted and where no other therapies are available and where progression of the cancer with resultant ongoing and continuous symptomatology can be identified, or Ann-Arbor Stage IV (4) classification; or Leukaemia where all treatment modalities have failed and been exhausted and where no other therapies are available, where progression of the cancer can be identified, and where there is resultant ongoing and continuous symptomatology; or Malignant brain tumour classified as Grade III (3) based on the WHO grading system for malignant neuroepithelial tumours of the central nervous system, where all treatment modalities have failed and been exhausted and where no other therapies are available and where progression of the cancer can be identified, or Grade IV (4) based on the WHO grading system for malignant neuroepithelial tumours of the central nervous system; or Multiple myeloma where all treatment modalities have failed and been exhausted and where no other therapies are available, where progression of the cancer can be identified, and where there is resultant ongoing and continuous symptomatology.
and at least one of the following:
Signs and symptoms of ischaemia which are consistent with myocardial infarction; or Confirmatory new (or presumed new) ECG changes associated with myocardial infarction with the development of any one of the following:
ST changes;
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T wave inversion;
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Left bundle branch block (LBBB);
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Pathological Q waves; or
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Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality. A rise in cardiac biomarkers resulting from a percutaneous procedure for coronary artery disease is excluded unless the baseline value is normal and the elevation is greater than five times the 99 th percentile of the upper reference limit. If the above evidence is inconclusive or superseded by technological advances, we will consider other appropriate and medically recognised tests that unequivocally diagnose that a myocardial infarction of the degree of severity or greater as outlined above has occurred. Other acute coronary syndromes including but not limited to angina pectoris are excluded. Primary pulmonary hypertension Primary pulmonary hypertension means the presence of irreversible raised pressure in the pulmonary arteries. The measurement reported must be the average level measured by cardiac catheterisation and be at least 30mmHG (mm of mercury) at rest. There must also be right ventricular dilatation and hypertrophy on echocardiogram with characteristic ECG changes.
Heart
The life assured has suffered or undergone one of the following conditions :
Cardiomyopathy Cardiomyopathy means impaired ventricular function of variable aetiology, resulting in permanent and irreversible left ventricular ejection fraction of less than 40% (two measurements at least six months apart) whilst on ongoing optimal therapy for a minimum of six months, and significant and irreversible physical impairment to the degree of at least Class III (3) of the New York Heart Association Functional Classification System of cardiac impairment.
1166 ALB-ST version 2 Effective 12 May 2026
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