Major neurological disease
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;
The life assured has suffered or undergone one of the following conditions :
Alzheimer’s disease The unequivocal diagnosis of Alzheimer's disease, resulting in significant cognitive impairment or permanent irreversible inability to perform two activities of daily living . The diagnosis is confirmed by an appropriate specialist in psychogeriatrics, psychiatry, neurology or geriatrics. Coma Means a state of unconsciousness with no reaction to external stimuli or internal needs which, at the recommendation of an appropriate specialist , results in continuous mechanical ventilation by means of tracheal intubation for at least seven days or the admission to the intensive care ward of a hospital for at least fifteen consecutive days.
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:
Coma caused by alcohol or drug abuse is specifically excluded.
ST changes;
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Creutzfeldt-Jakob disease The diagnosis of Creutzfeldt-Jakob disease confirmed by an appropriate specialist neurologist. The life assured must exhibit signs and symptoms of cerebellar dysfunction, severe progressive dementia, uncontrolled muscle spasm, tremor and athetosis, resulting in the life assured requiring permanent and continual medical supervision. Dementia The unequivocal diagnosis of dementia, resulting in significant cognitive impairment or permanent irreversible inability to perform two activities of daily living . The diagnosis is confirmed by an appropriate specialist in psychogeriatrics, psychiatry, neurology or geriatrics. Encephalitis The unequivocal diagnosis of severe inflammatory disease of the brain diagnosed by an appropriate specialist approved by AIA . The life assured must have also sustained a neurological deficit resulting in total and irreversible inability to perform one of the activities of daily living . Idiopathic Parkinson’s disease The unequivocal diagnosis of Idiopathic Parkinson’s disease as confirmed by an appropriate specialist and resulting in total and irreversible inability of the life assured to perform one of the activities of daily living.
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.
1119 AL- ST version 1 Effective 14 November 2025
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