AIA Living Business Progressive Care Policy Wording

Severity Level

Conditions

 Malignant brain tumour classified as Grade IV based on World Health Organisation (WHO) grading system

1

 Malignant brain tumour classified as Grade III based on World Health Organisation (WHO) grading system

2

 Malignant brain tumour classified as Grade II based on World Health Organisation (WHO) grading system

 Benign brain or spinal cord tumour – a non-malignant tumour or cyst in the brain or spinal cord, resulting in:

– permanent neurological deficit with persisting clinical symptoms; or

– treatment using major interventional treatment necessary for the therapeutic management of the tumour as deemed appropriate and medically necessary ; or

3

– removal through surgery (whether it is able to be removed or not) as deemed appropriate and medically necessary .

Does not include:

– angiomas, haematomas, granulomas and cerebral abscesses; and

– tumours in the pituitary gland, unless in the opinion of an appropriate specialist an open craniotomy to remove it is medically necessary .

 Malignant brain tumour classified as Grade I based on World Health Organisation (WHO) grading system

4

 Benign brain or spinal cord tumour – a non-malignant tumour or cyst in the brain or spinal cord. Does not include tumours in the pituitary gland, angiomas, haematomas, granulomas and cerebral abscesses.

5

Other cancers

Severity Level

Conditions

 Myeloma classified as stage 3 on the Durie Salmon scale or ISS, requiring chemotherapy or radiotherapy or immunotherapy

1

 Myeloablative bone marrow transplant specifically to treat cancer

 Aplastic anaemia means the life assured has suffered the first occurrence of bone marrow failure which results in anaemia, neutropenia and thrombocytopenia, requiring treatment over a period of at least two months with at least one of the following:

– Blood product transfusion

– Marrow stimulating agents

– Immunosuppressive agents

– Bone marrow transplantation

– Haemopoietic stem cell transplantation

2

 Confirmed diagnosis of myelodysplastic syndrome with a high (>4.5-6) International Prognostic Scoring System requiring continuing and ongoing supportive care with regular transfusion of blood products, chemotherapy, or other equivalent treatments  Reduced intensity conditional bone marrow or autologous bone marrow or stem cell transplant specifically to treat cancer

 Transplant waiting list for the transplant of bone marrow specifically to treat cancer

Myelofibrosis

1156 ALB-PC version 7 Effective 12 May 2026

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