AIA Living Business Progressive Care Policy Wording

Severity Level

Conditions

that is documented by an electrocardiogram and occurs out of hospital, and is due to:

– cardiac asystole; or

– ventricular fibrillation with or without ventricular tachycardia.

25. Schedule of Categories – brain and nerves category

Key term

Stroke means the diagnosis of a stroke that meets all of the following:  cerebrovascular incident producing neurological deficits lasting more than 24 hours; and

 evidenced by acute onset of new objective neurological signs and symptoms; and

 evidenced by neuro-imaging changes consistent with the signs and symptoms; and

confirmed by a registered medical specialist .

Includes where there is infarction of brain tissue, intracranial or subarachnoid haemorrhage or embolization from extracranial source. Transient ischaemic attacks, migraine, vascular disease affecting the eye, optic nerve or vestibular functions, and incidental imaging findings (CT or MRI brain scan without clearly related clinical symptoms (silent stroke)), or as a result of hypoxia and trauma are excluded. Permanent neurological deficit with persisting clinical symptoms means symptoms of dysfunction in the nervous system that are present on clinical examination and expected to last throughout the life assured ’s life.

Symptoms that are covered include:

numbness

difficulty in walking

hyperaesthesia (increased sensitivity)

lack of coordination

paralysis

tremor

localised weakness

seizures

dysarthria (difficulty with speech)

lethargy

aphasia (inability to speak)

dementia

dysphagia (difficulty in swallowing)

delirium

visual impairment

coma.

However, the following symptoms are not covered:

 An abnormality seen on brain or other scans without definite related clinical symptoms

 Neurological signs occurring without symptomatic abnormality e.g. brisk reflexes without other symptoms

Symptoms of psychological or psychiatric origin.

Severity Level

Conditions

Stroke resulting in the life assured :

– at least six months after the stroke is suffering at least 25% permanent whole person impairment as defined in the American Medical Association ‘Guides to the Evaluation of Permanent Impairment’, 5th edition, or an equivalent guide to impairment approved by AIA ; or

1

– at least three months after the stroke has been an ‘admitted patient’ for a continuous period of at least three months and undergoing optimal therapy for the entire three months; and

1156 ALB-PC version 7 Effective 12 May 2026

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