30. Schedule of Categories – other health conditions category
Severity Level
Conditions
Chronic liver failure means the life assured suffers end-stage liver failure as evidenced by:
– Permanent jaundice; or
– Ascites; or
– Encephalopathy.
Chronic lung failure means the life assured has irreversible chronic lung disease as confirmed by a registered medical specialist on the basis of respiratory function tests and which satisfies any of the following criteria:
– Type 1 respiratory failure defined as O2 <60mm hg;
– Type 2 respiratory failure defined as CO2 >45mm hg;
– the provision of home oxygen therapy according to clinical practice guidelines for hypoxia O2 <55mm hg (or 60mm hg in the presence of pulmonary hypertension);
– FEV1 <35% predicted;
– DLCO (diffusing capacity or gas transfer) <40% predicted; or
– is unable to perform at least one of the activities of daily living as a result of the respiratory failure.
Chronic kidney failure means the kidneys of the life assured have reached the end-stage of renal disease resulting in chronic irreversible failure of the kidneys to function, as a result of which regular renal dialysis is instituted or transplantation performed. 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.
1
Advanced Type 1 diabetes means the life assured has suffered at least two of the following complications as a direct result of Type 1 diabetes as confirmed by an appropriate specialist :
– Nephropathy requiring regular dialysis or a kidney transplant.
– Proliferative retinopathy.
– Peripheral vascular disease leading to chronic infection or gangrene, requiring a surgical procedure.
– Neuropathy including:
• irreversible autonomic neuropathy resulting in postural hypotension, and/or motility problems in the gut with intractable diarrhoea or,
• polyneuropathy leading to severe mobility problems due to sensory and/or motor deficits.
Advanced AIDS means HIV infection with a persistent CD4 cell count of less than 200/ul despite appropriate continuous antiretroviral therapy. There must be an associated AIDS defining illness with AIDS resulting in at least one of the following:
– Kaposi's Sarcoma or Lymphoma.
– Pneumocystis Carinii infection, cryptococcal infection or any other opportunistic infection of the lungs or nervous system
– Tuberculosis or other mycobacterium infection at any site.
– Progressive multifocal leukoencephalopathy.
– HIV Encephalopathy.
– HIV wasting syndrome characterised by more than 10% weight loss, chronic intractable diarrhoea and chronic candidiasis of the respiratory tract or gastrointestinal tract.
Page 28 of 33
1106 AL-PC version 7 Effective 12 May 2026
Powered by FlippingBook