Severity Level
Conditions
deviations below the young adult mean for bone density). This must be measured in at least two sites by dual energy x-ray absorptiometry (DEXA). – An exclusion applies in cases where there are spontaneous fractures or minimal traumas that are due to an accident but where coincidental osteoporosis exists. Severe rheumatoid arthritis means that the life assured before age 50 has been unequivocally diagnosed by an appropriate specialist as suffering from clinically severe rheumatoid arthritis persisting for at least six weeks.
The diagnosis must be supported by:
a. evidence that at least three or more of the following joints are affected:
– Metacarpophalangeal joints in the hands;
– Proximal interphalangeal joints in the hands; and
– Metatarsophalangeal joints in the wrist, elbow, foot, knee, or ankle; and
b. positive rheumatoid serology or other appropriate diagnostic test evidencing rheumatoid arthritis, together with evidence confirming at least three of the following criteria:
– Simultaneous bilateral and symmetrical joint soft tissue swelling or fluid;
– Joint deformity typical of rheumatoid arthritis;
– Rheumatoid nodules beneath the skin; or
– X-ray imaging showing erosion to joints typical of rheumatoid arthritis.
Degenerative osteoarthritis and all other arthritides are excluded.
Type 1 diabetes means a definite diagnosis with total insulin deficiency and continuous dependence on exogenous insulin for survival. Dependence on insulin must persist for a continuous period of at least three months. Advanced Type 2 Diabetes means that the life assured suffers severe diabetes mellitus, either insulin or non-insulin dependent, as certified by an appropriate specialist and resulting in at least one of the following:
– Severe diabetic retinopathy resulting in visual acuity uncorrected and corrected of 6/36 or worse in both eyes; or
– Severe diabetic neuropathy causing motor and/or autonomic impairment; or
– Diabetic gangrene leading to surgical intervention; or
– Severe diabetic nephropathy causing chronic irreversible stage 4 renal impairment.
Severe osteoporosis means that the life assured after the age of 50 has been unequivocally diagnosed by an appropriate specialist as suffering from severe osteoporosis. The diagnosis must confirm that the life assured : – Suffers at least two vertebral body fractures or a fracture of the neck or the femur, due to osteoporosis; and – Has a bone mineral density reading with a T-score of less than -2.5 (i.e. 2.5 standard deviations below the young adult mean for bone density). This must be measured in at least two sites by dual energy x-ray absorptiometry (DEXA).
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– An exclusion applies in cases where there are spontaneous fractures or minimal traumas that are due to an accident but where coincidental osteoporosis exists.
The maximum amount payable for severe osteoporosis diagnosed after the age of 50 is $10,000.
Severe rheumatoid arthritis means that the life assured after the age of 50 has been unequivocally diagnosed by an appropriate specialist as suffering from clinically severe rheumatoid arthritis persisting for at least six weeks. The diagnosis must be supported by:
a. evidence that at least three or more of the following joints are affected:
– Metacarpophalangeal joints in the hands;
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1106 AL-PC version 7 Effective 12 May 2026
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