SEVERE ILLNESS OR INJURY
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If the Life Assured suffers a medical condition that does not satisfy any condition leading to either a full or partial claim under this Policy and it is deemed medically necessary to:
undergo Major Invasive Surgery ; or
•
• be treated using Major Interventional Treatment ;
which results in hospital admission to:
• an intensive care unit for a period greater than 48 continuous hours; or • a High Dependency Unit for a period greater than 96 continuous hours; and the Life Assured is unable to perform at least one (1) Activity of Daily Living for a continuous period of ninety (90) days from first being admitted into the intensive care unit or High Dependency Unit (as applicable) as certified by a Registered Medical Specialist .
A medical condition arising from alcohol or drug abuse or other self-inflicted means is specifically excluded.
This Benefit does not apply to any condition specifically excluded in this Policy or where an underwriting exclusion has been applied. Major Invasive Surgery – an invasive procedure occurring in a hospital operating theatre involving the incision, excision, manipulation, or suturing of tissue, under general anaesthesia, spinal anaesthesia or epidural. Elective cosmetic procedures are excluded. Major Interventional Treatment – non-surgical procedures or treatments initiated to treat the claimed medical condition including but not limited to: stereotactic radiosurgery, laser therapy, ultrasonic aspiration, chemotherapy, or radiotherapy. Pharmaceutical therapies administered outside of a clinical setting are excluded. High Dependency Unit - A specially staffed and equipped section of an intensive care complex that provides a level of care intermediate between intensive care and general ward care. Patients may be admitted to the high dependency unit: • from the intensive care unit as a step-down prior to transfer to the ward; or • directly from the ward, recovery or emergency areas. The Trauma Cover Benefit will not be paid if the Critical Illness directly or indirectly was caused by or resulted from self-inflicted injury, whether the Life Assured is sane or insane Exclusions specific to the optional Women’s Additional Cancer Benefit ; • Lobular Carcinoma-in-situ (LCIS) of the breast is specifically excluded. • No Benefit will be paid if the condition is first Diagnosed within the first six (6) months of Benefit inception. • Prophylactic breast surgery, for instance, as a result of family history of breast cancer, is excluded.
EXCLUSIONS
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BCP-TC-05/2026
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