Severity Level
Conditions
independent blood tests.
Acute renal dialysis means undergoing more than two treatments of haemodialysis over a three week period or a cumulative total of more than 24 hours haemofiltration due to a rapid decline of renal function leading to renal failure. Stage 3 Chronic Obstructive Pulmonary Disease (COPD) means a disease of the airways of the lung causing obstruction to the exhalation of air. There must be permanent and irreversible reduction of the maximum volume of air expelled in one second (FEV1) of between 31% and 49% of predicted. There must be permanent and irreversible obstruction to airflow demonstrated by a FEV1/ FVC ratio of less than 50% and there must be less than 5% variation in three repeated measurements, (which must be performed under the direction of a specialist respiratory physician) whilst on optimal therapy. They must be measured in a respiratory laboratory, which has regular quality control audits available to Sovereign. These measurements must be repeated after an interval of at least three months and must also satisfy the criteria mentioned above for a claim to be considered.
Removal of large bowel means that the life assured has undergone a surgical procedure to remove the entire large bowel.
Pneumonectomy means the undergoing of surgery to remove an entire lung. The treatment must be considered medically necessary by an appropriate specialist .
Systemic sclerosis means an unequivocal diagnosis of systemic sclerosis by an appropriate specialist , causing the life assured to be totally and irreversibly unable to perform any one of the activities of daily living without assistance of another adult person. Systemic lupus erythematosus with lupus nephritis means that the life assured has been unequivocally diagnosed by an appropriate specialist with systemic lupus erythematosus with lupus nephritis in the clinical setting, evidenced by the presence of any four or more of the following twelve criteria: – Malar rash: Fixed erythema, flat or raised, over the malar eminences, tending to spare the nasolabial folds. – Discoid rash: Erythematosus, raised patches with adherent kerotic scaling and follicular plugging, atrophic scarring may occur in older lesions. – Photosensitivity: Skin rash as a result of unusual reaction to sunlight, evidenced by patient history or specialist’s report. – Oral ulcers: Oral or nasopharyngeal ulceration reported by physician. – Arthritis: Non-erosive arthritis involving two or more peripheral joints, characterised by tenderness, swelling, or effusion. – Serositis: Pleuritis - convincing history of pleuritic pain or pleuritic rub heard by a physician or evidence of pleural effusion; or pericarditis - documented by ECG or rub or evidence of pericardial effusion. – Renal disorder: Persistent proteinuria greater than 0.5 grams per day; or greater than 2+ if quantitation not performed; or tubular casts - may be red cell, haemoglobin, granular, cellular or mixed. – Neurological disorder: Seizures - in the absence of offending drugs or known metabolic derangements, e.g. uraemia, ketoacidosis; or electrolyte imbalance. – Hematologic disorder: Hemolytic anaemia - with reticulocytosis; or leucopoenia - less than 3,500/mm3 on two (2) or more occasions; or thrombocytopenia - less than 100,000mm3 in the absence of offending drugs. – Immunologic disorder: Positive LE cell preparation; or anti-DNA: antibody to native DNA in abnormal titre; or anti-Sm: presence of antibody to Sm (Smooth Muscle) nuclear antigen; or false positive serologic test for syphilis known to be positive for at least six (6) months and confirmed by Treponema pallidum immobilisation or fluorescent treponemal antibody absorption test. – Antinuclear antibody: An abnormal titre of antinuclear antibody by immunofluorescence or an equivalent assay at any point in time and in the absence of drugs known to be associated with ‘drug-induced lupus' syndrome. – Alopecia: Diffuse thinning and fragility of the hair in the absence of other causes (such as alopecia areata, drugs, iron deficiency and androgenic alopecia).
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866 TCB-PC version 12 Effective 12 May 2026
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