TCM Business Progressive Care Policy Wording

Visual acuity of 6/36 or less in both eyes;

 Field of vision reduced to 10 degrees or less of arc in the better eye;

 A combination of visual defects resulting in the same degree of visual impairment as either of the points above; or

 Other evidence from a registered medical practitioner or specialist acceptable to Sovereign that confirms that the above requirements are likely to be satisfied.

Tetralogy of Fallot

A congenital anatomical abnormality of the heart with severe or total right ventricular outflow tract obstruction and a ventricular septal defect. The diagnosis must be confirmed by an appropriate specialist and supported by an echocardiogram and must require surgical repair.

Transposition of Great Vessels

The complete transposition of the aorta and pulmonary artery. The diagnosis must be confirmed by an appropriate specialist and supported by an echocardiogram and must require surgical repair.

Deafness

Congenital hearing impairment in both ears, identified during newborn hearing screening and confirmed by an appropriate specialist as resulting in:

 an average hearing threshold in both ears, whether aided or unaided, of 91db or greater as measured at 500, 1000 and 1500 Hz; or

 the recommendation for an insertion of a cochlear ear implant.

Pregnancy Complications Benefit conditions

Disseminated intravascular coagulation (DIC)

Over activation of the coagulation and fibrinolytic system resulting in microvascular thrombosis and consumption of platelets and coagulation factors.

DIC complicating pregnancy may follow any major haemorrhage, pre-eclampsia, amniotic fluid embolism, endotoxic shock, and when foetal death occurs after 20 weeks.

Eclampsia

The occurrence of grand mal seizures in the presence of hypertension, proteinuria and oedema complicating a pregnancy, and not being due to other causes such as epilepsy.

Hydatidiform mole

Development of multiple fluid filled cysts in the uterus after the degeneration of the placenta which results in the death of the embryo as confirmed by an registered medical practitioner .

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866 TCB-PC version 12 Effective 12 May 2026

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