No claim will be paid in respect of the reinstated Trauma Cover Benefit for:
a) A Critical Illness that occurs prior to the cover being reinstated.
b) A Critical Illness which: •
arises in connection with;
is a complication of;
• • • •
results from;
is a consequence of;
is a complication of treatment for; a Critical Illness event for which We paid a claim under the original Trauma Cover Benefit . c) The same Critical Illness for which We have paid a claim under Trauma Cover Benefit for the Life Assured , unless the second claim event is for Critical Cancer, Malignant Melanoma or Prostate Cancer, and meets all of the following: • The Critical Cancer , Malignant Melanoma or Prostate Cancer claim event occurs at least twelve (12) months after the original claim event date; • arises in a different organ system as the original cancer; • is not considered by the treating oncologist as likely to be secondary of the original cancer; • is an unrelated or different type of cancer. d) Any Heart Condition if the original claim was for either a Heart Condition or Stroke (as defined in Clause 3 “ Critical Illness ” under Section D “Trauma Cover Benefit Definitions” below), except where the claim in respect of the reinstated Trauma Cover Benefit is for Heart Valve Replacement, Heart Valve Surgery, or Pulmonary Arterial Hypertension (Primary), and these illnesses have not previously been claimed for; and are not considered as likely to be secondary or directly resulting from the original Critical Illness. e) Stroke (as defined in Clause 3 “ Critical Illness ” under Section D “Trauma Cover Benefit Definitions” below) or any condition directly resulting from a Stroke, if the original claim was for a Heart Condition , except where the original claim was for Heart Valve Replacement, Heart Valve Surgery, or Pulmonary Arterial Hypertension (Primary). f) Any exclusion which applied to the original Trauma Cover Benefit . In the event of a claim in respect of the reinstated Children’s Trauma Top Up Benefit option , no claim will be paid for: • the Children’s Trauma Top Up Benefit option where an Insured Child has already had an eligible claim under this Benefit ; or • the Children’s Congenital Conditions Benefit where an Insured Child has already had an eligible claim under this Benefit ; or • any Exclusion which applied to the original Children’s Trauma Top Up Benefit option .
PC-TC-05/2026
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