above and his or her intellectual capacity has reduced or deteriorated to such an extent that the life assured requires full-time care .
The life assured has reached end-stage respiratory failure as diagnosed by an appropriate specialist in respiratory disease. As a result, the life assured requires continuous oxygen therapy and has a FEV 1 test result of less than one litre.
Paraplegia
Chronic renal failure
Total and permanent loss of function of both legs due to injury or disease of the spinal cord.
The kidneys of the life assured have reached the end-stage of renal disease resulting in chronic irreversible failure of the kidneys to function, as a result of which regular renal dialysis is instituted or transplantation performed.
Permanent blindness
Complete and irrecoverable loss of the sight of both eyes (whether aided or unaided) as a result of sickness or injury. The extent of vision must be 6/36 or less in both eyes. Blindness as a result of alcohol or drug abuse is specifically excluded.
HIV
Infection with the Human Immunodeficiency Virus (HIV) must have been acquired by accident or violence during the course of the life assured’s normal occupation or through the medium of a blood transfusion, transfusion of blood products, organ transplant, assisted reproduction technique or other medical procedure or operation performed by a registered healthcare professional and/or in a registered hospital care institution, surgical centre or surgical clinic. You must prove this to our satisfaction. Seroconversion to the HIV infection must occur within six months of the accident. HIV infection transmitted by any other means, including but not limited to sexual activity or non-medical intravenous drug use, is not covered under this appendix . Any incident giving rise to a potential claim must be reported to us within 30 days of the incident and be supported by a negative HIV Antibody Test taken within seven days after the incident. Sovereign may decline your claim if we are not given access to independently test all blood samples used, if we require, or if the life assured does not allow Sovereign to take further independent blood tests.
Permanent loss of hearing
The life assured, as a result of sickness or injury, loses all hearing in both ears (aided or unaided). This loss must be total and permanent as assessed three months after the event.
Permanent loss of speech
The life assured, as a result of sickness or injury, loses the ability to produce intelligible speech, both natural and assisted. This loss must be total and permanent as assessed three months after the event. Loss of speech related to any psychological cause is excluded.
Permanent loss of limbs
The life assured, as a result of sickness or injury, loses two or more limbs (the complete severance of an entire hand or foot).
Quadriplegia
Intensive care benefit
Total and permanent loss of function of both upper and lower limbs due to injury or disease of the spinal cord.
A state of unconsciousness with no reaction to stimuli or internal needs, persisting continuously for at least 96 hours, requiring the use of endo-tracheal intubation in the intensive care unit of a hospital.
Other key conditions
Aplastic anaemia
Major burns
The life assured has suffered the first occurrence of bone marrow failure which results in anaemia, neutropenia and thrombocytopenia, requiring treatment over a period of at least two months with at least one of the following:
The life assured has suffered tissue injury caused by thermal, electrical or chemical agents. As a result, the life assured has full thickness or third-degree burns to: at least 20% of the body surface area (as measured by age appropriate use of The Rule of 9 or the Lund and Browder Body Surface Chart); or 50% of both hands, requiring surgical debridement and/or grafting; or 25% of the face, requiring surgical debridement and/or grafting.
blood product transfusion; or
marrow stimulating agents; or
immunosuppressive agents; or
bone marrow transplantation.
Chronic liver failure
The life assured suffers end-stage liver failure as evidenced by:
Major transplant surgery
The life assured has had one or more of the following human organs or substances completely transplanted from a human into that life assured’s body:
Permanent jaundice; or
Ascites; or
Encephalopathy.
Kidney; or
Liver disease arising from alcohol or drug abuse is specifically excluded.
Heart; or
Lung; or
Chronic lung disease
Liver; or
809 TCP-EDI version 6 Effective 21 May 2019
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