CANCER OF SPECIFIED SEVERITY:
I. A malignant tumor characterized by the uncontrolled growth and spread of malignant cells
with invasion and destruction of normal tissues. This diagnosis must be supported by
histological evidence of malignancy. The term cancer includes leukemia, lymphoma and
sarcoma.
II. The following are excluded –
i. All tumors which are histologically described as carcinoma in situ, benign, pre-malignant,
borderline malignant, low malignant potential, neoplasm of unknown behavior, or noninvasive, including but not limited to: Carcinoma in situ of breasts, Cervical dysplasia CIN-1,
CIN -2 and CIN-3.
ii. Any non-melanoma skin carcinoma unless there is evidence of metastases to lymph nodes
or beyond;
iii. Malignant melanoma that has not caused invasion beyond the epidermis;
iv. All tumors of the prostate unless histologically classified as having a Gleason score
greater than 6 or having progressed to at least clinical TNM classification T2N0M0
v. All Thyroid cancers histologically classified as T1N0M0 (TNM Classification) or below;
vi. Chronic lymphocytic leukaemia less than RAI stage 3
vii. Non-invasive papillary cancer of the bladder histologically described as TaN0M0 or of a
lesser classification,
viii. All Gastro-Intestinal Stromal Tumors histologically classified as T1N0M0 (TNM
Classification) or below and with mitotic count of less than or equal to 5/50 HPFs;
(ii) OPEN CHEST CABG
I. The actual undergoing of heart surgery to correct blockage or narrowing in one or more
coronary artery(s), by coronary artery bypass grafting done via a sternotomy (cutting through the
breast bone) or minimally invasive keyhole coronary artery bypass procedures. The diagnosis
must be supported by a coronary angiography and the realization of surgery has to be confirmed
by a cardiologist.
II. The following are excluded:
i. Angioplasty and/or any other intra-arterial procedures
(iii) MYOCARDIAL INFARCTION
(First Heart Attack of specific severity)
I. The first occurrence of heart attack or myocardial infarction, which means the death of a
portion of the heart muscle as a result of inadequate blood supply to the relevant area. The
diagnosis for Myocardial Infarction should be evidenced by all of the following criteria:
i. A history of typical clinical symptoms consistent with the diagnosis of acute myocardial
infarction (For e.g. typical chest pain)
New characteristic electrocardiogram changes
iii. Elevation of infarction specific enzymes, Troponins or other specific biochemical markers.
II. The following are excluded:
i. Other acute Coronary Syndromes
ii. Any type of angina pectoris
iii. A rise in cardiac biomarkers or Troponin T or I in absence of overt ischemic heart disease
OR following an intra-arterial cardiac procedure.
(iv) KIDNEY FAILURE REQUIRING REGULAR DIALYSIS
I. End stage renal disease presenting as chronic irreversible failure of both kidneys to function,
as a result of which either regular renal dialysis (haemodialysis or peritoneal dialysis) is
instituted or renal transplantation is carried out. Diagnosis has to be confirmed by a specialist
medical practitioner.
(v) MAJOR ORGAN /BONE MARROW TRANSPLANT (as recipient)
I. The actual undergoing of a transplant of:
i. One of the following human organs: heart, lung, liver, kidney, pancreas, that resulted from
irreversible end-stage failure of the relevant organ, or
ii. Human bone marrow using haematopoietic stem cells. The undergoing of a transplant has
to be confirmed by a specialist medical practitioner.
II. The following are excluded:
i. Other stem-cell transplants
ii. Where only islets of langerhans are transplanted

(vi) STROKE RESULTING IN PERMANENT SYMPTOMS
I. Any cerebrovascular incident producing permanent neurological sequelae. This includes
infarction of brain tissue, thrombosis in an intracranial vessel, haemorrhage and embolisation
from an extracranial source. Diagnosis has to be confirmed by a specialist medical practitioner
and evidenced by typical clinical symptoms as well as typical findings in CT Scan or MRI of
the brain. Evidence of permanent neurological deficit lasting for at least 3 months has to be
produced.
II. The following are excluded:
i. Transient ischemic attacks (TIA)
ii. Traumatic injury of the brain
iii. Vascular disease affecting only the eye or optic nerve or vestibular functions.
(vii) PERMANENT PARALYSIS OF LIMBS
I. Total and irreversible loss of use of two or more limbs as a result of injury or disease of the
brain or spinal cord. A specialist medical practitioner must be of the opinion that the paralysis
will be permanent with no hope of recovery and must be present for more than 3 months.
(viii)MULTIPLE SCLEROSIS WITH PERSISTING SYMPTOMS
I. The unequivocal diagnosis of Definite Multiple Sclerosis confirmed and evidenced by all of
the following:
i. investigations including typical MRI findings which unequivocally confirm the diagnosis to
be multiple sclerosis and
ii. there must be current clinical impairment of motor or sensory function, which must have
persisted for a continuous period of at least 6 months.
II. Neurological damage due to Systemic lupus erythematosus (SLE) is excluded.
(ix) AORTIC SURGERY
The actual undergoing of major surgery to repair or correct an aneurysm, narrowing, obstruction
or dissection of the aorta through surgical opening of the chest or abdomen. For the purpose of
this definition, aorta shall mean the thoracic and abdominal aorta but not its branches.
Surgery performed using only minimally invasive or intra-arterial techniques are excluded
RIMARY (IDIOPATHIC) PULMONARY HYPERTENSION
I. An unequivocal diagnosis of Primary (Idiopathic) Pulmonary Hypertension by a Cardiologist
or specialist in respiratory medicine with evidence of right ventricular enlargement and the
pulmonary artery pressure above 30 mm of Hg on Cardiac Cauterization. There must be
permanent irreversible physical impairment to the degree of at least Class IV of the New York
Heart Association Classification of cardiac impairment.
II. The NYHA Classification of Cardiac Impairment are as follows:
i. Class III: Marked limitation of physical activity. Comfortable at rest, but less than ordinary
activity causes symptoms.
ii. Class IV: Unable to engage in any physical activity without discomfort. Symptoms may be
present even at rest.
III. Pulmonary hypertension associated with lung disease, chronic hypoventilation, pulmonary
thromboembolic disease, drugs and toxins, diseases of the left side of the heart, congenital heart
disease and any secondary cause are specifically excluded.
(xi) ALZHEIMER’S DISEASE/DEMENTIA:
Deterioration or loss of intellectual capacity as confirmed by clinical evaluation and imaging
tests, arising from Alzheimer’s Disease or irreversible organic disorders, resulting in significant
reduction in mental and social functioning requiring the continuous supervision of the Life
Assured for a minimum period of 6 months from date of diagnosis. This diagnosis must be
supported by the clinical confirmation of an appropriate Registered Medical practitioner who is
also a Neurologist and supported by the Corporation’s appointed doctor.
The following are excluded:
(i) Non-organic disease such as neurosis and psychiatric illnesses; and
(ii) Alcohol-related brain damage.
(xii) BLINDNESS
I. Total, permanent and irreversible loss of all vision in both eyes as a result of illness or
accident.
II. The Blindness is evidenced by:
i. corrected visual acuity being 3/60 or less in both eyes or ;
ii. the field of vision being less than 10 degrees in both eyes.
III. The diagnosis of blindness must be confirmed and must not be correctable by aids or
surgical procedure.
(xiii)THIRD DEGREE BURNS
I. There must be third-degree burns with scarring that cover at least 20% of the body’s surface
area. The diagnosis must confirm the total area involved using standardized, clinically accepted,
body surface area charts covering 20% of the body surface area.
(xiv) OPEN HEART REPLACEMENT OR REPAIR OF HEART VALVES
I. The actual undergoing of open-heart valve surgery is to replace or repair one or more heart
valves, as a consequence of defects in, abnormalities of, or disease-affected cardiac valve(s). The
diagnosis of the valve abnormality must be supported by an echocardiography and the
realization of surgery has to be confirmed by a specialist medical practitioner. Catheter based
techniques including but not limited to, balloon valvotomy/valvuloplasty are excluded.
(xv) BENIGN BRAIN TUMOR
I. Benign brain tumor is defined as a life threatening, non-cancerous tumor in the brain, cranial
nerves or meninges within the skull. The presence of the underlying tumor must be confirmed by
imaging studies such as CT scan or MRI.
II. This brain tumor must result in at least one of the following and must be confirmed by the
relevant medical specialist.
i. Permanent Neurological deficit with persisting clinical symptoms for a continuous period
of at least 90 consecutive days or
ii. Undergone surgical resection or radiation therapy to treat the brain tumor.
III. The following conditions are excluded:
Cysts, Granulomas, malformations in the arteries or veins of the brain, hematomas, abscesses,
pituitary tumors, tumors of skull bones and tumors of the spinal cord.