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Progressive Care

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Glossary

Progressive Care

A new way of looking at insurance

New Zealanders are increasingly surviving illnesses, so Progressive Care is designed with the future in mind. Payments are based on the severity of a medical condition, the more serious it is, the greater the payment. And unlike other insurance products, Progressive Care doesn’t cancel after a claim, but can pay out on subsequent claims, whilst cover remains. It provides you greater choice and flexibility.

When you need it most


Progressive Care offers a more flexible approach to personal insurance.

It covers a wide range of illnesses, and gives you financial support, when you need it most.

Find out more

When you need it most


Thanks to advances in modern medicine, many serious conditions are now treatable and more survivable. Decades ago, chances were a cancer diagnosis would be terminal. In each of the past two decades, New Zealand’s cancer survival rates have improved.1 And it’s not just cancer treatments where huge advances are being made.

While that’s great news for all New Zealanders, dealing with treatment and recovery comes at a cost, and can take a toll on your finances – this is where Sovereign Progressive Care comes in. Progressive Care provides financial support when you need it, so you can focus on what matters most.

1 Ministry of Health, 2013/2014 National Cancer Control Strategy & Action Plan.

When you need it most


Valuable protection for you and your family

With your Progressive Care payment, you can choose to:

  • Fund the treatments you may need to keep the condition from worsening
  • Eliminate or reduce your debts
  • Offset lower levels of income for an income-earner returning to work following a serious illness or injury
  • Create cash for an emergency fund or cash reserve
  • Take the time you need to recover
  • Boosting retirement savings

When you need it most


Valuable protection for your business

Progressive Care can also help protect your business by:

  • Eliminating or reducing debt
  • Replacing revenue put at risk
  • Protecting against contractual penalties for non-completion/non-performance
  • Paying the recruitment costs of replacement staff
  • Providing financial assistance to prepare for sale, trade or even winding up of your business

A new way of looking at insurance


Progressive Care delivers you comprehensive cover, it even features a Guaranteed Enhancement Benefit. That means if at any time in the future we make a change to a section and/or condition within a section of TotalCareMax policy and the change is favourable to you, the enhancement will automatically be applied to your Progressive Care policy.1

1. Please refer to the Guaranteed Enhancement Benefit policy wording for more detail.

Option add-on benefit


Adding Specialist and Diagnostic Testing gives you the freedom to select the best specialist available and avoid a long wait for essential treatment. This benefit is designed to pay for your specialist consultations, such as oncologist and cardiologist procedures like MRI and CT scans. It covers up to $3,000 per life assured, per policy year. It also provides access to Best Doctors*, a world-leading medical advice service supported by a global network of specialists.

* Best Doctors is a trademark of Best Doctors Inc. in the United States and other countries and is used under licence.

Claim what you need when you need to


Progressive Care can pay out in the early stages of an illness, giving you access to treatment that could prevent the condition from becoming worse, and allowing you the time off work you need to recover. You don’t have to wait until the illness or injury is life-threatening before making a claim.

Find out more
 

How it works


Progressive Care's unique severity levels mean it can pay out more than once and in amounts linked to the severity of your medical condition, as diagnosed by your specialist*.

* Severity levels start at 10% (least severe) through to 100% (more severe).

You can claim more than once


Progressive Care allows you to claim more than once for different conditions while keeping your cover.

Find out more

Your cover continues even after you claim


When your policy commences, the sum assured is the same for each of the categories of conditions.

Once a claim is paid under a specific category of condition, the sum assured for that particular category decreases by the payment amount, leaving the remaining sum available for any future claims under that category.1 The sum assured for other categories remains unaffected (except where there are related claims).2

1. Unless the severity level of the condition is 100%, in which case the sum assured for that category is exhausted. Where multiple claims occur within a 12 month period, Sovereign will deduct those claims from any current claim. Please see policy document for further details.
Claims are subject to the terms and conditions of the policy wording.

Range of conditions


Sovereign’s Progressive Care covers more than 60 medical conditions across five categories of conditions; Heart & Arteries, Cancer, Brain & Nerves, Loss of Function and Other Health Events, all with various stages of severity.

* Subject to any previous claims paid under the policy

Range of conditions


With Progressive Care, you can claim for any of the specified medical conditions through the life of your policy. Depending on the circumstances of your condition, you could claim 10%, 25%, 50%, 75% or 100% of the sum insured. And subject to any previous claims under your policy, you can also make extra claims if:

  • Your condition gets worse
  • You suffer from a more severe related condition
  • You suffer from a new condition

How do subsequent claims work?
Find out more

Can you afford to be without Progressive Care?


Have you thought about what your family's future would look like if your health took a turn for the worse and you weren’t adequately insured?

If you think insurance is too expensive and complicated, and doesn’t pay out when you really need it to, then Sovereign’s Progressive Care could be your answer.

See how Progressive Care helped Steve

See how Progressive Care helped Karen

See how Progressive Care helped Joan

See how Progressive Care helped Michael

Steve 48


A 48 year-old boat builder who also enjoys pottering around in his backyard, Steve takes out Progressive Care cover of $250,000.

Find out more

The individuals and events depicted in this case study are examples of what could happen and are not based on actual situations. Any similarity to any company, person (living or dead) is merely coincidental.

Karen 33


A 33 year-old mother of two, Karen works part-time. She takes out Progressive Care cover of $250,000.

Find out more

The individuals and events depicted in this case study are examples of what could happen and are not based on actual situations. Any similarity to any company, person (living or dead) is merely coincidental.

Joan 40


At 40 years of age, Joan is promoted to General Manager of Marketing. She’s a smoker and works long hours. She takes out Progressive Care cover of $250,000.

Find out more

The individuals and events depicted in this case study are examples of what could happen and are not based on actual situations. Any similarity to any company, person (living or dead) is merely coincidental.

Michael 28


Aged 28, Michael gets married and buys a house. He and his Adviser review his insurance to better protect himself and his financial future. He takes out Progressive Care cover of $250,000

Find out more

The individuals and events depicted in this case study are examples of what could happen and are not based on actual situations. Any similarity to any company, person (living or dead) is merely coincidental.

  • michael
  • karen
  • steve
  • joan

Progressive Care at a Glance

Progressive Care. It's a new way of looking at insurance

  • Money when you need it most
  • Your condition doesn't have to be life-threatening for you to claim
  • The more serious the condition, the greater the payout.
  • Covers you for more than 60 conditions
  • You can claim more than once
  • With a Progressive Care payment at an early stage of an illness you can have the financial freedom to consider immediate treatment which could prevent the condition becoming worse, or take the time you need to recover.
  • Structured so that you keep your cover
View the benefit sheet

Talk to an Adviser

If you would like to find out more about Progressive Care or get detailed, no-obligation advice, please fill in the form and we will have an Adviser contact you. We know you’re busy, one of our experts will give you a call when it’s best for you.

Alternatively you can contact us on 0800 500 108.

  • Your details:

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What does Progressive Care offer me?

Benefit payments: Lump-sum payments in line with severity of medical condition.

Severity levels: Benefit payment options of 10%, 25%, 50%, 75% and 100% of the sum assured available.

Minimum sum assured: $50,000

Maximum sum assured: $1,000,000

Eligible ages: From 16 years onwards with individual consideration from age 70.

Accessibility of cover: You could receive more payments if your condition gets worse, you suffer from a more severe, related condition, or you suffer from a new condition.

Choice of cover: Progressive Care is available as either personal or business protection, to suit your needs. You also have the choice to have this as a standalone benefit, or an accelerated benefit linked to a TotalCareMax Life cover policy.

Optional add-on benefits
Specialist and Diagnostic Testing: Gives you the freedom to select the best specialist available and to avoid a long wait for essential treatment. This benefit is designed to pay for your specialist consultations, such as oncologist and cardiologist procedures like MRI and CT scans. It covers up to $3,000 per life assured, per policy year. It also provides access to Best Doctors*, a world-leading medical advice service supported by a global network of specialists.

Waiver of premium benefit: Can help pay your premiums if you are unable to work*.

* See policy wording for definition

How do subsequent claims work?

The way a subsequent claim is determined depends on whether it is for a new condition or related to a condition for which a benefit payment has already been received.

Where a claim is related to a condition for which a payment has previously been made, the severity level must be greater to qualify for a benefit payment. The amount payable will also depend on the cover remaining in the relevant category.

Benefit payments also depend on the time that has passed since the previous claim payment. Where a new claim is made within 12 months of the previous claim, the benefit amount for the current claim will be offset by all claim amounts paid in the relevant 12 month period. This offset will not apply, however, where either the current or previous claim is/was for a condition that is the result of an accident.

If a single event causes you to have one or more simultaneously arising conditions, we will pay one claim only, for the condition with the highest severity level.

* Best Doctors is a trademark of Best Doctors Inc. in the United States and other countries and is used under licence.

Benefits

Support when you need it most
When you’re diagnosed with a serious illness or condition, money should be the least of your worries. We know that taking time off for treatment and recovery comes at a cost and can take a toll on your finances – this is where Sovereign Progressive Care comes in. Progressive Care provides financial support when you need it and however you choose to spend it, so you can focus on what matters most.

Progressive claim payments
As Progressive Care pays out based on the severity of an illness or condition, you don’t have to wait until the condition is life-threatening before making a claim. With a Progressive Care payment at an early state of an illness, you can have the financial freedom to consider immediate treatment which could prevent the condition becoming worse, or take the time you need to recover.

Your cover continues even after you claim
When your policy initially commences, the sum assured is the same for each of the categories of conditions. Once a claim is paid under a specific category, the sum assured for that particular category decreases by the payment amount, leaving the remaining sum available for cover for any future claims under that category.1 The sum assured for other categories remains unaffected, except where they are related claims.2

The sum assured across all other categories will remain available until a claim is paid from any one of those categories. The sum assured will then be the maximum amount available for all subsequent claims in that category^.

1. Unless the severity level of the condition is 100%, in which case the sum assured for that category is exhausted. Where multiple claims occur within a 12 month period, Sovereign will deduct those claims from any current claim. Please see policy document for further details.
2. Claims are subject to the terms and conditions of the policy wording.

Valuable protection for you, your family or business

With your Progressive Care payment, you can choose to:

  • Fund the treatments you may need to keep the condition from worsening
  • Eliminate or reduce your debts
  • Offset lower levels of income for an income-earner returning to work following a serious illness or injury
  • Create cash for an emergency fund or cash reserve
  • Boost your retirement savings

Progressive Care can also help protect your business by:

  • Eliminating or reducing debt
  • Replacing revenue put at risk
  • Protecting against contractual penalties for non-completion/non-performance
  • Paying the recruitment costs of replacement staff
  • Providing financial assistance to prepare for sale, trade or even winding up of your business

Guaranteed Enhancement Benefit

Progressive Care features a Guaranteed Enhancement Benefit. That means if at any time in the future we make a change to a section and/or condition within a section of TotalCareMax policy and the change is favourable to you, the enhancement will automatically be applied to your Progressive Care policy. 1

1. Please refer to the Guaranteed Enhancement Benefit policy wording for more detail.

Why Sovereign?

After taking care of New Zealanders for the past 25 years, Sovereign is turning insurance on its head by dedicating ourselves to help you take charge of your health. From now on we’ll be doing our bit to help you keep healthy, and encouraging you to do yours.

Sovereign has an A.M. Best financial strength rating of A+ (Superior)*. It’s a rating we have maintained for the last seven years.

As a values based company, we believe in putting people first. That means not only our customers but also our staff and the wider community.

* Given by A.M. Best Inc., an approved insurance rating agency. A copy of the scale, of which this rating forms part, is available here.

Other things you should know:

The availability of insurance cover is subject to your application being approved. All applications are subject to individual consideration. Special conditions, exclusions and premium loadings may apply. This insurance is underwritten by Sovereign Assurance Company Limited (‘Sovereign’). For full details of the products and benefits offered by Sovereign, please refer to the policy document(s) which are available from Sovereign. Sovereign, the policy insurer, is part of the Commonwealth Bank of Australia Group and is a related company of ASB Bank Limited and its subsidiaries (‘the Banking Group’). None of the Banking Group, the Commonwealth Bank of Australia, any of their directors, or any other person, guarantees Sovereign or its subsidiaries, or any of the products issued by Sovereign or its subsidiaries. The information contained on this website is general in nature and is not intended as advice. It may not be relevant to individual circumstances and before making any insurance decision, you should consult a professional Adviser. Copies of our disclosure statements are available on request, free of charge.

Sovereign’s Privacy Policy

What's covered?
Progressive Care covers 62 medical conditions across five categories:

Heart & Arteries - 25%, 50%, 75%, 100%

  • Heart attack
  • Out of hospital cardiac arrest
  • Coronary artery bypass graft
  • Angioplasty
  • Aortic surgery
  • Heart valve surgery
  • Defibrillator insertion
  • Pacemaker insertion
  • Minor heart valve surgery
  • Cardiomyopathy
  • Congestive cardiac failure
  • Severe peripheral vascular disease

Cancer - 10%, 25%, 50%, 75%, 100%

  • Malignant tumour
  • Prostate cancer
  • Malignant melanoma
  • Carcinoma in situ
  • Urinary bladder cancer
  • Non-Hodgkin’s Lymphoma
  • Hodgkin’s Lymphoma
  • Leukaemia
  • Malignant brain tumour
  • Benign brain tumour
  • Myeloma
  • Aplastic anaemia
  • Bone marrow or stem cell transplant
  • Transplant waiting list for bone marrow transplant
  • Myelodysplastic syndrome

Brain & Nerves - 25%, 50%, 75%, 100%

  • Stroke
  • Dementia
  • Alzheimer’s disease
  • Parkinson’s disease
  • Major head trauma
  • Motor neurone disease
  • Multiple sclerosis
  • Muscular dystrophy
  • Encephalitis
  • Meningitis
  • Peripheral neuropathy

Loss of Function - 25%, 50%, 75%, 100%

  • Coma
  • Paralysis - Diplegia, Hemiplegia, Paraplegia, Quadriplegia, Tetraplegia
  • Loss of independent existence
  • Severe burns
  • Loss of sight
  • Loss of hearing
  • Loss of speech
  • Loss of limbs
  • Intensive Care Benefit

Other Health Events - 10%, 25%, 50%, 75%, 100%

  • Chronic liver failure
  • Chronic lung failure
  • Chronic kidney failure
  • Primary pulmonary hypertension
  • Major organ transplant (or waiting list)
  • Acute renal dialysis
  • Chronic Obstructive Pulmonary Disease
  • Severe ulcerative colitis
  • Severe Crohn’s disease
  • Type 1 diabetes mellitus
  • HIV
  • Advanced AIDS

Please refer to the Progressive Care policy wording document for full terms and conditions associated with this product.

Severity Levels

10% - severity level 5

Prostate cancer Prostate cancer where the tumour is described histologically as TNM Classification T1 and has a Gleason score of 5 or less.

Malignant melanoma
Malignant melanoma of Clark level 1; or of less than 1mm Breslow thickness.

Carcinoma in situ
Carcinoma in situ (Tis) - equivalent of ”In Situ” summary staging. The presence of malignant/cancerous cells at a stage of development such that they have not spread into surrounding healthy tissue. The tumour must be classified as Tis according to the TNM Classification or FIGO Stage 0.

Urinary bladder cancer
Cancer of the urinary bladder – Stage Ta.

Benign brain tumour
Benign brain tumour – a non-malignant tumour or cyst in the brain. Does not include tumours in the pituitary gland, angiomas, haematomas, granulomas and cerebral abscesses.

Bone marrow or stem cell transplant
Bone marrow or stem cell transplant to treat a disease other than cancer.

Myelodysplastic syndrome
Confirmed diagnosis of myelodysplastic syndrome requiring continuing and ongoing supportive care with regular transfusion of blood products, chemotherapy, or other equivalent treatments

Type 1 diabetes mellitus Type 1 diabetes mellitus means a definite diagnosis with total insulin deficiency and continuous dependence on exogenous insulin for survival. Dependence on insulin must persist for a continuous period of at least three months.

25% - severity level 4

Out of hospital cardiac arrest Out-of-hospital cardiac arrest means cardiac arrest not associated with any medical procedure and that is documented by an electrocardiogram and occurs out of hospital, and is due to:

  • cardiac asystole; or
  • ventricular fibrillation with or without ventricular tachycardia.

Angioplasty
Percutaneous coronary angioplasty means percutaneous coronary angioplasty or other percutaneous coronary artery procedures performed by a Consultant Cardiologist to dilate and treat one or two coronary arteries during the same procedure. The procedure may or may not involve the use of a stent.

Pacemaker insertion
Permanent pacemaker insertion means the permanent insertion of an artificial pacemaker to correct an abnormal rhythm of the heart. The abnormal rhythm of the heart must have been documented on electrocardiograph (ECG) and be available to us.

Minor heart valve surgery
Minor heart valve surgery means the undergoing of a catheter based endovascular valve repair or valve implantation as a consequence of heart valve defects or abnormalities.

Malignant tumour Cancer classified as Stage I based on TNM classification.

Prostate cancer

  • Prostate cancer which is histologically described as both TNM Classification T1 and Gleason score of 5 or less, requiring major treatment (including but not limited to prostatectomy, radiotherapy or chemotherapy).
  • Prostate cancer where the tumour is described histologically as TNM Classification T1 and has a Gleason score of 6 or greater.

Malignant melanoma
Malignant melanoma of Clark level 2; or of less than or equal to 2mm and greater than 1mm Breslow thickness.

Carcinoma in situ

  • Carcinoma in situ (Tis) with organ removal. Tumours showing the malignant changes of carcinoma in situ or which are histologically described as pre-malignant, resulting directly in the removal of the entire organ.
  • Carcinoma in situ of the breast requiring any of the following:
    • The removal of the entire breast (total mastectomy) or
    • Breast conserving surgery (lumpectomy, quadrantectomy, segmental mastectomy) and radiotherapy or
    • Breast conserving surgery and chemotherapy

Non-Hodgkin’s Lymphoma
Classified as Stage I based on Ann-Arbor classification

Hodgkin’s Lymphoma
Classified as Stage I based on Ann-Arbor classification

Leukaemia
Chronic lymphocytic leukaemia classified as RAI Stage 0 or I

Malignant brain tumour
Malignant brain tumour classified as Grade I based on World Health Organisation (WHO) grading system

Myeloma
Myeloma classified as stage 1 on the Durie Salmon scale or ISS, requiring chemotherapy or radiotherapy

StrokeStroke means an infarction of the central nervous system tissue due to ischemia, or intracerebral or subarachnoid haemorrhage, as evidenced by:

  • Pathological, imaging or other objective evidence of cerebral or spinal cord injury in a defined vascular distribution; and
  • Clinical evidence of cerebral or spinal cord injury based on acute onset of symptoms, and other etiologies excluded.

The stroke must be confirmed by a specialist neurologist, and severity* assessed after 6 months after the stroke.

Transient ischaemic attacks, cerebral events due to migraine, hypoxia or physical injury, vascular disease affecting the eye, optic nerve or vestibular functions are excluded. Transient ischaemic attack means a transient episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction.

*Severity will be determined using the Barthel Index (BI) which assesses ten functional tasks of daily living, scoring the individual depending on independence in each task. Scores range from 0 and 100, with a higher score indicating greater independence.

Loss of sight Loss of sight in one eye means irrecoverable loss of sight in one eye (whether aided or unaided) as a result of sickness or injury. This is evidenced by:

  • Visual acuity of 6/60 or less in that eye; or
  • Field of vision is reduced to 20 degrees or less of arc.

Loss of hearing
Loss of hearing in one ear means the life assured, as a result of sickness or injury, loses all hearing in one ear (aided or unaided). The loss must be total and permanent as assessed three months after the event.

Loss of limbs
Loss of one limb means the life assured, as a result of sickness or injury, permanently loses the entire use of one limb.

Severe ulcerative colitis Severe ulcerative colitis means diagnosis of ulcerative colitis that requires permanent immunosuppressive medication.

Severe Crohn’s disease
Severe Crohn’s disease means diagnosis of Crohn’s disease that requires permanent immunosuppressive medication.

50% - severity level 3

Heart attack Heart attack means the death of a portion of the heart muscle as a result of inadequate blood supply to the relevant area, confirmed by a cardiologist or general physician and evidenced by:

  • Typical rise and/or fall of cardiac biomarkers (Troponin T or Troponin I or CK-MB) with at least one value above the 99th percentile of the upper reference limit;
and at least one of the following:
  • Signs and symptoms of ischaemia which are consistent with myocardial infarction; or
  • New serial ECG manifestations of acute myocardial infarction with the development of any one of the following:
    • ST changes;
    • T wave inversion;
    • Left bundle branch block (LBBB);
    • Pathological Q waves; or

Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality.

A rise in cardiac biomarkers resulting from a percutaneous procedure for coronary artery disease is excluded unless the baseline value is normal and the elevation is greater than 3 times the 99th percentile of the upper reference limit.

If the above tests are inconclusive Sovereign will also consider the evidence in conjunction with other appropriate and medically recognised tests.

Other acute coronary syndromes including but not limited to angina pectoris are excluded.

Heart valve surgery
Heart valve surgery means the undergoing of open heart surgery that is considered necessary to correct or replace cardiac valves as a consequence of heart valve defects or abnormalities.

Defibrillator insertion
Permanent cardiac defibrillator insertion means the permanent insertion of an automatic implantable defibrillator after the occurrence of ventricular tachycardia or ventricular fibrillation.

Severe peripheral vascular disease
Severe peripheral vascular disease means severe restriction of blood flow through the arteries below the knee as measured by doppler readings of less than 30 per cent of normal and a claudication distance of 20 metres, with gangrene and amputation of more than one toe.

Malignant tumour Advanced cancer classified as Stage II based on TNM classification.

Prostate cancer
Prostate cancer where the tumour is described histologically as TNM Classification T2 or greater.

Malignant melanoma
Malignant melanoma of Clark level 3 or above; or more than 2mm Breslow thickness; or showing evidence of ulceration.

Non-Hodgkin’s Lymphoma
Classified as Stage II based on Ann-Arbor classification

Hodgkin’s Lymphoma
Classified as Stage II based on Ann-Arbor classification

Leukaemia
Chronic lymphocytic leukaemia classified as Rai Stage II
Chronic myeloid leukaemia (not requiring bone marrow transplant)

Malignant brain tumour
Malignant brain tumour classified as Grade II based on World Health Organisation (WHO) grading system

Benign brain tumour
Benign brain tumour – a non-malignant tumour or cyst in the brain resulting in permanent neurological deficit with persisting clinical symptoms or requiring surgery for its removal. Does not include tumours in the pituitary gland, angiomas, haematomas, granulomas and cerebral abscesses.

Myeloma
Myeloma classified as stage 2 on the Durie Salmon scale or ISS, requiring chemotherapy or radiotherapy

Stroke Stroke resulting in Barthal Index Score < 80.

Dementia and Alzheimer’s disease
Dementia and Alzheimer’s Disease – means the diagnosis of either Advanced Dementia or Alzheimer’s disease by a consultant neurologist, psychiatrist or geriatrician which meets the following criteria:

  • There must be permanent clinical loss of the cognitive ability to do one or more of the following for which no other physical cause has been identified: remember, reason, perceive, understand, express and give effect to ideas;
  • and neurological and physical investigations are required to confirm the diagnosis such as blood and urine tests, brain scans, mental status assessment to determine the level of mental deterioration.

Parkinson’s disease
Parkinson’s Disease diagnosis - The unequivocal diagnosis of Idiopathic Parkinson’s disease by an appropriate specialist approved by Sovereign.

Multiple sclerosis
Multiple sclerosis diagnosis - the unequivocal diagnosis of multiple sclerosis confirmed by CT or MRI scans and diagnosed by an appropriate specialist approved by Sovereign.

Muscular dystrophy
Muscular dystrophy diagnosis - The unequivocal diagnosis of muscular dystrophy diagnosed by an appropriate specialist approved by Sovereign.

Encephalitis
Encephalitis diagnosis - The unequivocal diagnosis of severe inflammatory disease of the brain diagnosed by an appropriate specialist approved by Sovereign.

Meningitis
Meningitis diagnosis - the diagnosis of meningitis by an appropriate specialist approved by Sovereign.

Major burns Major burns means tissue injury caused by thermal, electrical or chemical agents causing third degree burns to:

  • at least 9%, but less than 20%, of the body surface area as measured by the ‘Rule of Nines’ or the Lund and Browder Body Surface Chart
  • the whole of one hand or 50% of the surface area of both hands combined, requiring surgical debridement and/or grafting or
  • the whole of one foot or 50% of the surface area of both feet combined, requiring surgical debridement and/or grafting.

Acute renal dialysis 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.

Chronic Obstructive Pulmonary Disease
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 less than 31-49% 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.

75% - severity level 2

Heart attack Heart attack* resulting in permanent and irreversible left ventricular ejection fraction of 30 to 40% (two measurements of at least six months apart) whilst on ongoing optimal therapy for a minimum of six months, and significant and irreversible physical impairment to the degree of at least Class III of the New York Heart Association Functional Classification System of cardiac impairment.

* Key term defined in policy document

Coronary artery bypass graft
Coronary artery bypass graft means the undergoing of surgery on the advice of a Consultant Cardiologist to correct narrowing or blockage of coronary arteries with by-pass grafts.

Angioplasty
Percutaneous coronary angioplasty 3 vessels means percutaneous coronary angioplasty or other percutaneous coronary artery procedures performed by a Consultant Cardiologist to dilate and treat three or more coronary arteries during the same procedure. The procedure may or may not involve the use of a stent.

Aortic surgery
Aortic surgery means the undergoing of surgery or endovascular repair that is considered necessary to correct any narrowing, dissection or aneurysm of the thoracic or abdominal aorta.

Cardiomyopathy
Cardiomyopathy means impaired ventricular function of variable aetiology, resulting in permanent and irreversible left ventricular ejection fraction of 30 to 40% (two measurements of at least six months apart) whilst on ongoing optimal therapy for a minimum of six months, and significant and irreversible physical impairment to the degree of at least Class III of the New York Heart Association Functional Classification System of cardiac impairment.

Malignant tumour Advanced cancer classified as Stage III or above based on TNM classification.

Non-Hodgkin’s Lymphoma
Classified as Stage III based on Ann-Arbor classification

Hodgkin’s Lymphoma
Classified as Stage III based on Ann-Arbor classification

Leukaemia
Advanced chronic lymphocytic leukaemia classified as Rai Stage III
Chronic myeloid leukaemia (requiring bone marrow transplant)
Acute lymphoblastic leukaemia

Brain tumour
Malignant brain tumour classified as Grade III based on World Health Organisation (WHO) grading system

Aplastic anaemia
Aplastic anaemia means 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:

  • Blood product transfusion
  • Marrow stimulating agents
  • Immunosuppressive agents
  • Bone marrow transplantation

Bone marrow or stem cell transplant

  • Bone marrow or stem cell transplant specifically to treat cancer
  • Transplant waiting list for the transplant of bone marrow specifically to treat cancer

Stroke Stroke resulting in Barthal Index Score < 80.

Peripheral neuropathy
Peripheral neuropathy – means the irreversible inflammation or degradation of a peripheral nerve, diagnosed by an appropriate specialist approved by Sovereign.

Coma
Coma means a state of unconsciousness with no reaction to stimuli or internal needs, persisting continuously for at least 72 hours, requiring the use of life-support systems. Coma arising from drug and alcohol abuse is specifically excluded.

Severe burns Severe burns means 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.

Major organ transplant (or Transplant waiting list) Major organ transplant (or Transplant waiting list) means the life assured has undergone, or been placed on the major organ transplant waiting list in New Zealand or Australia for, a transplant from a human donor of one or more of the following organs or substances:

  • Kidney
  • Heart
  • Lung
  • Liver
  • Pancreas
  • Intestine
  • The transplant of all other organs, parts of organs or any other tissue transplant is excluded.

Chronic Obstructive Pulmonary Disease
Stage 4 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 less than 30% of predicted. There must be permanent and irreversible obstruction to airflow demonstrated by a FEV1/ FVC ratio of less than 30% 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.

HIV
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, or surgical centre or surgical clinic. You must prove this to Sovereign's satisfaction. Sero-conversion to the HIV infection must occur within six (6) 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.

100% - severity level 1

Heart attack Heart attack* resulting in permanent and irreversible left ventricular ejection fraction of less than 30% (two measurements of at least six months apart) whilst on ongoing optimal therapy for a minimum of six months, and significant and irreversible physical impairment to the degree of at least Class III of the New York Heart Association Functional Classification System of cardiac impairment.

* Key term defined in policy document.

Cardiomyopathy
Cardiomyopathy means impaired ventricular function of variable aetiology, resulting in permanent and irreversible left ventricular ejection fraction of less than 30% (two measurements of at least six months apart) whilst on ongoing optimal therapy for a minimum of six months, and significant and irreversible physical impairment to the degree of at least Class III of the New York Heart Association Functional Classification System of cardiac impairment.

Severe congestive cardiac failure
Congestive cardiac failure means the inability of the heart muscle on either the right or left side of the heart, or both, to pump blood effectively resulting in a backflow into vessels supplying the heart. This must be diagnosed by a Consultant Cardiologist and optimal therapy must have been established for at least six months. There must be at least 4 signs of congestive heart failure present for a claim to be considered. The signs of congestive heart failure include:

  • Presence of third heart sound
  • Jugular venous pressure above 6 cms
  • Rales present in both bases on auscultation
  • Cardiomegaly on chest x-ray
  • Grade 3, or gross ascites, associated with marked abdominal distension
  • Severe oedema to a level above the knee.

Severe peripheral vascular disease
Severe peripheral vascular disease means severe restriction of blood flow through the arteries below the knee as measured by doppler readings of less than 30 per cent of normal and a claudication distance of 20 metres, resulting in amputation of the leg below the knee or higher.

Cancer

Malignant tumour Any metastatic cancer classified as Stage III or above based on TNM classification where all treatment modalities have failed and been exhausted and where no other therapies are available and where progression of the cancer can be identified.

Non-Hodgkin’s Lymphoma
Advanced lymphoma classified as Stage IV

Hodgkin’s Lymphoma
Advanced lymphoma classified as Stage IV

Leukaemia
Acute myeloid leukaemia
Advanced chronic lymphocytic leukaemia classified as RaiStage IV

Brain tumour
Malignant brain tumour classified as Grade IV based on World Health Organisation (WHO) grading system

Myeloma
Myeloma classified as stage 3 on the Durie Salmon scale or ISS, requiring chemotherapy or radiotherapy

Brain & Nerves

Stroke Stroke resulting in Barthal Index Score < 80

Dementia and Alzheimer’s disease
Dementia and Alzheimer’s Disease with severity - the diagnosis of advanced Dementia or Alzheimer's disease and resulting in significant cognitive impairment or permanent* irreversible inability to perform two activities of daily living*.

Parkinson’s disease
Parkinson’s disease with severity - The unequivocal diagnosis of Idiopathic Parkinson’s disease where the condition cannot be controlled by medication and shows signs of progressive impairment.

Major head trauma
Major head trauma means accidental cerebral injury resulting in permanent neurological deficit with persisting clinical symptoms*.

* Key term defined in policy document.

Motor neurone disease
Motor neurone disease – unequivocal diagnosis of motor neurone disease diagnosed by an appropriate specialist approved by Sovereign.

Multiple sclerosis
Multiple sclerosis with severity – The unequivocal diagnosis of multiple sclerosis confirmed by CT or MRI scans and the life assured must meet an Expanded Disability Status Scale (EDSS) level of 7.5 or more.

Muscular dystrophy
Muscular dystrophy with severity - the unequivocal diagnosis of muscular dystrophy diagnosed by an appropriate specialist approved by Sovereign and resulting in permanent and irreversible inability to perform two activities of daily living*.

* Key term defined in policy document.

Loss of function

Paralysis - Diplegia, Hemiplegia, Paraplegia, Quadriplegia, Tetraplegia Paralysis means the total and permanent loss of function of two or more limbs as a result of sickness or injury causing permanent damage to the nervous system. This includes, but is not limited to, quadriplegia, paraplegia, diplegia and hemiplegia.

Loss of independent existence
Loss of independent existence means the life assured is totally and irreversibly disabled, with the effect that he or she, as a result of sickness or injury:

  • Is unable to perform without the physical assistance of someone else at least two activities of daily living for himself or herself (if the life assured can perform the activity on his or her own by using special equipment we will treat the life assured as being able to perform that activity); or
  • Suffers significant cognitive impairment means mental deterioration and loss of intellectual ability, evidenced by deterioration in memory, orientation and reasoning, which are measurable and result from demonstrable organic cause as diagnosed by an appropriate specialist in psychogeriatrics, psychiatry, neurology or geriatrics. The degree of cognitive impairment must be sufficiently severe to require a minimum of 16 hours of daily supervision by a nursing service approved by Sovereign. Determination of a cognitive impairment will be made on the basis of clinical data and valid standardised measures of such impairments.

Loss of sight
Total blindness means irrecoverable loss of sight of both eyes (whether aided or unaided) as a result of sickness or injury. This is evidenced by:

  • Visual acuity of 6/36 or less in both eyes; or
  • Field of vision is reduced to 10 degrees or less of arc in the better eye; or
  • A combination of visual defects resulting in the same degree of visual impairment as either of the points above.

Loss of sight in one eye and one limb
Loss of sight in one eye and loss of one limb means irrecoverable loss of sight in one eye (whether aided or unaided) as a result of sickness or injury. This is evidenced by:

  • Visual acuity of 6/60 or less in that eye; or
  • Field of vision is reduced to 20 degrees or less of arc and means the life assured, as a result of sickness or injury, permanently loses the entire use of one limb (entire hand or entire foot).

Loss of hearing
Total deafness means the life assured, as a result of sickness or injury, loses all hearing in both ears (aided or unaided). The loss must be total and permanent as assessed three months after the event.

Loss of speech
Loss of speech means 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.

Intensive Care Benefit
Intensive care benefit - 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. The life assured must have also sustained a neurological deficit causing inability to perform one of the activities of daily living*. Unconsciousness caused by drug and alcohol abuse is specifically excluded.

* Key term defined in policy document.

Other health events

Chronic liver failure Chronic liver failure means the life assured suffers end-stage liver failure as evidenced by:

  • Permanent jaundice; or
  • Ascites; or
  • Encephalopathy.

Liver disease arising from drug and alcohol abuse is specifically excluded.

Chronic lung failure
Chronic lung failure means the life assured has reached end-stage respiratory failure as diagnosed by an appropriate specialist in respiratory disease. As a result of the respiratory failure, the life assured:

  • Requires continuous oxygen therapy & has a FEV 1 test result of less than 1 litre; or
  • Is unable to perform at least one of the activities of daily living.

Chronic kidney failure
Chronic kidney failure means 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.

Primary pulmonary hypertension
Primary pulmonary hypertension means the presence of irreversible raised pressure in the pulmonary arteries. The measurement reported must be the average level measured by cardiac catheterisation and be at least 30mmHG (mm of mercury) at rest. There must also be right ventricular dilatation and hypertrophy on echocardiogram with characteristic ECG changes.

Type 1 diabetes mellitus
Advanced type 1 diabetes mellitus means the life assured has suffered at least two of the following complications as a direct result of Type 1 diabetes as confirmed by an appropriate specialist:

  • Nephropathy requiring regular dialysis or a kidney transplant proliferative retinopathy
  • Peripheral vascular disease leading to chronic infection or gangrene, requiring a surgical procedure
  • Neuropathy including:
    • Irreversible autonomic neuropathy resulting in postural hypotension, and/or motility problems in the gut with intractable diarrhoea or,
    • Polyneuropathy leading to severe mobility problems due to sensory and/or motor deficits.

Advanced AIDS
Advanced AIDS - HIV infection with a persistent CD4 cell count of less than 200/ul despite appropriate continuous antiretroviral therapy. There must be an associated AIDS defining illness with AIDS resulting in at least one of the following:

  • Kaposi's Sarcoma or Lymphoma
  • Pneumocystis Carinii infection, cryptoccal infection or any other opportunistic infection of the lungs or nervous system
  • Tuberculosis or other mycobacterium infection at any site
  • Progressive Multifocal Leukoencephalopathy
  • HIV Encephalopathy
  • HIV Wasting Syndrome characterised by more than 10% weight loss, chronic intractable diarrhoea and chronic candidiasis of the respiratory tract or gastrointestinal tract.

Please refer to the Progressive Care policy wording document for full terms and conditions associated with this product.

A - Z Glossary

AIDS

(Benefit category: Other health conditions – Infectious diseases)

Human immunodeficiency virus infection / acquired immunodeficiency syndrome (HIV/AIDS) is a disease of the human immune system caused by infection with human immunodeficiency virus (HIV).

ALZHEIMER’S DISEASE

(Benefit category: Brain and nerves – Other neurological conditions)

Alzheimer’s disease, first described by the German neurologist Alois Alzheimer, is a physical disease affecting the brain that causes a gradual decline in the person’s ability to remember, understand, communicate and reason.

During the course of the disease, abnormal proteins form ‘plaques’ and ‘tangles’ in the structure of the brain. Tangles lead to the death of brain cells and the brain shrinks, especially in the inner part of the brain’s temporal lobes. These changes disrupt the messenger molecules, which carry messages between brain cells and prevent the brain working efficiently.

Alzheimer’s is a progressive disease which usually starts in the 40s or 50s. Gradually over time more parts of the brain are damaged. As this happens, the symptoms become more severe.

ANGIOPLASTY

(Benefit category: Heart and arteries – Cardiac surgery)

Arteries supply oxygen to muscles. The coronary arteries supply the oxygenated blood to the heart muscle and sometimes the arteries can become narrowed or blocked. In coronary artery balloon angioplasty, the narrowed artery is stretched back to its normal diameter by a small inflatable balloon which is guided to the heart under X-ray control.

Sometimes the artery is held open by a piece of expandable metal or plastic, called a stent. The stent remains in place after the balloon is deflated and removed. The patient remains in hospital for a few hours and is then able to go home.

AORTIC SURGERY

(Benefit category: Heart and arteries – Cardiac surgery)

The aorta is the biggest artery in the body and carries blood from the heart to all parts of the body via a system of branching arteries. The thoracic aorta is in the chest and continues through the diaphragm, into the abdomen, where it is called the abdominal aorta. Because of disease, the wall of the artery can split (dissection) or it may bulge (aneurysm). Both of these conditions have to be repaired or they can leak and cause death.

APLASTIC ANAEMIA

(Benefit category: Cancer – Other cancers)

Blood cells are produced by bone marrow. Aplastic anaemia is when the marrow stops producing enough blood cells. The only ways it can be treated are to either make the bone marrow produce cells again, give blood transfusions until the marrow recovers or to have a suitable donor give some of their marrow – a bone marrow transplant.

With successful treatment, patients can lead a relatively normal life for 10–15 years.

BENIGN BRAIN TUMOUR

(Benefit category: Cancer – Brain Tumours)

Some types of tumours in the brain are benign. The cells of a benign brain tumour do not infiltrate and grow into brain tissue. However, a benign brain tumour can cause symptoms and problems as it gets bigger. This is because it can increase the pressure inside the skull and press on the delicate brain tissue. Also, some benign pituitary tumours release large amounts of hormones into the bloodstream which can cause various problems. Therefore, unlike many other types of benign tumours, a benign brain tumour often needs treatment to ease symptoms.

BURNS

(Benefit category: Loss of function)

Doctors use the ‘Rule of 9’ to determine how severe a burn is. This divides the skin into areas that represent about 9% of the total body surface. The more of the body involved, the more severe the burn.

CARCINOMA IN SITU

(Benefit category: Cancer – Solid tumours)

Many forms of cancer originate from a ‘carcinoma-in-situ’ (CIS) lesion. Therefore, CIS is considered a precursor that may, if left untreated long enough, transform into a more malignant form of ‘cancer’. Many doctors will not refer to ‘carcinoma-in-situ’ as ‘cancer’ when explaining a laboratory report to a patient. However, because most forms of CIS have a real potential to turn into invasive carcinoma, CIS is usually treated in much the same way as a malignant tumour.

CARDIAC ARREST

(Benefit category: Heart – Heart attack)

Cardiac arrest, also known as cardiopulmonary arrest or circulatory arrest, is the cessation of normal circulation of the blood due to failure of the heart to contract effectively. Medical personnel may refer to an unexpected cardiac arrest as a sudden cardiac arrest (SCA).

A cardiac arrest is different from (but may be caused by) a heart attack, where blood flow to the muscle of the heart is impaired.

CARDIAC FAILURE

(Benefit category: Heart – Heart attack)

Heart failure, often called congestive heart failure or congestive cardiac failure. Occurs when the heart is unable to provide sufficient pump action to maintain blood flow to meet the needs of the body.

CARDIOMYOPATHY

In cardiomyopathy, the heart muscle becomes diseased, resulting in failure of the heart as a pump.

Three different types of cardiomyopathy are:

  • Dilated cardiomyopathy is the most common. The cavity of the heart is enlarged and the walls are stretched. The heart is so weak it does not pump normally.
  • Hypertrophic cardiomyopathy is where the muscle mass in the left ventricle enlarges.
  • With restrictive cardiomyopathy, the walls of the heart become rigid and hard to move. This type is usually caused by another disease process.

Cardiomyopathy can be controlled if the underlying disorder can be corrected. If the underlying cause is not corrected, then the cardiomyopathy is incurable and will inevitably lead to death unless a heart transplant is available.

CHRONIC LIVER FAILURE

(Benefit category: Other health conditions – Organ failure)

Liver failure is the inability of the liver to perform its normal synthetic and metabolic function as part of normal physiology.

CHRONIC LUNG DISEASE

(Benefit category: Other health conditions – Organ failure)

Disease or poisons in the air, such as smoke or other gases, easily damage the delicate membranes in the lungs. Once the lung is damaged, it does not fully recover and over time will absorb less oxygen until a point is reached where extra oxygen is required in the air breathed.

The lungs can fail when the:

  • Airway is blocked
  • Lung is damaged by disease
  • Muscles around the chest do not work properly.

Chronic bronchitis, emphysema and asthma can cause lung damage. The chest muscles fail in multiple sclerosis, polio and muscular dystrophy.

CHRONIC RENAL FAILURE

(Benefit category: Other health conditions – Organ failure)

Chronic Renal Failure is a medical condition in which the kidneys fail to adequately filter waste products from the blood.

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

(Benefit category: Other health conditions – Organ failure)

Chronic Obstructive Pulmonary Disease is a lung disease defined by persistently poor airflow as a result of breakdown of lung tissue (known as emphysema) and dysfunction of the small airways.

COMA

(Benefit category: Loss of function)

A coma is medically defined as a state of unconsciousness for more than six hours, in which a person: cannot be awakened; fails to respond normally to painful stimuli, light, or sound; lacks a normal sleep-wake cycle; and, does not initiate voluntary actions. A person in a state of coma is described as being comatose.

Although a coma patient may appear awake, they are unable to consciously feel, speak, hear, or move.

CORONARY ARTERY BYPASS

(Benefit category: Heart and arteries – Cardiac Surgery)

Coronary artery bypass surgery is an operation to re-route blood past the narrowed arteries. Up to four new routes may be needed. At surgery, a blood vessel from another part of the body is used to bypass the diseased coronary artery.

CROHN’S DISEASE

(Benefit category: Other health conditions – Organ failure)

Crohn’s disease is a type of inflammatory bowel disease that may affect any part of the gastrointestinal tract

DEMENTIA

(Benefit category: Brain and nerves – Other neurological conditions)

Dementia is a serious loss of global cognitive ability in a previously unimpaired person, beyond what might be expected from normal aging. It may be static, the result of a unique global brain injury, or progressive, resulting in long-term decline due to damage or disease in the body.

DIABETES (DIABETES MELLITUS)

(Category: Other health conditions – organ failure)

During the digestive process, much of the food that is eaten is converted into glucose, commonly known as blood sugar. Glucose circulates in the bloodstream and is used as food for the body’s cells. However, the cells cannot absorb glucose alone. A hormone called insulin, which is produced in the pancreas, must first bind to the cell surface. When this occurs, cells of the body are activated and are able to absorb the glucose. This process returns the body’s blood sugar to a normal level.

Diabetes mellitus is a disorder that affects the body’s ability to efficiently utilize blood glucose. In Type 1 diabetes, the pancreas does not produce enough insulin, so glucose cannot be absorbed to refuel the cells. In Type 2 diabetes, insulin is produced, but it does not work properly and the glucose is not absorbed consistently by the cells. Both types of diabetes have the same result: glucose is not absorbed by the cells. That is why people with diabetes have high blood sugar levels. Without proper absorption of glucose from the bloodstream, cells are starved of food.

Regardless of which type of diabetes a person may have, people with diabetes must monitor their blood sugar levels. Depending on the type and severity of the disease, diabetes can be managed with diet or with medication.

When diabetes progresses to the advanced stages, people can experience complications such as blindness, advanced circulatory disease, chronic infection or gangrene that could result in surgery such as amputation.

DIPLEGIA

(Benefit category: Loss of function)

Diplegia is when like parts of the body are paralysed i.e. both arms or both legs. This can be caused by disease or injury in either the brain or the spinal cord.

HEART ATTACK

(Benefit category: Heart and arteries – heart attack)

The coronary arteries supply the heart muscle with oxygenated blood and if they become blocked, a portion of the heart muscle does not receive enough oxygen and it dies.

HEART VALVE SURGERY

(Benefit category: Heart and arteries – Cardiac surgery)

Like any other pump, the heart needs valves to ensure the blood does not flow the wrong way. There are four valves in the heart:

  • Mitral
  • Tricuspid
  • Aortic
  • Pulmonary

Each valve can become affected by disease and either become narrowed or leak. When this happens, the valves need to be repaired or replaced. If they are not, the heart will gradually fail.

HEMIPLEGIA

(Benefit category: Loss of function)

Hemiplegia is the total paralysis of the arm, leg and trunk on one side of the body.

HIV

(Benefit category: Other health conditions – Infectious diseases)

HIV is a slowly replicating retrovirus that causes acquired immunodeficiency syndrome (AIDS), a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive.

HODGKIN’S LYMPHOMA

(Benefit category: Cancer – Blood disorders)

Hodgkin’s lymphoma is a type of lymphoma, which is a cancer originating from white blood cells called lymphocytes. Hodgkin's lymphoma is characterized by the orderly spread of disease from one lymph node group to another and by the development of systemic symptoms with advanced disease.

LEUKEMIA

(Benefit category: Cancer – Leukemias)

Leukemia is a type of cancer of the blood or bone marrow characterized by an abnormal increase of immature white blood cells called "blasts".

Types of leukemia include:

  • Lymphocytic - affecting circulating lymphocyte cells. This is in contrast to lymphoma, which is a solid tumor of the same type of cells.
  • Myeloid - affecting myeloid tissue.
  • Lymphoblastic - leukemia, or cancer of the white blood cells characterized by excess lymphoblasts.

LYMPHOMA

(Benefit category: Cancer – Blood disorders)

Lymphoma is a type of blood cancer that occurs when the white blood cells that form a part of the immune system and help protect the body from infection and disease, divide faster than normal cells or live longer than they are supposed to. Lymphoma may develop in the lymph nodes, spleen, bone marrow, blood or other organs and eventually they can form a tumour.

MAJOR HEAD TRAUMA

(Benefit category: Brain and nerves – Other neurological conditions)

A blow to the outside of the skull can result in the brain moving and hitting the hard skull, or tearing. Both cause bleeding and bruising, resulting in damage to brain cells.

MALIGNANT TUMOUR

(Benefit category: Cancer – Solid tumours)

Cancer starts when a cell or group of cells changes from being normal and begins to grow in an uncontrollable fashion. The uncontrolled growth expands in the first site damaging normal tissue and cells can spread via the bloodstream or the lymphatic system to other parts of the body where they can multiply.

MOTOR NEURONE DISEASE (MND)

(Benefit category: Brain and nerves – Other neurological conditions)

MND is the name given to a group of related diseases which affect the motor neurones that control muscles. The motor neurones degenerate and cause a progressive weakness and muscle-wasting.

MULTIPLE SCLEROSIS (MS)

(Benefit category: Brain and nerves – Other neurological conditions)

In MS, nerve cells lose their myelin coating which acts like the insulation on electrical wiring. The myelin is destroyed and replaced by hard scar tissue. When nerve impulses reach a damaged area they are blocked or delayed in travelling to or from the brain.

MUSCULAR DYSTROPHY

(Benefit category: Brain and nerves – Other neurological conditions)

Muscular dystrophy is a group of diseases, usually genetic, that cause progressive weakness and degeneration of muscles that control movement.

MYELODYSPLASTIC SYNDROME

(Benefit category: Cancer – Other cancers)

The myelodysplastic syndromes are a diverse collection of hematological (blood-related) medical conditions that involve ineffective production (or dysplasia) of the myeloid class of blood cells.

MYELOMA

(Benefit category: Cancer – Other cancers)

Myeloma is a cancer of plasma cells, a type of white blood cell normally responsible for producing antibodies. In multiple myeloma, collections of abnormal plasma cells accumulate in the bone marrow, where they interfere with the production of normal blood cells.

NON-HODGKIN’S LYMPHOMA

(Benefit category: Cancer – Blood disorders)

The non-Hodgkin lymphomas are diverse group of blood cancers that include any kind of lymphoma except Hodgkin's lymphomas. Types of non-Hodgkin lymphomas vary significantly in their severity, from indolent to very aggressive.

PARAPLEGIA

(Benefit category: Loss of function)

Paraplegia is the paralysis of the legs and lower part of the body. Very often it also involves loss of sensation and paralysis of the bladder and bowels.

PARKINSON’S DISEASE

(Benefit category: Brain and nerves – Other neurological conditions)

Parkinson’s disease is a degenerative disorder of the central nervous system. The motor symptoms of Parkinson's disease result from the death of dopamine-generating cells in the substantia nigra, a region of the midbrain

PERIPHERAL VASCULAR DISEASE

(Benefit category: Heart and arteries – other cardiovascular conditions)

Peripheral vascular disease refers to the obstruction of large arteries not within the coronary, aortic arch vasculature, or brain.

PULMONARY HYPERTENTION

(Benefit category: Heart and arteries – other cardiovascular conditions)

The heart pumps blood to the lungs through the pulmonary artery. As a result of disease, the pressure in the pulmonary arteries can become too high and the heart has to work much harder to pump the blood through the lungs. The heart muscle gradually gets bigger until it is so big that it becomes weak and unable to pump properly.

QUADRIPLEGIA / TETRAPLEGIA

(Benefit category: Loss of function)

If the spinal cord is injured or develops disease, the muscles of both the arms, both the legs, and also the trunk become paralysed.

STROKE

(Benefit category: Brain and nerves – Stroke)

The brain controls all our bodily functions. Normal function is dependent on a good oxygen supply through the cerebral arteries. If either a clot (cerebral embolism or thrombosis) or a haemorrhage (cerebral aneurysm) cuts off the oxygen supply, then a portion of the brain will die. This is a stroke. Lack of oxygen for only three minutes will cause brain cells to die. What happens to the person depends upon where in the brain the cells die.