Manulife (Singapore) Pte. Ltd.
A Manulife Company

Manulife CI FlexiCare (Deluxe)
General conditions
1.

The contract
This policy is a written confirmation of a contract between you and us. This is a regular-premium
non-participating life insurance policy that covers the life insured against critical illness.

2.

Definitions
Unless we say otherwise, the following are definitions of words and expressions we use in this policy.
Activities of daily living means:
(a) Washing
the ability to wash in the bath or shower (including getting into and out of the
bath or shower) or wash satisfactorily by other means;
(b) Dressing
the ability to put on, take off, secure and unfasten all garments and, as
appropriate, any braces, artificial limbs or other surgical appliances;
(c) Transferring
the ability to move from a bed to an upright chair or wheelchair and vice
versa;
(d) Mobility
the ability to move indoors from room to room on level surfaces;
(e) Toileting
the ability to use the lavatory or otherwise manage bowel and bladder
functions so as to maintain a satisfactory level of personal hygiene;
(f) Feeding
the ability to feed oneself once food has been prepared and made available.
The diagnosis of activities of daily living must be confirmed by medical examiner.
Age means the life insured’s age as at his or her last birthday, on the policy effective date.
Application means information you and/or the life insured gave to buy this basic benefit or any
supplementary benefit of this policy. Whether we accept your application depends on our
assessment of the information submitted.
Basic benefit means the basic insurance cover as shown on the schedule page or endorsement
and as stated in the basic benefit conditions of this basic benefit contract.
Basic sum insured means the sum insured of the basic benefit of the policy as may be changed or
adjusted in accordance with this basic benefit contract. It is used to calculate the benefits of this
policy.
Child means the biological or adopted (in accordance with the adoption laws of Singapore) child (but
not the step-child) of the life insured who is between the age of 30 days old and less than 18 years
old as at the date of diagnosis. For avoidance of doubt the child need not have come into existence
at point of purchase of this policy.
Current sum insured means the total maximum sum insured claimable under each of the following
benefits:
(i) For comprehensive CI benefit of this basic benefit contract, it means 100% of basic sum
insured.
(ii) For advanced stage CI booster of this basic benefit contract, it means 200% of basic sum
insured.
(iii) For CoverMeAgain Booster (Deluxe) supplementary benefit, it means 600% of the basic sum
insured, (if applicable).
Critical illness or CI means the conditions defined in Appendix A of this basic benefit contract.
Critical illness benefit or CI benefit means the amount payable in the event of a claim for CI as
determined in accordance with clause 21 of this contract.
Dates
(i) Date of event means the date of diagnosis of a critical illness or the date of ICU or HDU
admission for recovery care plus benefit. However, in the case of angioplasty and other invasive
treatment for coronary artery and certain other conditions as defined in Appendix A, it shall mean
the date of treatment.
(ii) Grace period means a period of 30 calendar days after the premium due date.
(iii) Policy anniversary means any anniversary of the policy effective date.

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A Manulife Company

(iv) Policy monthiversary means the same day of each subsequent month as the policy effective
date.
(v) Policy start date (or policy effective date) means the date when this policy takes effect, as
shown on the schedule page. If there is no day in any month or year that coincides with the
policy effective date, the policy anniversary, policy monthiversary, and policy year (where
applicable) will be the first calendar day of the next calendar month.
(vi) Policy issue date means the date when this policy is issued, as shown on the schedule page.
(vii) Policy year means a consecutive 12-month period. The first policy year begins on the policy
effective date and ends 1 day before the first policy anniversary. Each subsequent policy year
begins on the day of the policy anniversary and ends 1 day before the next policy anniversary.
(viii) Benefit start date means the date when the cover for the basic benefit or any supplementary
benefit takes effect, as shown on the schedule page.
(ix) Benefit end date means the date when the basic benefit or any supplementary benefit cover
ends, as shown on the schedule page or endorsement.
(x) Premium end date means the date on which the final premium is due and is to be paid, as
shown on the schedule page.
(xi) Premium due date means the date when the premium is due and payable according to the
payment frequency you have chosen.
(xii) Policy term means the period starting from the benefit start date up to the benefit end date, or
when this policy terminates, whichever is earlier.
Death benefit means the basic benefit as defined in clause 20.
Diagnosis or diagnosed means the definitive diagnosis made by a medical examiner, based on
radiological, clinical, histological or laboratory evidence which we accept. We may appoint another
medical examiner to examine the life insured or the evidence presented. The opinion and diagnosis
of this medical examiner will be final and binding.
Endorsement means any document issued and signed by our Chief Executive Officer to change the
terms of this policy. It forms an integral part of this policy.
Intensive care unit (ICU) means the unit of a hospital that is dedicated to the management and
monitoring of patients with severe or life-threatening conditions. High dependency unit and other
accommodation wards are not considered an intensive care unit.
High dependency unit (HDU) means a unit of a hospital for patients who do not yet require
admission into an ICU or a step-down unit where the patients have been shifted down from an ICU. It
is one level of care below that of an ICU. For avoidance of doubt, general ward is not considered as
HDU.
Hospital means an institution which:
(a) is licensed as a medical or surgical hospital in Singapore;
(b) provides 24-hour nursing services by registered nurses under the permanent supervision of a
doctor;
(c) keeps daily medical records for its patients; and
(d) is not mainly a rest or convalescent facility, a place of custodial care, a facility for the elderly or
alcoholics or drug addicts or to treat mental disorders, or a nursing home, a spa or a hydroclinic,
a hospice centre or home.
Life insured means the person named as the life insured on the schedule page or endorsement.
This is the person that this policy insures.
Medical examiner means:
(a) any medical practitioner or specialist doctor registered with a recognised degree in western
medicine who is licensed and authorised to practise in his or her country, who has the relevant
skill to provide medical or surgical services for the illness, disability or disease; or
(b) any medical practitioner or specialist doctor in Singapore we choose if you or the life insured
makes a claim for basic benefit or supplementary benefit under this policy.
This person must not be you or the life insured, or your or the life insured’s husband or wife, relative
or business partner.
Medically necessary means such treatment, procedure or other medical services which, in the
professional opinion of a medical examiner, is appropriate and consistent with the symptoms and
findings or diagnosis and direct treatment and does not adversely affect the life insured’s medical
condition. The treatment must:

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A Manulife Company

(a) be clinically appropriate, in terms of type, frequency, extent, site and duration, and considered
effective for the life insured’s medical condition;
(b) not be for the convenience of the patient or medical examiner (for example, treatment that can
be provided out of a hospital, but is provided as an inpatient treatment);
(c) be provided in accordance with generally accepted standard of medical practice and with the
medical examiner’s specialty society recommendations and established clinical protocols; and
(d) not be associated with treatment, procedure, supplies or other medical services of an
experimental or investigative nature.
For these purposes, generally accepted standard of medical practice means standards that are
based on credible scientific evidence published in peer-reviewed medical literature generally
recognized by the relevant medical community.
Permanent means a condition which is expected to last throughout the lifetime of the life insured
with no prospect of improvement, irrespective of when the policy ends.
Permanent neurological deficit means a permanent symptom of dysfunction in the nervous system
that are present on clinical examination and expected to last throughout the lifetime of the life insured.
Symptoms that are covered include numbness, paralysis, localised weakness, dysarthria (difficulty
with speech), aphasia (inability to speak), dysphagia (difficulty swallowing), visual impairment, difficulty
in walking, lack of coordination, tremor, seizures, dementia, delirium and coma.
Policy
(i) This policy is made up of the following:
a. the application form, any amendments, other forms and documents provided by you and
the life insured to apply for this policy;
b. this basic benefit contract;
c. the supplementary benefit contract (if any);
d. the schedule page;
e. the endorsement (if any);
f. any counter offers we made, and you accepted; and
g. any information and documents provided by you and the life insured with or after your
application.
(ii) We may issue revised schedule pages and/or endorsements to show changes made to this
policy. Any change to this policy must be in writing and signed by our Chief Executive Officer.
(iii) We are not bound by any representation made by or to any other person not included in this
policy.
Pre-existing condition means (a) the diagnosis of any condition; or (b) the occurrence of any of the
following events in relation to any condition, before (1) the policy issue date; or (2) the most recent
reinstatement date of this policy, whichever is the latest, which would have affected our decision to
accept your application:
(i)
such condition has presented sign or symptom which you or life insured was aware of or should
have been aware of, and should have sought medical advice or treatment;
(ii) treatment, test or investigation was recommended by or received from a medical examiner for
such condition; or
(iii) the life insured or child has arranged or received medical consultation, test or investigation for
such condition.
Premium means the amount of money that you pay in accordance with the payment frequency as
shown on the schedule page or endorsement. It consists of the premiums payable for the basic
benefit and supplementary benefit (if any) as reflected in our records.
Schedule page forms part of this policy setting out specific details.
Special CI conditions benefit means the amount payable as determined in accordance with clause
23 of this basic benefit contract.
Special CI condition(s) means any condition or illness defined and described in Appendix B of this
basic benefit contract.
Supplementary benefit means an optional insurance coverage attached to this basic benefit
contract. You can find details of supplementary benefit on schedule page or endorsement, and
terms in the supplementary benefit contract.

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A Manulife Company

Terminal illness or TI means an illness which, in the opinion of a medical examiner and with the
agreement of our appointed medical examiner, is likely to lead to death within 12 months from the
date of diagnosis.
Total premiums paid to date means and is equivalent to total premiums paid to us on the basic
benefit without interest. It will not include any premiums paid in advance.
We, our, us refers to Manulife (Singapore) Pte. Ltd.
You, your, yourself refers to the policy owner as shown in schedule page or endorsement (if there
is an assignment to change the ownership of this policy).

3.

Free-look period
(a) You may cancel this policy by writing to us within 14 days after you receive this policy.
(b) If you cancel the policy within this free-look period, we will refund all premiums paid without
interest and less any medical or other expenses we have had to pay in processing your
application.
(c) If we send this policy to you by post or email, it will be considered delivered by us and received
by you 7 days after the date of posting or email sent.

4.

Premiums
(a) The premium rate or amount for this basic benefit contract is not guaranteed. We reserve the
right to change it by giving you 30 calendar days’ notice.
(b) If there is a supplementary benefit contract attached to this policy, the premium rate or amount
includes the premium for the supplementary benefit contract.
(c) You must pay the premiums by the premium due date. It is your responsibility to pay all
premiums when due and until the premium end date as shown on the schedule page.
(d) We will not process the payment if we do not receive the full premiums for the policy.
(e) If you pay premiums by a direct debit facility (GIRO), we may charge an administrative fee for
any GIRO transaction which has not been successful.

5.

Basic sum insured
(a) The basic sum insured on the policy start date is shown on the schedule page.
(b) While this policy is in force, subject to our approval and conditions:
(i) you may ask to increase the basic sum insured within the first 6 months from the policy
issue date. If we approve the request, we will charge a higher premium based on the new
basic sum insured from the policy start date and you will have to pay us the extra
premium and interest (at a rate we decide) on the extra premium; or
(ii) you may ask to decrease the basic sum insured. If we approve the request, we will charge
you a premium based on the new basic sum insured starting from the next premium due
date.
(c) You must continue to pay premiums for the new basic sum insured.
(d) The current sum insured will be increased or decreased in accordance to the new basic sum
insured.

6.

Lapsing and reinstating the policy
(a) This policy will lapse (no cover will be provided) if you do not pay the premium by the end of the
grace period. You may ask us to reinstate the policy within 3 years from the date the policy
lapses.

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A Manulife Company

(b) We will decide whether to reinstate the policy and we must receive:
(i) evidence of the life insured’s eligibility for insurance cover (you will have to pay for any
medical reports and tests needed);
(ii) all overdue premiums which would have been paid had the policy not lapsed and the
interest we may charge on these premiums (in a way which we will decide); and
(iii) any amount you may owe us.
(c) We can include new terms and conditions on the reinstated policy.

7.

Non-disclosure
(a) Under the Insurance Act 1966 of Singapore, you and the life insured must disclose all facts you
and/or the life insured know or ought to know (including any facts which may affect our decision
to provide insurance cover under this policy).
(b) If you and/or the life insured misrepresent or fail to disclose any facts (as described above), we
may void this policy. We may determine at our sole discretion whether to refund all premiums
received without interest, less any policy debt, amounts you owe to us, medical and other
expenses incurred and to be incurred by us under this policy.

8.

Incontestability
(a) Except for fraud, non-payment of premium, any claim that is not covered under this policy, or
non-disclosure as described under clause 7, we will not contest the validity of or void this policy
after 2 years from any of the following dates, whichever is the latest:
(i) policy issue date;
(ii) the effective date of the most recent reinstatement of the policy; or
(iii) the effective date of the most recent increase in the basic sum insured of this policy (where
applicable).
(b) If we contest the validity of or void this policy, we may determine at our sole discretion whether
to refund all premiums received without interest, less any policy debt, amounts you owe to us,
medical and other expenses incurred and to be incurred by us under this policy.

9.

Suicide
(a) If the life insured dies from suicide, whether sane or insane, within 1 year from the policy issue
date, we will not pay the death benefit and will refund all premiums paid without interest and
less any policy debt, medical or other expenses we have had to pay in connection with this
policy and this policy will end.
(b) If the life insured dies from suicide, whether sane or insane, within 1 year from the date of the
most recent reinstatement of the policy, we will not pay the death benefit and will refund all
premiums paid from the start date of the most recent reinstatement without interest and less any
policy debt, medical or other expenses we have had to pay in connection with this policy and
this policy will end.
(c) If the life insured dies from suicide, whether sane or insane, after 1 year from the policy issue
date or the date of the most recent reinstatement of this policy but before 1 year from the date
of any increase to the premium resulting from an increase in basic sum insured, we will not pay
the increased death benefit and will refund the additional premiums paid for the increase in the
basic sum insured, without interest and less any policy debt, medical or other expenses we
have had to pay in connection with the request to increase the basic sum insured and this policy
will end.

10.

Making a claim
(a) You or the person making a claim must give us notice in writing of the claim within 30 days of the
event (or as soon as possible).

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A Manulife Company

(b) You or the person making the claim must give us, 30 days after giving notice of the claim (or as
soon as possible), evidence of the event. We must receive:
(i) this policy;
(ii) proof of ownership or entitlement of the person making the claim;
(iii) the birth certificate, identification documents or other relevant documents we may need for
the life insured or the person making the claim;
(iv) the completed claim form and the medical report;
(v) proof of the event giving rise to the claim under this policy; and
(vi) any other document we may ask for so we can process the claim.
(c) We may appoint another medical examiner to examine the life insured in Singapore or the
evidence presented. Our determination of the claim will consider all medical information received
as well as the opinion and diagnosis of any medical examiner(s) appointed by us. A final
determination by us on this basis will be binding on the life insured and us. You will have to pay
any travel, accommodation and other costs, but not the cost of the examination carried out by our
appointed medical examiner.
(d) We will not be legally responsible if you or the person making the claim fails to provide the
documents which we need to check the claim or entitlement under this policy.
(e) If the age or sex (or both) were incorrect on the application, we will change the benefits due
under this policy to those which would have been appropriate had the age or sex been correctly
stated.
(f)

If we make a payment under this policy, this will fulfill our duty under this policy and we will have
no further responsibility to you or any other person for the claim. This will apply to any action,
claim, proceedings, cost, damages, demand, interest, liability, loss, penalty, tax and expenses
you or the person making the claim may suffer or have to pay as a result of or in connection with
the claim.

(g) We can ask you or the person claiming to repay any amount which we have paid as a result of
any mistake or oversight (including on our part or on the part of our employees or
representatives).

11.

Residence, travel and occupation
There are no restrictions on where the life insured stays, travels or works, unless we say otherwise.

12.

Non-participating
This policy does not participate or share in the profits of our participating fund. When you ask to end
the policy or if the policy lapses or ends, it will have no cash value.

13.

Assignment
(a) While this policy is in force and during the lifetime of the life insured, you may use your policy
as security or collateral or you may fully transfer the benefits of the policy to another person or
organisation.
(b) You must give us:
(i) written notice of the assignment; and
(ii) a copy of the assignment.
(c) We will only treat the notice of assignment as received when it is delivered to our registered
address. If you provide this notice through our or your representative, we will only treat it as
received when the representative delivers it to our registered address.
(d) By acknowledging the notice of assignment, we are not responsible for whether the assignment
is valid or legally enforceable.

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14.

Termination
This policy will automatically terminate on the earliest occurrence of any one of the following events:
(a)
(b)
(c)
(d)
(e)

15.

when we receive your written notice to terminate this policy;
when this policy lapses or terminates pursuant to the terms and conditions of this policy;
when the life insured dies;
on the benefit end date of this basic benefit contract; or
when the current sum insured is fully paid out.

Governing law
This policy is subject to, governed by and construed in accordance with the laws of Singapore. The
Singapore courts shall have exclusive jurisdiction over this policy.

16.

Contracts (Rights of Third Parties) Act 2001 of Singapore
A person who is not directly involved in this policy will have no rights under the Contracts (Rights of
Third Parties) Act 2001 of Singapore to enforce any of the terms.

17.

Policy transactions
If you want to carry out any transaction under this policy, you must use the forms we provide you.
You must tell us about any change in your personal information, especially your correspondence or
residential address including your email and mobile number.

18.

Currency
Unless otherwise specifically prescribed in this policy, all premiums and benefits quoted in this policy
are in Singapore dollars. Payments to us under this policy or payments which we make under this
policy will also be in Singapore dollars.

19.

Policy Owners’ Protection Scheme
“This policy is protected under the Policy Owners’ Protection Scheme which is administered by the
Singapore Deposit Insurance Corporation (SDIC). Coverage for your policy is automatic and no
further action is required from you. For more information on the types of benefits that are covered
under the scheme as well as the limits of coverage, where applicable, please contact us or visit the
Life Insurance Association of Singapore (LIA) or SDIC websites (www.lia.org.sg or www.sdic.org.sg).”

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A Manulife Company

Basic benefit conditions
20.

Death benefit
(a) While this policy is in force, if the life insured dies, we will pay 100% of the total premiums
paid to date less any policy debt and claims paid prior to the death of the life insured. Upon the
payment of the death benefit, this policy will end.
(b) Prior to the death claim, if a claim payout has been made for any of the benefits covered under
the policy that is more than the total premiums paid to date then the policy will terminate upon
such payment and no death benefit shall be payable.

21.

Comprehensive CI benefit
(a) While this policy is in force, if the life insured is diagnosed with an early, intermediate or
advanced (including extended advanced) stage CI, subject to our approval, we will pay the
comprehensive CI benefit:
Critical Illness Stage
Early Stage
Intermediate Stage
Advanced Stage

CI benefit
100% of the basic sum insured
100% of the basic sum insured
100% of the basic sum insured

(b) The payment of the comprehensive CI benefit is subject to the following limits of compensation:
(i) the comprehensive CI benefit is only payable once under the basic benefit contract;
(ii) the maximum amount payable of total claims arising from comprehensive CI benefit during
the policy term is 100% of the basic sum insured;
(iii) if there is more than one CI diagnosed on the same date, we will pay the highest CI benefit
of all the critical illnesses diagnosed at that date;
(iv) if the CI is diagnosed as the cause of terminal illness or loss of independent existence, the
claim can only be submitted under the diagnosed CI but not terminal illness or loss of
independent existence;
(v) For terminal illness or loss of independent existence, if the total CI benefit paid have
reached 100% of the basic sum insured, no benefit is payable for future CI benefit under
these two CI conditions;
(vi) the most we will pay for an early stage CI condition under this policy and all policies we have
issued covering the same life insured shall not exceed $250,000;
(vii) the most we will pay for an intermediate stage CI condition under this policy and all policies
we have issued covering the same life insured shall not exceed $350,000; and
(viii) the most we will pay in total for comprehensive CI benefit under this policy and all policies
we have issued covering the same life insured for any (i) critical illness benefits; (ii) waiver
of premium benefits due to CI and TI; and (iii) TI benefits shall not exceed $2 million (TI/CI
limit). Out of the TI/CI limit, the total TI benefits under such policies shall not exceed $1
million. When we make any benefit payments for such insured events, we will reduce the
TI/CI limit by the amount we have paid respectively, where applicable.
(c) After the payment of the comprehensive CI benefit, the current sum insured will be reduced
by the amount paid for that comprehensive CI benefit.
(d) If the amount paid under this benefit is equivalent to the current sum insured and if the total
premiums paid to date is higher than the current sum insured, we will instead pay the total
premiums paid to date less any policy debt and all claims paid by us under this policy (including
claims that have not reduced the current sum insured) as this benefit and this policy will end.
This amount paid will not affect the limits stated in clause 21(b)(viii).
22.

Advanced stage CI booster
(a) While this policy is in force, if the life insured is diagnosed with an advanced stage CI (including
extended advanced stage CI), subject to our approval, we will pay 200% of the basic sum
insured.
(b) We will only pay this benefit once under this policy.

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A Manulife Company

(c) After the payment of the advanced stage CI booster, the current sum insured will be reduced
by the amount paid under this benefit.
(d) If the amount paid under this benefit is equivalent to the current sum insured, this policy will
end upon such payment.

23.

Special CI conditions benefit
While this policy is in force, if the life insured is diagnosed with a special CI condition before the
policy anniversary immediately after the life insured’s 85th birthday for non-juvenile specific
conditions or 18th birthday for juvenile specific conditions, subject to our approval, we will pay 20% of
the basic sum insured as special CI conditions benefit and the below will apply:
(a) we will only pay for each covered special CI condition once. If the life insured is diagnosed
with the same covered special CI condition again, we will not pay for another claim for the same
special CI condition;
(b) we will pay the special CI conditions up to 6 claims provided each of these claims is for a
different covered special CI condition;
(c) the most we will pay under this policy and all other policies we have issued covering the same
life insured is $25,000 for each claim, less any policy debt, amounts you owe to us, medical and
other expenses incurred and to be incurred by us under this policy;
(d) payment of special CI conditions benefit will not reduce the current sum insured.

24.

Serious illness of a child benefit
While this policy is in force, if the life insured’s child is diagnosed with an advanced stage CI, subject
to our approval, we will pay $10,000 and the below will apply:
(a) the most we will pay for serious illness of a child benefit under this policy is $20,000 and
provided that each claim must be on a different child;
(b) the most we will pay for serious illness of a child benefit under this policy and all other policies
we have issued covering the same child shall not exceed $40,000 per child and $80,000 in total
per family; and
(c) payment of serious illness of a child benefit will not reduce the current sum insured.

25.

Recovery care plus benefit
(a) While this policy is in force, if the life insured stays in both the ICU and HDU together (not only
the HDU admission alone) for a total of 4 days or more from the date of admission, in 1 hospital
admission before the policy anniversary immediately after the life insured’s 85th birthday,
subject to our approval, we will pay 20% of the basic sum insured, subject to a maximum of
$25,000.
(b) The stay in ICU or HDU must be confirmed as medically necessary.
(c) For avoidance of doubt, we will pay this benefit in addition to comprehensive CI benefit if the
ICU or HDU admission is due to a CI condition (as defined in Appendix A).
(d) Payment of recovery care plus benefit will not reduce the current sum insured.
(e) We will pay this benefit only once under this policy.
(f)

The most we will pay for this policy and all other policies we have issued covering the same life
insured for this benefit (including similar benefits provided under any benefit name or
specification in other policies), is subject to a maximum of $25,000.

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A Manulife Company

26.

Survival period
For the payment of basic benefit(s) under this policy, the life insured must survive for at least 7
days from the date of event. Otherwise, only the death benefit shall be payable, and the policy will
end upon payment of death benefit.

27.

Waiting period
(a) We will not cover and pay any stage of the following CI for the life insured if the life insured is
diagnosed within 90 calendar days from the policy issue date or the most recent reinstatement
date of this policy, whichever is the latest:
(i)
major cancer;
(ii) heart attack of specified severity;
(iii) other serious coronary artery disease;
(iv) the date of diagnosis of any CI leading to performance of coronary artery bypass surgery;
(v) the date of diagnosis of any CI leading to performance of angioplasty and other invasive
treatment for coronary artery; and/or
(vi) any of the special CI conditions.
(b) Any increase in basic sum insured within 90 calendar days from the date the life insured is
diagnosed with any CI or conditions stated in subclause (a) above will be fully excluded while
determining the amount for comprehensive CI benefit and special CI conditions benefit. We
will determine the amount for comprehensive CI benefit and special CI conditions benefit as
if such increase in basic sum insured had never occurred.
(c) We will not cover and pay the recovery care plus benefit if the life insured is diagnosed with
an illness which directly or indirectly, partly or wholly, results in ICU or HDU admission, and the
diagnosis is within 90 days from the policy issue date or the most recent reinstatement date of
this policy, whichever is the latest.

28.

Exclusions
(a) We will not cover and pay the comprehensive CI benefit, advanced stage CI booster and
special CI conditions benefit if the illness or condition is caused by or arises from any one of
the following:
(i) any self-inflicted injury, provoked assault or attempted suicide, whether the life insured is
sane or insane;
(ii) the life insured is being under the influence of any narcotic, alcohol, gas or fumes, voluntarily
taken, administered, absorbed or inhaled or drugs not prescribed by a medical examiner;
(iii) infection from any Human Immunodeficiency Virus (HIV), Acquired Immunodeficiency
Syndrome (AIDS) or any AIDS-related condition unless such infection can fully fulfil the
definition of HIV Due to Blood Transfusion and Occupationally Acquired HIV under item 15
of Appendix A in this basic benefit contract;
(iv) donation of any of the life insured’s organs; or
(v) any pre-existing condition.
(b) We will not cover and pay the serious illness of the child benefit, if the illness of the child is
caused directly or indirectly, wholly or partly by any pre-existing condition, before:
(i) the policy issue date; or
(ii) the most recent reinstatement date of this policy,
whichever is the latest, unless the condition or illness had been declared and accepted by us.
(c) We will not cover and pay the recovery care plus benefit if the illness or condition of the life
insured is caused by or arises directly or indirectly, wholly or partly from any one of the following:
(i) any self-inflicted injury, provoked assault or attempted suicide, whether the life insured is
sane or insane;
(ii) the life insured is being under the influence of any narcotic, alcohol, gas or fumes,
voluntarily taken, administered, absorbed or inhaled or drugs not prescribed by a medical
examiner;
(iii) infection from any Human Immunodeficiency Virus (HIV), Acquired Immunodeficiency
Syndrome (AIDS) or any AIDS-related condition unless such infection can fully fulfil the
definition of HIV Due to Blood Transfusion and Occupationally Acquired HIV under item 15
of Appendix A in this basic benefit contract;
(iv) donation of any of the life insured’s organs;

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(v) any pre-existing condition;
(vi) overseas medical treatment;
(vii) pregnancy or complications from pregnancy, childbirth, abortion, miscarriage, prenatal or
postnatal care, birth control, sterilisation and treatment or tests pertaining to fertility;
(viii) psychological disorders, personality disorders, mental conditions or behavioural disorders,
including any addiction or dependence arising from these disorders such as gambling or
gaming addiction;
(ix) elective cosmetic or plastic surgery for purposes of beautification except constructive surgery
to treat functional defect due to Injury sustained;
(x) treatments for obesity, weight reduction or weight improvement;
(xi) medical or surgical procedures which are experimental in nature or not generally accepted
as standard medical treatment by the medical profession;
(xii) sex-change operations;
(xiii) war or any act related to it, or service in the armed forces or in a civil defence force supporting
any country at war;
(xiv) riot, insurrection, civil commotion, strikes, or terrorist activities except as a victim; or
(xv) injuries arising while engaging in hazardous sports such as speed racing (boat, horse or
automobile), mountaineering or rock climbing necessitating the use of guides or ropes, skiing
or any kind including jet-ski, skating sport, parachuting (unless trying to save human life),
ballooning, hang gliding, bungee-jumping, and underwater activities involving the use of
breathing apparatus.

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Manulife CI FlexiCare (Deluxe)
Appendix A
Critical Illness Definitions
Conditions
1. Alzheimer's
Disease/Sever
e Dementia

2. Persistent
Vegetative
State (Apallic
Syndrome)

Early Stage
Diagnosis of Dementia
including Alzhemier’s
Disease
Diagnosis of dementia by
neurological assessment
by an appropriate
specialist confirming
cognitive impairment
characterized by a Mini
Mental State Examination
score of 24 or less out of
30 (20 to 24 out of 30) as
assessed by 2
neuropsychometric tests
performed 6 months apart
which clearly define the
severity of the impairment.
The life insured must
have been placed on
disease modifying
treatment prescribed by a
specialist and must be
under the continuous care
of a specialist.

Intermediate Stage
Moderate to Severe
Alzheimer’s Disease
A definite diagnosis of
Alzheimer’s disease or
dementia due to
irreversible organic brain
disorders by a consultant
neurologist. The Minimental exam score must
be less than 20 out of 30
as assessed by two (2)
neuropsychometric tests
performed six (6) months
apart which clearly define
the severity of the
impairment. There must
also be permanent clinical
loss of the ability to do all
the following:
• Remember;
• Reason; and
• Perceive, understand,
express and give effect
to ideas.

The following are
excluded:
• Non-organic diseases
such as neurosis and
psychiatric illnesses; and
• Alcohol related brain
damage.

This diagnosis must be
supported by the clinical
confirmation of an
appropriate consultant and
supported by our
appointed medical
examiner.

Coverage on Early Stage
Alzheimer expires on the
policy anniversary on
which the life insured is
Age 85 Last Birthday.

The following are
excluded:
• Non-organic diseases
such as neurosis and
psychiatric illnesses;
and
• Alcohol related brain
damage.
Locked in syndrome
Condition in which a
person is aware but
cannot move or
communicate verbally due
to complete paralysis of all
voluntary muscles in the
body except for vertical
eye movements and
blinking. There should be
evidence of quadriplegia
and inability to speak. This
diagnosis must be
supported by evidence of
infarction of the ventral
pons and EEG indicating
that the person is not

Akinetic Mutism
Organic brain damage
which results in a person
being unable to talk or
move despite the fact that
they appear alert at times.
This diagnosis must be
supported by evidence
showing organic brain
damage and definitely
confirmed by a consultant
neurologist holding such
an appointment at an
approved hospital. This
condition has to be
medically documented for
a continuous period of at

Advanced Stage1
Alzheimer’s Disease /
Severe Dementia
Deterioration or loss of
cognitive function 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 insured. This
diagnosis must be
supported by the clinical
confirmation of an
appropriate consultant and
supported by our
appointed medical
examiner.
The following are
excluded:
• Non-organic diseases
such as neurosis and
psychiatric illnesses;
and
• Alcohol related brain
damage.

Persistent Vegetative
State (Apallic Syndrome)
Universal necrosis of the
brain cortex with the
brainstem intact. This
diagnosis must be
definitely confirmed by a
consultant neurologist
holding such an
appointment at an
approved hospital. This
condition has to be
medically documented for
at least one (1) month.

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Conditions

Early Stage
least one 1 month.
Akinetic mutism because
of psychological reasons is
excluded.

3. Irreversible
Aplastic
Anaemia

Pure Red Cell Aplasia
(PRCA)
Complete or nearly
complete cessation of red
cell production in the bone
marrow without effects on
other hematopoietic cells.
The condition must have
resulted in reversible but
severe anaemia, meeting
both of the following
criteria:
• Hemoglobin <4 g/dL or
Hematocrit <10
percent;
• Absolute reticulocyte
count <10,000/microL
or reticulocyte
percentage <0.5
percent;
The diagnosis must be
confirmed by a specialist
in the relevant field based
on a bone marrow biopsy.

4. Severe
Bacterial
Meningitis

Bacterial Meningitis with
full recovery
Bacterial infection resulting
in severe inflammation of
the membranes of the
brain or spinal cord which
requires hospitalisation.
This diagnosis must be
confirmed by:
• The presence of
bacterial infection in
cerebrospinal fluid by
lumbar puncture; and
• A consultant neurologist.
Bacterial Meningitis in the
presence of HIV infection
is excluded.

Intermediate Stage
unconscious. The
diagnosis must be
definitely confirmed by a
consultant neurologist
holding such an
appointment at an
approved hospital. This
condition has to be
medically documented for
a continuous period at
least one 1 month.
Reversible Aplastic
Anaemia
Acute reversible bone
marrow failure confirmed
by biopsy which results in
anemia, neutropenia and
thrombocytopenia
requiring treatment with
any one (1) of the
following:
• Blood product
transfusion; or
• Bone marrow
stimulating agents; or
• Immunosuppressive
agents; or
• Bone marrow or
haematopoietic stem
cell transplantation.
The diagnosis must be
confirmed by a specialist
in the relevant field.

Advanced Stage1

Irreversible Aplastic
Anaemia
Chronic persistent and
irreversible bone marrow
failure, confirmed by
biopsy, which results in
anaemia, neutropenia and
thrombocytopenia
requiring treatment with at
least one (1) of the
following:
• Blood product
transfusion;
• Bone marrow
stimulating agents;
• Immunosuppressive
agents; or
• Bone marrow or
haematopoietic stem
cell transplantation.
The diagnosis must be
confirmed by a
haematologist.

Bacterial Meningitis with
Reversible Neurological
Deficit
Bacterial infection resulting
in severe inflammation of
the membranes of the
brain or spinal cord
resulting in reversible
neurological deficit, that
resolves fully within 6
weeks of the confirmed
meningitis infection.

Severe Bacterial
Meningitis
Bacterial infection resulting
in severe inflammation of
the membranes of the
brain or spinal cord
resulting in significant,
irreversible and
permanent neurological
deficit. The neurological
deficit must persist for at
least 6 weeks.

This diagnosis must
be confirmed by:
• The presence of
bacterial infection in
cerebrospinal fluid by
lumbar puncture and
the offending organism
must be identified; and
• A consultant
neurologist.

This diagnosis must be
confirmed by:
• The presence of
bacterial infection in
cerebrospinal fluid by
lumbar puncture; and
• A consultant neurologist.
Bacterial Meningitis in the
presence of HIV infection
is excluded.

Bacterial Meningitis in the
presence of HIV infection
is excluded.

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Conditions
5. Benign
Brain Tumour

Early Stage
Surgical Removal of
Pituitary Tumour (by
Transphenoidal/Transna
sal Hypophysectomy)
The actual undergoing of
surgical removal of a
pituitary tumour by
transphenoidal /
transnasal
hypophysectomy
necessitated as a result of
symptoms associated with
increased intracranial
pressure caused by the
tumour or where surgical
removal is considered
necessary upon the advice
of an appropriate specialist
or neurosurgeon. The
presence of the underlying
tumour must be confirmed
by imaging studies such
as CT scan or MRI.
Removal of the following
are excluded:
• Cysts;
• Abscess;
• Angioma;
• Granulomas;
• Vascular Malformations;
• Haematomas; and
• Tumours of the spinal
cord and skull base.

6. Blindness
(Irreversible
Loss of Sight)

Corneal Transplant
The receipt of a transplant
of a whole cornea due to
irreversible scarring with
resulting reduced visual
acuity which cannot be
corrected with other
methods.

Intermediate Stage
Surgical Removal of
Pituitary Tumour (by
Open Craniotomy)
The actual undergoing of
total surgical removal of a
pituitary tumour by open
craniotomy necessitated
as a result of symptoms
associated with increased
intracranial pressure
caused by the tumour or
where surgical removal is
considered necessary
upon the advice of an
appropriate specialist or
neurosurgeon. The
presence of the underlying
tumour must be confirmed
by imaging studies such
as CT scan or MRI.
Surgical removal of the
pituitary by transphenoidal
hypophysectomy is
excluded.
Removal of the following
are excluded:
• Cysts;
• Abscess;
• Angioma;
• Granulomas;
• Vascular Malformations;
• Haematomas; and
• Tumours of the spinal
cord and skull base.

Irreversible Loss of
Sight in One Eye
Permanent and
irreversible loss of sight in
one (1) eye as a result of
illness or accident to the
extent that even when
tested with the use of
visual aids, vision is
measured at 6/60 or worse
in one (1) eye using a
Snellen eye chart or
equivalent test, or visual
field of 20 degrees or less
in one (1) eye. The
blindness must be
confirmed by an
ophthalmologist.
Blindness resulting from
alcohol or drug misuse will
be excluded.
The blindness must not be
correctable by surgical
procedures, implants or
any other means.

Advanced Stage1
Benign Brain Tumour
Benign brain tumour
means a non-malignant
tumour located in the
cranial vault and limited to
the brain, meninges or
cranial nerves where all of
the following conditions
are met:
• It has undergone
surgical removal or, if
inoperable, has caused
a permanent
neurological deficit;
and
• Its presence must be
confirmed by a
neurologist or
neurosurgeon and
supported by findings on
Magnetic Resonance
Imaging, Computerised
Tomography, or other
reliable imaging
techniques.
The following are
excluded:
• Cysts;
• Abscess;
• Angioma;
• Granulomas;
• Vascular Malformations;
• Haematomas; and
• Tumours of the pituitary
gland, spinal cord and
skull base.
Blindness (Irreversible
Loss of Sight)
Permanent and
irreversible loss of sight in
both eyes as a result of
illness or accident to the
extent that even when
tested with the use of
visual aids, vision is
measured at 6/60 or worse
in both eyes using a
Snellen eye chart or
equivalent test, or visual
field of 20 degrees or less
in both eyes. The
blindness must be
confirmed by an
ophthalmologist.
The blindness must not be
correctable by surgical
procedures, implants or
any other means.

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Conditions
7. Coma

Early Stage
Coma for 48 hours
Coma that persists for at
least forty-eight (48)
continuous hours. This
diagnosis must be
supported by evidence of
all of the following:
• No response to external
stimuli for at least fortyeight (48) hours;
• The use of life support
measures to sustain life;
and
• Brain damage resulting
in permanent
neurological deficit
which must be assessed
at least thirty (30) days
after the onset of the
coma.
For the above definition,
medically induced coma
and coma resulting directly
from alcohol or drug abuse
are excluded.

Intermediate Stage
Severe Epilepsy
Severe epilepsy confirmed
by all of the following:
• diagnosis made by a
specialist in the relevant
field by the use of
electroencephalography
(EEG), magnetic
resonance imaging
(MRI), position emission
tomography (PET) or
any other appropriate
diagnostic test that is
available,
• there must be
documentation of
recurrent unprovoked
tonic-clonic or grand mal
seizures of more than 5
attacks per week, and
be known to be resistant
to optimal therapy as
confirmed by drug
serum-level testing, and
• the life insured must
have been taking at
least two (2) prescribed
antiepileptic
(anticonvulsant)
medications for at least
six (6) months on the
recommendation of a
specialist in the relevant
field.

Advanced Stage1
Coma for 96 hours
A coma that persists for at
least ninety-six (96) hours.
This diagnosis must be
supported by evidence of
all of the following:
• No response to external
stimuli for at least ninetysix (96) hours;
• Life support measures
are necessary to sustain
life; and
• Brain damage resulting
in permanent
neurological deficit
which must be assessed
at least thirty (30) days
after the onset of the
coma.
For the above definition,
medically induced coma
and coma resulting directly
from alcohol or drug abuse
are excluded.

Febrile or absence (petit
mal) seizures alone will
not satisfy the requirement
of this definition.
Coma for 72 hours
Coma that persists for at
least seventy-two (72)
continuous hours. This
diagnosis must be
supported by evidence of
all of the following:
• no response to external
stimuli for at least
seventy-two (72) hours;
and
• the use of life support
measures to sustain life;
and
• brain damage resulting
in permanent
neurological deficit
which must be assessed
at least thirty (30) days
after the onset of the
coma.

For the above definition,

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Conditions

Early Stage

8. Coronary
Artery Bypass Surgery

Transmyocardial Laser
Therapy
The undergoing of
transmyocardial laser
therapy for the treatment
of refractory angina. This
benefit is not payable in
addition to any other form
of cardiac
revascularization
treatment including CABG
and coronary angioplasty.

9. Deafness
(Irreversible
Loss of
Hearing)

Partial Loss of Hearing
Permanent binaural
hearing loss with the loss
of at least 60 decibel in all
frequencies of hearing as
a result of illness or
accident. The hearing loss
must be established by a
specialist in the relevant
field and supported by an
objective diagnostic test to
indicate the quantum loss
of hearing.
Cavernous sinus
thrombosis surgery
The actual undergoing of a
surgical drainage for
cavernous sinus

Intermediate Stage
medically induced coma
and coma resulting directly
from alcohol or drug abuse
are excluded.
Port Access or Key hole
Cardiac Surgery
Coronary Artery Bypass
Grafting or Coronary
artherectomy performed
by port access procedures
to correct blockages in the
coronary arteries or use
Enhanced External
Counterpulsation Device
for intractable angina not
responsive to medial
therapy and not amenable
to other surgical or
percutaneous techniques
will also be covered under
this benefit. All
intravascular procedures
and MIDCAB surgery are
excluded. All
percutaneous
intravascular techniques
are excluded. The
diagnosis of significant
coronary artery obstruction
and the necessity of the
above procedures must be
certified by a Specialist
and also must be
supported by angiographic
evidence. When Early
Coronary Arterial Disease
(Early Stage Critical
Illness benefit) or
Moderate Coronary Artery
Disease (Intermediate
stage Critical Illness) has
been claimed under this
policy, the benefit Port
Access or Key hole
Cardiac Surgery will no
longer be payable.
Cochlear Implant
Surgery
The actual undergoing of a
surgical cochlea implant
as a result of permanent
damage to the cochlea or
auditory nerve. The
surgical procedure as well
as the insertion of the
implant must be certified to
be absolutely necessary
by a specialist in the
relevant field.

Advanced Stage1

Coronary Artery By-Pass
Surgery
The actual undergoing of
open-chest surgery or
Minimally Invasive Direct
Coronary Artery Bypass
surgery to correct the
narrowing or blockage of
one (1) or more coronary
arteries with bypass grafts.
This diagnosis must be
supported by angiographic
evidence of significant
coronary artery obstruction
and the procedure must be
considered medically
necessary by a consultant
cardiologist.
Angioplasty and all other
intra arterial, catheter
based techniques,
‘keyhole’ or laser
procedures are excluded.

Deafness (Irreversible
Loss of Hearing)
Total and irreversible loss
of hearing in both ears as
a result of illness or
accident. This diagnosis
must be supported by
audiometric and sound
threshold tests provided
and certified by an Ear,
Nose, Throat (ENT)
specialist.
Total means “the loss of at
least 80 decibels in all
frequencies of hearing”.
Irreversible means “cannot
be reasonably restored to

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Conditions

Early Stage
thrombosis. The presence
of Cavernous Sinus
Thrombosis as well as the
requirement for surgical
intervention must be
certified to be absolutely
necessary by a specialist
in the relevant field.

Intermediate Stage

10. End Stage
Liver Failure

Liver Surgery
Partial hepatectomy of at
least one (1) entire lobe of
the liver that has been
found necessary as a
result of illness or accident
of the life insured.

Liver Cirrhosis
Cirrhosis of the liver with a
HAI-Knodell Scores of 6
and above as evident by
liver biopsy. The
diagnosis must be
unequivocally confirmed
by a specialist in the
relevant field and based
on the histological findings
of the liver biopsy.

Liver disease secondary to
alcohol or drug abuse is
excluded.

11. End Stage
Lung Disease

Severe Asthma
Evidence of an acute
attack of Severe asthma
with persistent status
asthmaticus that requires
hospitalization and
endotracheal intubation
and mechanical ventilation
for a continuous period of
at least four (4) hours on
the advice of a specialist in
the relevant field.
Insertion of a Vena Cava
Filter
The surgical insertion of a
vena cava filter after there
has been documented
proof of recurrent
pulmonary emboli. The
need for the insertion of a
vena cava filter must be
certified to be absolutely
necessary by a specialist
in the relevant field.

Liver disease secondary to
alcohol or drug abuse is
excluded.
Surgical Removal of One
Lung
Complete surgical removal
of a lung as a result of an
illness or an accident of
the life insured.
Partial removal of a lung is
not included in this benefit.

Advanced Stage1
at least 40 decibels by
medical treatment, hearing
aid and/or surgical
procedures consistent with
the current standard of the
medical services available
in Singapore after a period
of 6 months from the date
of intervention.”
End Stage Liver Failure
End stage liver failure as
evidenced by all of the
following:
• Permanent jaundice;
• Ascites; and
• Hepatic
encephalopathy
Liver disease secondary to
alcohol or drug abuse is
excluded.

End Stage Lung Disease
End stage lung disease,
causing chronic respiratory
failure. This diagnosis
must be supported by
evidence of all of the
following:
• FEV1 test results which
are consistently less
than 1 litre;
• Permanent
supplementary oxygen
therapy for hypoxemia;
• Arterial blood gas
analyses with partial
oxygen pressures of
55mmHg or less (PaO2
<=55mmHg); and
• Dyspnea at rest.
The diagnosis must be
confirmed by a respiratory
physician.

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Conditions
12. Fulminant
Hepatitis

Early Stage
Biliary Tract
Reconstruction Surgery
Biliary tract reconstruction
surgery involving
choledochoenterostomy
(choledochojejunostomy or
choledochoduodenostomy
) for the treatment of biliary
tract disease, including
biliary atresia, that is not
amenable to other surgical
or endoscopic measures.
The procedure must be
considered the most
appropriate treatment by a
specialist in hepatobiliary
disease. This benefit is not
payable for the
consequences of gall
stone disease or
cholangitis.

13. Heart
Attack of
Specified
Severity

Cardiac Pacemaker
Insertion
Insertion of a permanent
cardiac pacemaker that is
required as a result of
serious cardiac arrhythmia
which cannot be treated
via other means. The
insertion of the cardiac
pacemaker must be
certified to be absolutely
necessary by a specialist
in the relevant field.
Pericardiectomy
The undergoing of a total
or partial pericardiectomy
as a result of pericardial
disease. The surgical
procedure must be
certified to be absolutely
necessary by a specialist
in the relevant field.

Intermediate Stage
Chronic Primary
Sclerosing Cholangitis
This benefit is payable for
chronic primary sclerosing
cholangitis confirmed on
cholangiogram imaging
confirming progressive
obliteration of the bile
ducts. The diagnosis
must be made by a
gastroenterologist and the
condition must have
progressed to the point
where there is permanent
jaundice.
The benefit is payable only
where there is a need
immunosuppressive
treatment, drug therapy for
intractable pruritis or if
biliary tract obliteration has
required balloon dilation or
stenting of the bile ducts.
Biliary tract sclerosis or
obstruction as a
consequence of biliary
surgery, gall stone
disease, infection,
inflammatory bowel
disease or other
secondary precipitants is
excluded.
Cardiac Defibrillator
Insertion
Insertion of a permanent
cardiac defibrillator as a
result of cardiac
arrhythmia which cannot
be treated via any other
method. The surgical
procedure must be
certified to be absolutely
necessary by a specialist
in the relevant field.
Early Cardiomyopathy
The unequivocal
diagnosis of
cardiomyopathy which has
resulted in the presence of
permanent physical
impairments to at least
Class III of the New York
Heart Association (NYHA)
classification of Cardiac
Impairment.
The diagnosis must be
confirmed by a specialist
in the relevant field.
Cardiomyopathy that is
directly related to alcohol
misuse is excluded.
The NYHA Classification
of Cardiac Impairment
(Source: “Current Medical

Advanced Stage1
Fulminant Hepatitis
A submassive to massive
necrosis of the liver by the
Hepatitis virus, leading
precipitously to liver
failure.
This diagnosis must be
supported by all of the
following:
• Rapid decreasing of
liver size as confirmed
by abdominal
ultrasound;
• Necrosis involving entire
lobules, leaving only a
collapsed reticular
framework;
• Rapid deterioration of
liver function tests;
• Deepening jaundice;
and
• Hepatic
encephalopathy.

Heart Attack of Specified
Severity
Death of heart muscle due
to ischaemia, that is
evident by at least three of
the following criteria
proving the occurrence of
a new heart attack:
• History of typical chest
pain;
• New characteristic
electrocardiographic
changes; with the
development of any of
the following: ST
elevation or depression,
T wave inversion,
pathological Q waves or
left bundle branch block;
• Elevation of the cardiac
biomarkers, inclusive of
CKMB above the
generally accepted
normal laboratory levels
or Cardiac Troponin T or
I at 0.5ng/ml and above;
• Imaging evidence of new
loss of viable
myocardium or new
regional wall motion
abnormality. The
imaging must be done

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Conditions

14. Open
Chest Heart
Valve Surgery

15. HIV Due to
Blood
Transfusion
and
Occupationall
y Acquired
HIV

Early Stage

Percutaneous
Valvuloplasty or
Valvotomy
The actual undergoing of
simple percutaneous
transvascular balloon
valvuloplasty or valvotomy
without any deployment of
device or prosthesis
necessitated by damage of
the heart valve as
confirmed by a specialist
in the relevant field and
established by a cardiac
echocardiogram.
All other surgical
corrective methods will be
excluded.

HIV Due to Assault
Infection with the Human
Immunodeficiency Virus
(HIV) which resulted from
a physical or sexual
assault occurring after the
date of issue, date of
endorsement or date of
reinstatement of this
policy, whichever is the
later, provided that all the
following conditions are
met:
• The incident must be
reported to the
appropriate authority
and that a criminal case
must be opened; and
• Proof of the assault
giving rise to the
infection must be
reported to us within
thirty (30) days of the

Intermediate Stage
Diagnosis & Treatment –
39th Edition”):
Class I: No limitation of
physical activity. Ordinary
physical activity does not
cause undue fatigue,
dyspnea, or anginal pain.
Class II: Slight limitation of
physical activity. Ordinary
physical activity results in
symptoms.
Class III: Marked limitation
of physical activity.
Comfortable at rest, but
less than ordinary activity
causes symptoms.
Class IV: Unable to
engage in any physical
activity without discomfort.
Symptoms may be present
even at rest.
Valve Replacement or
Valve Repair with Device
The actual undergoing of a
heart valve replacement
with a mechanical or
biological tissue valve, or a
heart valve repair with
deployment of device or
prosthesis. It must be
deemed medically
necessary by a specialist
in the relevant field and
confirmed by a cardiac
echocardiogram.
All other surgical
corrective methods or
technique involving a
thoracotomy will be
excluded from this benefit.
HIV Due to Organ
Transplant
Infection with the Human
Immunodeficiency Virus
(HIV) through an organ
transplant, provided that
all of the following
conditions are met:
• The organ transplant
was medically
necessary or given as
part of a medical
treatment; and
• The organ transplant
was received in
Singapore after the date
of issue, date of
endorsement or date of
reinstatement of this
policy, whichever is the
later; and
• The source of the
infection is established
to be from the Institution

Advanced Stage1
by cardiologist specified
by us.
For the above definition,
the following are excluded:
• Angina;
• Heart attack of
indeterminate age; and
• A rise in cardiac
biomarkers or Troponin
T or I following an intraarterial cardiac
procedure including, but
not limited to, coronary
angiography and
coronary angioplasty.
Explanatory note: 0.5ng/ml
= 0.5ug/L = 500pg/ml
Open Chest Heart Valve
Surgery
The actual undergoing of
open-heart surgery to
replace or repair heart
valve abnormalities. The
diagnosis of heart valve
abnormality must be
supported by cardiac
catheterization or
echocardiogram and the
procedure must be
considered medically
necessary by a consultant
cardiologist.

HIV Due to Blood
Transfusion and
Occupationally Acquired
HIV
A) Infection with the
Human Immunodeficiency
Virus (HIV) through a
blood transfusion,
provided that all of the
following conditions are
met:
• The blood transfusion
was medically
necessary or given as
part of a medical
treatment;
• The blood transfusion
was received in
Singapore after the
date of issue, date of
endorsement or date of
reinstatement of this
policy, whichever is the
later; and

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Conditions

Early Stage
assault taking place;
and
• Proof that the assault
involved a definite
source of the HIV
infected fluids; and
• Proof of sero-conversion
from HIV negative to
HIV positive occurring
during the one hundred
and eighty (180) days
after the documented
assault. This proof must
include a negative HIV
antibody test conducted
within five (5) days of
the assault.
HIV infection resulting
from any other means
including consensual
sexual activity or the use
of intravenous drug is
excluded.
This benefit will not apply
where a cure has become
available prior to the
infection. "Cure" means
any treatment that renders
the HIV inactive or noninfectious.

Intermediate Stage
that provided the
transplant and the
Institution is able to
trace the origin of the
HIV to the infected
transplanted organ.
This benefit will not apply
where a cure has become
available prior to the
infection. "Cure" means
any treatment that renders
the HIV inactive or noninfectious.

Advanced Stage1
• The source of the
infection is established
to be from the
Institution that provided
the blood transfusion
and the Institution is
able to trace the origin
of the HIV tainted
blood.
B) Infection with the
Human Immunodeficiency
Virus (HIV) which resulted
from an accident occurring
after the date of issue,
date of endorsement or
date of reinstatement of
this policy, whichever is
the later whilst the life
insured was carrying out
the normal professional
duties of his or her
occupation in Singapore,
provided that all of the
following are proven to our
satisfaction:
• Proof that the accident
involved a definite
source of the HIV
infected fluids;
• Proof of sero-conversion
from HIV negative to
HIV positive occurring
during the one hundred
and eighty (180) days
after the documented
accident. This proof
must include a negative
HIV antibody test
conducted within five (5)
days of the accident;
and
• HIV infection resulting
from any other means
including sexual activity
and the use of
intravenous drugs is
excluded.
This benefit is only
payable when the
occupation of the life
insured is a medical
practitioner, housemen
medical student, state
registered nurse, medical
laboratory technician,
dentist (surgeon and
nurse) or paramedical
worker, working in medical
centre or clinic (in
Singapore).
This benefit will not apply
under either section A or B
where a cure has become

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Conditions

Early Stage

Intermediate Stage

16. End Stage
Kidney Failure

Surgical Removal of One
Kidney
The complete surgical
removal of one (1) kidney
necessitated by any illness
or accident. The need for
the surgical removal of the
kidney must be certified to
be absolutely necessary
by a specialist in the
relevant field. Kidney
donation is excluded.

Chronic Kidney Disease
A nephrologist must make
a diagnosis of chronic
kidney disease with
permanently impaired
renal function. There must
be laboratory evidence
that shows that renal
function is severely
decreased with an eGFR
less than 15ml/min/1.73m2
body surface area,
persisting for a period of 6
months or more.

17. Loss of
Independent
Existence

18. Irreversible
Loss of
Speech

Chronic Kidney
Impairment
A nephrologist must make
a diagnosis of chronic
kidney impairment with
advanced stage of chronic
renal insufficiency. There
must be laboratory
evidence that shows that
renal function is severely
decreased with an eGFR
less than 30ml/min/1.73m2
body surface area,
persisting for a period of
90 days or more.
Loss of Independent
Existence
(Early Stage)
Total and irreversible
physical loss of all fingers
including thumb of the
same hand due to
accident. This condition
must be confirmed by a
registered medical
practitioner. Loss of
fingers due to self-inflicted
injuries is excluded

Permanent (or
Temporary)
Tracheostomy

Advanced Stage1
available prior to the
infection. “Cure” means
any treatment that renders
the HIV inactive or noninfectious.
End Stage Kidney
Failure
Chronic irreversible failure
of both kidneys requiring
either permanent renal
dialysis or kidney
transplantation.

Loss of Independent
Existence
(Intermediate Stage)
A condition as a result of a
disease, illness or injury
whereby the life insured
is unable to perform
(whether aided or unaided)
at least 2 of the following 6
"activities of daily living",
for a continuous period of
6 months.

Loss of Independent
Existence
(Severe Stage)
A condition as a result of a
disease, illness or injury
whereby the life insured
is unable to perform
(whether aided or unaided)
at least 3 of the 6
"Activities of Daily
Living", for a continuous
period of 6 months.

This condition must be
confirmed by our
approved medical
examiner.

This condition must be
confirmed by our
approved medical
examiner.

Non-organic diseases
such as neurosis and
psychiatric illnesses are
excluded.

Non-organic diseases
such as neurosis and
psychiatric illnesses are
excluded.

For the purpose of this
definition, “aided” shall
mean with the aid of
special equipment, device
and/or apparatus and not
pertaining to human aid.
Loss of Speech due to
Vocal Cord Paralysis

For the purpose of this
definition, “aided” shall
mean with the aid of
special equipment, device
and/or apparatus and not
pertaining to human aid.
Irreversible Loss of
Speech

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Conditions

Early Stage
The performance of
tracheostomy for the
treatment of lung disease
or airway disease or as a
ventilatory support
measure following major
trauma or burns.
The life insured must
have been a patient in a
designated intensive care
unit under the care of a
medical specialist. The
benefit only payable if the
tracheostomy is required
to remain in place and
functional for a period of
three months. This benefit
would not be payable in
addition to any Major Head
Trauma, Major Burns, End
stage lung disease or
Major cancer benefit.

19. Major
Burns

Mild Severe Burns
Second degree (partial
thickness of the skin)
burns covering at least
20% of the surface of the
life insured’s body. The
burns must be treated by
an appropriately qualified
specialist.

20. Major
Cancer

Carcinoma in situ
Carcinoma in situ means
the focal autonomous new
growth of carcinomatous
cells confined to the cells
in which it originated and
has not yet resulted in the
invasion and/or destruction
of surrounding tissues.
‘Invasion’ means an
infiltration and/or active
destruction of normal
tissue beyond the
basement membrane. The
diagnosis of the
Carcinoma in situ must
always be supported by a
histo-pathological report.
Furthermore, the
diagnosis of Carcinoma in
situ must always be
positively diagnosed upon
the basis of a microscopic
examination of the fixed
tissue, supported by a
biopsy result.
Early Prostate Cancer

Intermediate Stage
This benefit is payable on
diagnosis of complete
and irrecoverable paralysis
of the vocal cords as a
consequence of
neurological disease or
injury. The benefit is only
payable where surgical
intervention is required on
the advice of an Ear,
Nose, and Throat (ENT)
surgeon to restore the loss
of speech.

Advanced Stage1
Total and irreversible loss
of the ability to speak as a
result of injury or disease
to the vocal cords. The
inability to speak must be
established for a
continuous period of
twelve (12) months. This
diagnosis must be
supported by medical
evidence furnished by an
Ear, Nose, Throat (ENT)
specialist.

The inability to speak must
be established for a
continuous period of
twelve (12) months. This
diagnosis must be
supported by medical
evidence furnished by an
Ear, Nose, Throat (ENT)
specialist.

All psychiatric related
causes are excluded.

All psychiatric related
causes are excluded.
Moderately Severe
Burns
Third degree (full
thickness of the skin)
burns covering at least
50% of the face of the life
insured. The burns must
be treated by an
appropriately qualified
specialist.
Carcinoma in situ of
Specified Organs treated
with Radical Surgery
The actual undergoing of a
Radical Surgery to arrest
the
spread of malignancy in
that specific organ, which
must be considered as
appropriate and necessary
treatment.
“Radical Surgery” is
defined in this policy as
the total and complete
removal of one (1) of the
following organs: breast
(mastectomy), prostate
(prostatectomy), corpus
uteri (hysterectomy), ovary
(oopherectomy), fallopian
tube (salpingectomy),
colon (partial colectomy
with end to end
anastomosis) or stomach
(partial gastrectomy with
end to end anastomosis).
The diagnosis of the
Carcinoma in situ must
always be positively

Major Burns
Third degree (full
thickness of the skin)
burns covering at least
20% of the surface of the
life insured’s body.

Major Cancer
A malignant tumour
positively diagnosed with
histological confirmation
and characterized by the
uncontrolled growth of
malignant cells with
invasion and destruction of
normal tissue.
The term Major Cancer
includes, but is not limited
to, leukemia, lymphoma
and sarcoma.
Major Cancer diagnosed
on the basis of finding
tumour cells and/or
tumour-associated
molecules in blood, saliva,
faeces, urine or any other
bodily fluid in the absence
of further definitive and
clinically verifiable
evidence does not meet
the above definition.
For the above definition,
the following are excluded:

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Conditions

Early Stage
Prostate cancer that is
histologically described
using the TNM
Classification as T1N0M0
or Prostate cancers
described using another
equivalent classification.
Early Thyroid Cancer
Thyroid cancer that is
histologically described
using the TNM
Classification as T1N0M0
as well as Papillary
microcarcinoma of thyroid.
Early Bladder Cancer
Bladder cancer that is
histologically described
using the TNM
Classification as Tis or
T1N0M0. Non-invasive
papillary urothelial
carcinoma of the bladder
(stage Ta) is excluded.
Early Chronic
Lymphocytic Leukemia
Chronic Lymphocytic
Leukemia (CLL) RAI Stage
1 or 2. CLL RAI stage 0 or
lower is excluded.
Neuroendocrine
Tumours
All Neuroendocrine
tumours histologically
classified as T1N0M0
(TNM Classification)
Gastro-Intestinal Stromal
Tumours
All Gastro-Intestinal
Stromal tumours
histologically classified as
Stage I or IA according to
the latest edition of the
AJCC Cancer Staging
Manual which are treated
with surgery or
chemotherapy as
recommended by an
oncologist.
Bone Marrow
Malignancies
All bone marrow
malignancies which do not
require recurrent blood
transfusions,
chemotherapy, targeted
cancer therapies, bone
marrow transplant,
haematopoietic stem cell

Intermediate Stage
diagnosed upon the basis
of a microscopic
examination of fixed
tissues additionally
supported by a biopsy of
the removed organ.
Early prostate cancer that
is histologically described
using the TNM
Classification as T1N0M0
or Prostate cancers
described using another
equivalent classification is
also covered if it has been
treated with a radical
prostatectomy.
The actual undergoing of
the surgeries listed above
and the surgery must be
certified to be absolutely
necessary by an
oncologist Partial surgical
removal such as
lumpectomy and partial
mastectomy and partial
prostatectomy are
specifically excluded.
Carcinoma in situ means
the focal autonomous new
growth of carcinomatous
cells confined to the cells
in which it originated and
has not yet resulted in the
invasion and/ or
destruction of surrounding
tissues. ‘Invasion’ means
an infiltration and/or active
destruction of normal
tissue beyond the
basement membrane. The
diagnosis of the
Carcinoma in situ must
always be supported by a
histopathological report.
The following conditions
are specifically excluded
from the coverage:
• Clinical diagnosis
• Any diagnosis on the
basis of finding tumour
cells and/or tumorassociated molecules in
blood, saliva, faeces,
urine or any other bodily
fluid in the absence of
further definitive and
clinically verifiable
evidence does not meet
the above definition.
• Any lesion or tumour
which is histologically

Advanced Stage1
A) All tumours which are
histologically classified as
any of the following:
• Pre-malignant;
• Non-invasive;
• Carcinoma-in-situ (Tis)
or Ta;
• Having borderline
malignancy;
• Having any degree of
malignant potential;
• Having suspicious
malignancy;
• Neoplasm of uncertain
or unknown behavior; or
• All grades of dysplasia,
squamous intraepithelial
lesions (HSIL and LSIL)
and intra epithelial
neoplasia;
B) Any non-melanoma
skin carcinoma, skin
confined primary
cutaneous lymphoma and
dermatofibrosarcoma
protuberans unless there
is evidence of metastases
to lymph nodes or beyond;
C) Malignant melanoma
that has not caused
invasion beyond the
epidermis;
D) All Prostate cancers
histologically described as
T1N0M0 (TNM
Classification) or below; or
Prostate cancers of
another equivalent or
lesser classification;
E) All Thyroid cancers
histologically classified as
T1N0M0 (TNM
Classification) or below;
F) All Neuroendocrine
tumours histologically
classified as T1N0M0
(TNM Classification) or
below;
G) All tumours of the
Urinary Bladder
histologically classified as
T1N0M0 (TNM
Classification) or below;
H) All Gastro-Intestinal
Stromal tumours
histologically classified as
Stage I or IA according to
the latest edition of the
AJCC Cancer Staging
Manual, or below;
I) Chronic Lymphocytic
Leukaemia less than RAI
Stage 3;

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Conditions

Early Stage
transplant or other major
interventionist treatment.
The diagnosis of the
above minor cancers must
be established by
histological evidence and
be confirmed by a
specialist in the relevant
field.
The following conditions
are specifically excluded
from coverage:
• Clinical diagnosis
• Any diagnosis on the
basis of finding tumour
cells and/or tumorassociated molecules in
blood, saliva, faeces,
urine or any other bodily
fluid in the absence of
further definitive and
clinically verifiable
evidence does not meet
the above definition.
• Any lesion or tumour
which is histologically
described as benign,
dysplasia, premalignant,
borderline malignant, or
suspicious malignant
potential.
• Cervical Dysplasia, CIN1, CIN-2 and CIN-3 and
low grade & high grade
squamous epithelial
lesions unless
specifically reported as
CIS (carcinoma in situ).
• Prostatic Intraepithelial
Neoplasia (PIN).
• Vulvar Intraepithelial
Neoplasia (VIN).
• Melanoma in situ and
any non-melanoma skin
carcinoma (in-situ or
invasive), skin confined
primary cutaneous
lymphoma and
dermatofibrosarcoma
protuberans.
• Non-invasive papillary
urothelial carcinoma of
the bladder (stage Ta).
• All tumours in the
presence of Human
Immunodeficiency Virus
(HIV) infection.

Intermediate Stage
described as benign,
dysplasia, premalignant,
borderline malignant, or
suspicious malignant
potential.
• Cervical Dysplasia, CIN1, CIN-2 and CIN-3 and
low grade & high grade
squamous epithelial
lesions unless
specifically reported as
CIS (carcinoma in situ).
• Prostatic Intraepithelial
Neoplasia (PIN).
• Vulvar Intraepithelial
Neoplasia (VIN).
• All tumours in the
presence of Human
Immunodeficiency Virus
(HIV) infection.

Advanced Stage1
J) All bone marrow
malignancies which do not
require recurrent blood
transfusions,
chemotherapy, targeted
cancer therapies, bone
marrow transplant,
haematopoietic stem cell
transplant or other major
interventionist treatment;
and
K) All tumours in the
presence of HIV infection.

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Conditions
21. Major Head
Trauma

22. Major
Organ / Bone
Marrow
Transplantatio
n

Early Stage
Head Trauma Requiring
Re-constructive Surgery
and Accidentally Spinal
Cord Injury
1) The actual undergoing
of re-constructive surgery
above the neck
(restoration or reconstruction of the shape
of and appearance of
facial structures which are
defective, missing or
damaged or misshapened)
performed by a specialist
in the relevant field to
correct disfigurement as a
direct result of an accident.
The need for surgery must
be certified to be
absolutely necessary by a
specialist in the relevant
field. Treatment relating to
teeth and/or any other
dental restoration alone is
excluded; or
2) Accidental cervical
spinal cord injury resulting
in loss of use of at least
one (1) entire limb, to be
assessed no sooner than
six weeks from the date of
the accident. The
diagnosis must be
confirmed by a specialist
in the relevant field and
supported by unequivocal
findings on Magnetic
Resonance Imaging,
Computerised
Tomography, or other
reliable imaging
techniques.
Accident” means an event
of violent, unexpected,
external, involuntary and
visible nature which is
independent of any other
cause and is the sole
cause of the injury.
Surgery for subdural
haematoma
The actual undergoing of
Burr Hole surgery to the
head to drain subdural
haematoma as a result of
an accident. The need for
the Burr Hole surgery must
be certified to be medically
necessary by a specialist.
Small Bowel Transplant
The receipt of a transplant
of at least one (1) meter of
small bowel with its own
blood supply via a

Intermediate Stage
Head Trauma Requiring
Open Craniotomy
Undergoing of open
craniotomy as a
consequence of major
head trauma by accident
for the treatment of
depressed skull fractures
or major intracranial injury.
Burr hole surgery is
excluded from this benefit.
Accident” means an event
of violent, unexpected,
external, involuntary and
visible nature which is
independent of any other
cause and is the sole
cause of the injury.

Advanced Stage1
Major Head Trauma
Accidental head injury
resulting in permanent
neurological deficit to be
assessed no sooner than
6 weeks from the date of
the accident. This
diagnosis must be
confirmed by a consultant
neurologist and supported
by relevant findings on
Magnetic Resonance
Imaging, Computerised
Tomography, or other
reliable imaging
techniques. "Accident”
means an event of violent,
unexpected, external,
involuntary and visible
nature which is
independent of any other
cause and is the sole
cause of the head injury.
The following are
excluded:
• Spinal cord injury; and
• Head injury due to any
other causes.

Major Organ/Bone
Marrow Transplant (on
waitlist)

Major Organ / Bone
Marrow Transplantation
The receipt of a transplant
of:

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Conditions

Early Stage
laparatomy resulting from
intestinal failure.
Corneal Transplant
The receipt of a transplant
of a whole cornea due to
irreversible scarring with
resulting reduced visual
acuity which cannot be
corrected with other
methods.

23. Motor
Neurone
Disease

Peripheral Neuropathy
This refers to severe
peripheral motor
neuropathy arising from
anterior horn cells
resulting in significant
motor weakness,
fasciculation and muscle
wasting. The diagnosis
must be confirmed by a
consultant neurologist as a
result of nerve conduction
studies and result in a
permanent need for the
use walking aids or a
wheelchair. Diabetic
neuropathy and
neuropathy due to alcohol
is excluded.

24. Multiple
Sclerosis

Early Multiple Sclerosis
There must be a definite
diagnosis of Multiple
Sclerosis confirmed by a
neurologist. The
diagnosis must be
supported by all of the
following:
• Investigations that
unequivocally confirm
the diagnosis to be
Multiple Sclerosis; and
• Well documented history
of exacerbations and
remissions of
neurological signs.

Intermediate Stage
This benefit covers those
who are on an official
organ
transplant waiting list for
the receipt of a transplant
of:
• Human bone marrow
using hematopoietic
stem cells preceded by
total bone marrow
ablation; or
• One (1) of the following
human organs: heart,
lung, liver, kidney or
pancreas that resulted
from irreversible end
stage failure of the
relevant organ.
Other stem cell transplants
are excluded.
This benefit is limited to
those on the official waitlist
for organ transplant on
Ministry of Health
Singapore list of hospitals
only.
Early Motor Neurone
Disease
Refers to the diagnosis of
motor neurone disease, a
progressive degeneration
of the corticospinal tracts
and anterior horn cells or
bulbar efferent neurons.
These include spinal
muscular atrophy,
progressive bulbar palsy,
amyotrophic lateral
sclerosis and primary
lateral sclerosis. A
neurologist must make the
definite diagnosis of a
motor neurone disease
and this diagnosis must
be supported by
appropriate investigations.
Mild Multiple Sclerosis
There must be a definite
diagnosis of Multiple
Sclerosis confirmed by a
neurologist. The
diagnosis must be
supported by all of the
following:
• Investigations that
unequivocally confirm
the diagnosis to be
Multiple Sclerosis;
• Any permanent residual
neurological deficit
confirmed by a
neurologist at 3 months;
and

Advanced Stage1
• Human bone marrow
using haematopoietic
stem cells preceded by
total bone marrow
ablation; or
• One (1) of the following
human organs: heart,
lung, liver, kidney or
pancreas that resulted
from irreversible end
stage failure of the
relevant organ.
Other stem cell transplants
are excluded.

Motor Neurone Disease
Motor neurone disease
characterised by
progressive degeneration
of corticospinal tracts and
anterior horn cells or
bulbar efferent neurones
which include spinal
muscular atrophy,
progressive bulbar palsy,
amyotrophic lateral
sclerosis and primary
lateral sclerosis. This
diagnosis must be
confirmed by a neurologist
as progressive and
resulting in permanent
neurological deficit.

Multiple Sclerosis
The definite diagnosis of
Multiple Sclerosis, and
must be supported by all
of the following:
• Investigations which
unequivocally confirm
the diagnosis to be
Multiple Sclerosis; and
• Multiple neurological
deficits which occurred
over a continuous period
of at least 6 months.
Other causes of
neurological damage such
as SLE and HIV are
excluded.

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Conditions

25. Muscular
Dystrophy

26. Other
Serious
Coronary
Artery Disease

Early Stage
Other causes of
neurological damage such
as SLE and HIV are
excluded.

Spinal Cord Disease or
Injury resulting in Bowel
and Bladder Dysfunction
Spinal cord disease or
chorda equina injury
resulting in permanent
bowel dysfunction
and bladder dysfunction
requiring permanent
regular self catheterisation
or a permanent urinary
conduit. The diagnosis
must be supported by a
consultant neurologist and
the permanency assessed
at six (6) months.

Intermediate Stage
• Well documented history
of exacerbations and
remissions of
neurological signs.
Other causes of
neurological damage such
as SLE and HIV are
excluded.
Moderate Muscular
Dystrophy
A group of hereditary
degenerative diseases of
muscle characterised by
weakness and atrophy of
muscle. The diagnosis of
muscular dystrophy must
be unequivocal and made
by a consultant
neurologist. The condition
must result in the inability
of the life insured to
perform (whether aided or
unaided) at least 2 of the 6
“Activities of Daily
Living” for a continuous
period of at least 6
months.

Mild Coronary Artery
Disease
The narrowing of the
lumen of two coronary
arteries by a minimum of
60%, as proven by
invasive coronary
angiography regardless of
whether any form of
coronary artery surgery
has been recommended or
performed.

For the purpose of this
definition, “aided” shall
mean with the aid of
special equipment, device
and/or apparatus and not
pertaining to human aid.
Moderate Coronary
Artery Disease
The narrowing of the
lumen of three coronary
arteries by a minimum of
60%, as proven by
invasive coronary
angiography regardless of
whether any form of
coronary artery surgery
has been recommended or
performed.

Diagnosis by Imaging or
non-invasive diagnostic
procedures such as CT
scan or MRI does not
meet the confirmatory
status required by the
definition.

Diagnosis by Imaging or
non-invasive diagnostic
procedures such as CT
scan or MRI does not
meet the confirmatory
status required by the
definition.

Coronary arteries herein
refer to right coronary
artery, left main stem, left
anterior descending and
left circumflex. The
branches of the above
coronary arteries are
excluded.

Coronary arteries herein
refer to right coronary
artery, left main stem, left
anterior descending and
left circumflex. The
branches of the above
coronary arteries are
excluded.

Advanced Stage1

Muscular Dystrophy
The unequivocal
diagnosis of muscular
dystrophy must be made
by a consultant
neurologist. The condition
must result in the inability
of the life insured to
perform (whether aided or
unaided) at least 3 of the 6
“Activities of Daily
Living” for a continuous
period of at least 6
months.
For the purpose of this
definition, “aided” shall
mean with the aid of
special equipment, device
and/or apparatus and not
pertaining to human aid.

Other Serious Coronary
Artery Disease
The narrowing of the
lumen of at least one (1)
coronary artery by a
minimum of 75% and of
two others by a minimum
of 60%, as proven by
invasive coronary
angiography, regardless of
whether or not any form of
coronary artery surgery
has been performed.
Diagnosis by Imaging or
non-invasive diagnostic
procedures such as CT
scan or MRI does not
meet the confirmatory
status required by the
definition.
Coronary arteries herein
refer to left main stem, left
anterior descending,
circumflex and right
coronary artery. The
branches of the above
coronary arteries are
excluded.

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Conditions

27. Paralysis
(Irreversible
Loss of Use of
Limbs)

Early Stage
When a Port Access or
Key hole Cardiac Surgery
'intermediate stage critical
illness' has been claimed
under this policy, the
benefit of Mild Coronary
Artery Disease will no
longer be payable.
Loss of Use of One Limb
Total and irreversible loss
of use of one (1) entire
limb due to injury or
disease persisting for a
period of at least 6 weeks
and with no foreseeable
possibility of recovery.
This condition must be
confirmed by a consultant
neurologist.
Self-inflicted injuries are
excluded.

28. Idiopathic
Parkinson’s
Disease

29.
Poliomyelitis

Early Parkinson’s
Disease
The unequivocal
diagnosis of idiopathic
Parkinson’s disease by a
specialist in the relevant
field.
This diagnosis must be
supported by all of the
following conditions:
• The disease cannot be
controlled with
medication; and
• There are signs of
progressive neurological
impairment

Peripheral Neuropathy
This refers to severe
peripheral motor
neuropathy resulting in
significant motor
weakness, fasciculation
and muscle wasting. The
diagnosis must be
confirmed by a consultant
neurologist as a result of
nerve conduction studies
and result in a permanent
need for the use walking
aids or a wheelchair.
Diabetic neuropathy and

Advanced Stage1

Intermediate Stage
When a Port Access or
Key hole Cardiac Surgery
'intermediate stage critical
illness' has been claimed
under this policy, the
benefit of Moderate
Coronary Artery Disease
will no longer be payable.
Loss of Use of One Limb
requiring Prosthesis
Total and irreversible loss
of use of one (1) entire
limb (above elbow or
above knee) which has
required the fitting and use
of prosthesis due to illness
or accident. This condition
must be confirmed by
specialists in the relevant
fields.

Paralysis (Irreversible
Loss of Use of Limbs)
Total and irreversible loss
of use of at least 2 entire
limbs due to injury or
disease persisting for a
period of at least 6 weeks
and with no foreseeable
possibility of recovery.
This condition must be
confirmed by a consultant
neurologist.

Self-inflicted injuries are
excluded.
Moderately Severe
Parkinson’s Disease
The unequivocal
diagnosis of idiopathic
Parkinson’s Disease by a
consultant neurologist.
This diagnosis must be
supported by all of the
following conditions:
• The disease cannot be
controlled with
medication; and
• Inability of the life
insured to perform
(whether aided or
unaided) at least 2 of the
6 “Activities of Daily
Living” for a continuous
period of at least 6
months.

Self-inflicted injuries are
excluded.
Idiopathic Parkinson’s
Disease
The unequivocal
diagnosis of idiopathic
Parkinson’s Disease by a
consultant neurologist.
This diagnosis must be
supported by all of the
following conditions:
• the disease cannot be
controlled with
medication; and
• inability of the life
insured to perform
(whether aided or
unaided) at least 3 of
the 6 “Activities of
Daily Living” for a
continuous period of at
least six (6) months.

For the purpose of this
definition, “aided” shall
mean with the aid of
special equipment, device
and/or apparatus and not
pertaining to human aid.
Poliomyelitis
(Intermediate Stage)
The occurrence of
Poliomyelitis where the
following conditions are
met:
• Poliovirus is identified as
the cause
• Paralysis of the
respiratory muscles
supported by ventilator
for a continuous period
of minimum 96 hours

For the purpose of this
definition, “aided” shall
mean with the aid of
special equipment, device
and/or apparatus and not
pertaining to human aid.
Poliomyelitis
The occurrence of
Poliomyelitis where the
following conditions are
met:
• Poliovirus is identified as
the cause,
• Paralysis of the limb
muscles or respiratory
muscles must be
present and persist for
at least 3 months.

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Conditions

Early Stage
neuropathy due to alcohol
is excluded.

Intermediate Stage

30. Primary
Pulmonary
Hypertension

Early Pulmonary
Hypertension
Primary or Secondary
pulmonary hypertension
with established right
ventricular hypertrophy
leading to the presence of
permanent physical
impairment of at least
Class III of the New York
Heart Association (NYHA)
Classification of Cardiac
Impairment.
The NYHA Classification
of Cardiac Impairment:
Class I: No limitation of
physical activity. Ordinary
physical activity does not
cause undue fatigue,
dyspnea, or anginal pain.
Class II: Slight limitation of
physical activity. Ordinary
physical activity results in
symptoms.
Class III: Marked limitation
of physical activity.
Comfortable at rest, but
less than ordinary activity
causes symptoms.
Class IV: Unable to
engage in any physical
activity without discomfort.
Symptoms may be present
even at rest.

Secondary Pulmonary
Hypertension
Secondary pulmonary
hypertension with
established right
ventricular hypertrophy
leading to the presence of
permanent physical
impairment of at least
Class IV of the New York
Heart Association (NYHA)
Classification of Cardiac
Impairment.
The NYHA Classification
of Cardiac Impairment:
Class I: No limitation of
physical activity. Ordinary
physical activity does not
cause undue fatigue,
dyspnea, or anginal pain.
Class II: Slight limitation of
physical activity. Ordinary
physical activity results in
symptoms.
Class III: Marked limitation
of physical activity.
Comfortable at rest, but
less than ordinary activity
causes symptoms.
Class IV: Unable to
engage in any physical
activity without discomfort.
Symptoms may be present
even at rest.

31.
Progressive
Scleroderma

Early Progressive
Scleroderma
A rheumatologist must
make the definite
diagnosis of progressive
systemic scleroderma,
based on clinically
accepted criteria. This
diagnosis must be
unequivocally supported
by biopsy and serological
evidence.
The following are
excluded:
• localised scleroderma
(linear scleroderma or
morphea);
• eosinophilic fasciitis;
and
• CREST syndrome

Progressive
Scleroderma with
CREST syndrome
A rheumatologist must
make the definite
diagnosis of systemic
sclerosis with CREST
syndrome, based on
clinically accepted criteria.
This diagnosis must be
unequivocally supported
by biopsy and serological
evidence. The disease
must involve the skin with
deposits of calcium
(calcinosis), skin
thickening of the fingers or
toes (sclerodactyly) and
also involve the
esophagus. There must
also be telangectasia
(dilated capillaries) and
Raynaud’s Phenomenon
causing artery spasms in
the extremities.

Advanced Stage1
The diagnosis must be
confirmed by a consultant
neurologist or specialist in
the relevant medical field.
Primary Pulmonary
Hypertension
Primary Pulmonary
Hypertension with
substantial right ventricular
enlargement confirmed by
investigations including
cardiac catheterisation,
resulting in permanent
physical impairment of at
least Class IV of the New
York Heart Association
(NYHA) Classification of
Cardiac Impairment.
The NYHA Classification
of Cardiac Impairment:
Class I: No limitation of
physical activity. Ordinary
physical activity does not
cause undue fatigue,
dyspnea, or anginal pain.
Class II: Slight limitation of
physical activity. Ordinary
physical activity results in
symptoms.
Class III: Marked limitation
of physical activity.
Comfortable at rest, but
less than ordinary activity
causes symptoms.
Class IV: Unable to
engage in any physical
activity without discomfort.
Symptoms may be present
even at rest.
Progressive
Scleroderma
A systemic collagenvascular disease causing
progressive diffuse fibrosis
in the skin, blood vessels
and visceral organs. This
diagnosis must be
unequivocally confirmed
by a consultant
rheumatologist and
supported by biopsy or
equivalent confirmatory
test and serological
evidence and the disorder
must have reached
systemic proportions to
involve the heart, lungs or
kidneys.
The following are
excluded:
• Localised scleroderma
(linear scleroderma or
morphea);
• Eosinophilic fascitis; and
• CREST syndrome.

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Conditions

Early Stage

32. Stroke with
Permanent
Neurological
Deficit

Brain Aneurysm Surgery
The actual undergoing of
surgical repair of an
intracranial aneurysm or
surgical removal of an
arterio-venous
malformation via
craniotomy or
endovascular procedures.
The surgical intervention
must be certified to be
absolutely necessary by a
specialist in the relevant
field.
Cerebral Shunt Insertion
The actual undergoing of
surgical implantation of a
shunt from the ventricles
of the brain to relieve
raised pressure in the
cerebrospinal fluid. The
need of a shunt must be
certified to be absolutely
necessary by a specialist
in the relevant field.

33. Open
Chest Surgery
to Aorta

Large Asymptomatic
Aortic Aneurysm
Large asymptomatic
abdominal or thoracic
aortic aneurysm or aortic
dissection as evidenced by
appropriate imaging
technique. The aorta must
be enlarged greater than
55mm in diameter and the
diagnosis must be

Intermediate Stage
The following are
excluded:
• localised scleroderma
(linear scleroderma or
morphea); and
• eosinophilic fasciitis.
Carotid Artery Surgery
The actual undergoing of
Endarterectomy of the
carotid artery which has
been necessitated as a
result of at least 80%
narrowing of the carotid
artery as diagnosed by an
arteriography or any other
appropriate diagnostic test
that is available.
Endarterectomy of blood
vessels other than the
carotid artery are
specifically excluded.
Percutaneous carotid
angioplasty excluded

Percutaneous or
Minimally Invasive
Surgery to Aorta
The actual undergoing of
percutaneous
intravascular angioplasty,
stenting techniques or
minimally invasive surgery
to repair or correct an
aneurysm, narrowing,
obstruction or dissection of
the aorta, as evidenced by

Advanced Stage1

Stroke with Permanent
Neurological Deficit
A cerebrovascular incident
including infarction of brain
tissue, cerebral and
subarachnoid
haemorrhage,
intracerebral embolism
and cerebral thrombosis
resulting in permanent
neurological deficit.
This diagnosis must be
supported by all of the
following conditions:
• Evidence of permanent
clinical neurological
deficit confirmed by a
neurologist at least 6
weeks after the event;
and
• Findings on Magnetic
Resonance Imaging,
Computerised
Tomography, or other
reliable imaging
techniques consistent
with the diagnosis of a
new stroke.
The following are
excluded:
• Transient Ischaemic
Attacks;
• Brain damage due to an
accident or injury,
infection, vasculitis, and
inflammatory disease;
• Vascular disease
affecting the eye or optic
nerve;
• Ischaemic disorders of
the vestibular system;
and
• Secondary
haemorrhage within a
pre-existing cerebral
lesion.
Open Chest Surgery to
Aorta
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

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Conditions

Early Stage
confirmed by a consultant
cardiologist.

34. Systemic
Lupus
Erythematosu
s with Lupus
Nephritis

Mild Systemic Lupus
Erythematosus
A multisystem,
multifactorial, autoimmune
disorder which mostly
affects females in their
childbearing years and is
characterised by the
development of autoantibodies directed against
various self-antigens. In
respect of this contract,
systematic lupus
erythematosus will be
restricted to those forms of
systematic lupus
erythematosus that require
systemic
immunosuppressive
therapy for multiple organ
involvement for at least 6
months under the direction
of a specialist. Evidence
must be provided from the
treating specialist that
proves to our satisfaction
that there has been
involvement of at least
three specified internal
organs. For the purposes
of this benefit the listed
specified organs are
restricted to the kidneys,

Intermediate Stage
an echocardiogram or any
other appropriate
diagnostic imaging test
that is available and
confirmed by a consultant
cardiologist or vascular
surgeon. For the purpose
of this definition, aorta
shall mean the thoracic
and abdominal aorta but
not its branches.
Minimally invasive cardiac
surgery refers to any
procedure performed
without a full sternotomy /
laparotomy or by a
percutaneous
intravascular route.
Minimally invasive cardiac
surgery therefore includes
any procedure performed
through Partial
Sternotomy, Minithoracotomy,
Thoracoscopy (Port
access or robotic), “Key
hole” route or any
minimally invasive cardiac
surgeries consistent with
the current standard of the
medical services available
in Singapore.
Moderately Severe
Systemic Lupus
Erythematosus (S.L.E)
with Lupus Nephritis
means an autoimmune
illness in which tissues
and cells are damaged by
deposition of pathogenic
autoantibodies and
immune complexes and
damage of the kidney
function.
The diagnosis of S.L.E.
with Lupus Nephritis will
be based on the following
conditions:
(1) Clinically there must be
at least 4 out of the
following presentations
suggested by The
American College of
Rheumatology.
1.1. Malar rash
1.2. Discoid rash
1.3. Photosensitivity
1.4. Oral ulcers
1.5. Arthritis
1.6. Serositis
1.7. Renal Disorder
1.8. Leukopenia
(<4,000/mL), or
Lymphopenia

Advanced Stage1
the thoracic and
abdominal aorta but not its
branches.
Surgery performed using
only minimally invasive or
intra-arterial techniques
are excluded.

Systemic Lupus
Erythematosus with
Lupus Nephritis
The unequivocal
diagnosis of Systemic
Lupus Erythematosus
(SLE) based on
recognised diagnostic
criteria and supported with
clinical and laboratory
evidence. In respect of this
contract, systemic lupus
erythematosus will be
restricted to those forms of
systemic lupus
erythematosus which
involve the kidneys (Class
III to Class VI lupus
nephritis, established by
renal biopsy, and in
accordance with the
RPS/ISN classification
system). The final
diagnosis must be
confirmed by a certified
medical examiner
specializing in
Rheumatology and
Immunology.
The RPS/ISN classification
of lupus nephritis:
Class I: Minimal
mesangial lupus nephritis

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Conditions

35. Severe
Encephalitis

Early Stage
brain, heart (or
pericardium), lungs (or
pleura) and joints. Joint
involvement is defined as
the presence of
polyarticular inflammatory
arthritis. Skin involvement
is not considered one (1)
of the specified organs for
the purposes of this
benefit.
Other forms, discoid lupus
and those forms with
haematological
involvement will be
specifically excluded. The
final diagnosis may have
to be supported by a
certified medical
examiner specialising in
Rheumatology and
Immunology.

Encephalitis with Full
Recovery
Severe inflammation of
brain substance (cerebral
hemisphere, brainstem or
cerebellum) requiring
hospitalisation. The
diagnosis must be
confirmed by a consultant
neurologist and supported
by any confirmatory
diagnostic tests.
Encephalitis caused by
HIV infection is excluded.

36. Terminal
Illness

Not applicable

Intermediate Stage
(<1,500/mL), or
Haemolytic anaemia, or
Thrombocytopenia
(<100,000/mL)
1.9. Neurological disorder
AND
(2) 2 or more of the
following tests being
positive
2.1. Anti-nuclear
Antibodies
2.2. L.E. cells
2.3 Anti-DNA
2.4 Anti-Sm (Smith IgG
Autoantibodies)
AND
(3) There is lupus
nephritis causing impaired
renal function with a
creatinine clearance rate
of 50 ml per minute or
less.
We reserve the right to
change this definition from
time to time to reflect the
changes in qualitative or
quantitative medical
categorization of this
illness so as to give effect
to the original intent of this
definition.
Mild Encephalitis
Severe inflammation of
brain substance (cerebral
hemisphere, brainstem or
cerebellum) resulting in
significant but reversible
neurological deficit and
there must be evidence of
hospitalization for at least
two (2) weeks. The
neurological deficit must
persist for at least six (6)
weeks. The diagnosis
must be confirmed by a
consultant neurologist and
supported by any
confirmatory diagnostic
tests.
Encephalitis caused by
HIV infection is excluded.
Not applicable

Advanced Stage1
Class II: Mesangial
proliferative lupus nephritis
Class III Focal lupus
nephritis (active and
chronic; proliferative and
sclerosing)
Class IV: Diffuse lupus
nephritis (active and
chronic; proliferative and
sclerosing; segmental and
global)
Class V: Membranous
lupus nephritis
Class VI: Advanced
sclerosis lupus nephritis

Severe Encephalitis
Severe inflammation of
brain substance (cerebral
hemisphere, brainstem or
cerebellum) and resulting
in permanent
neurological deficit
which must be
documented for at least 6
weeks. This diagnosis
must be certified by a
consultant neurologist, and
supported by any
confirmatory diagnostic
tests.
Encephalitis caused by
HIV infection is excluded.

Terminal Illness
The conclusive diagnosis
of an illness that is
expected to result in the
death of the life insured
within twelve (12) months.
This diagnosis must be
supported by a specialist
and confirmed by our
appointed Physician.

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Advanced Stage1
Terminal illness in the
presence of HIV infection
is excluded.
1 The Life Insurance Association Singapore (LIA) has standard Definitions for 37 severe-stage Critical Illnesses
(Version 2019). These Critical Illnesses fall under Version 2019. You may refer to www.lia.org.sg for the
standard definitions (Version 2019). For Critical Illnesses that do not fall under Version 2019, the definitions are
determined by the insurance company.
Conditions

Early Stage

Intermediate Stage

Note: ‘Angioplasty and Other Invasive Treatment for Coronary Artery’ is covered under the Special CI
Conditions Benefit.
Extended Advanced Stage CI Definitions
Extended Advanced
Stage CI Conditions
1. Acute
Necrohemorrhagic
Pancreatitis

Definition
Acute Necrohemorrhagic Pancreatitis
Acute inflammation and necrosis of pancreas parenchyma, focal enzymatic
necrosis of pancreatic fat and haemorrhage due to blood vessel necrosis,
where all of the following criteria are met:
(a) The necessary treatment is surgical clearance of necrotic tissue or
pancreatectomy; and
(b) The diagnosis is based on histopathological features and confirmed by a
physician who is a gastroenterologist.
Pancreatitis due to alcohol or drug abuse is excluded.

2. Adrenalectomy for
Adrenal Adenoma

Adrenalectomy for Adrenal Adenoma
Adrenalectomy for treatment of malignant systemic hypertension that was
secondary to an aldosterone secreting adrenal adenoma. Malignant
hypertension was uncontrolled by medical therapy. The adrenalectomy must
be certified to be medically necessary for the management of poorly
controlled hypertension by a medical examiner in the relevant field.

3. Creutzfeldt-Jakob
Disease

Creutzfeldt-Jakob Disease
The occurrence of Creutzfeldt-Jakob Disease or Variant Creutzfeldt-Jakob
Disease where there is an associated neurological deficit, which is solely
responsible for a permanent inability to perform at least 3 of the 6 “Activities
of Daily Living”.
Disease caused by human growth hormone treatment is excluded.

4. Chronic Auto-Immune
Hepatitis

Chronic Auto-Immune Hepatitis
A chronic necro-inflammatory liver disorder of unknown cause associated with
circulating auto-antibodies and a high serum globulin level.
The diagnosis must be based on all of the following criteria:
(1) hypergammaglobulinaemia
(2) the presence of at least one of the following auto-antibodies :
2.1 Anti-Nuclear Antibody;
2.2 Anti-smooth muscle antibodies;
2.3 Anti-actin antibodies;
2.4 Anti-LKM-1 antibodies;
2.5 Anti- LC1 antibodies; or
2.6 Anti-SLA/LP antibodies
(3) Liver Biopsy confirmation of the diagnosis of auto-immune hepatitis
This only covered if the life insured has been put on continuous
Immunosuppressive therapy for a period of at least 6 months and the
diagnosis must be confirmed by a specialist in gastroenterology or
hepatology.

5. Ebola

Ebola

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Extended Advanced
Stage CI Conditions

Definition
Infection with the Ebola virus where the following conditions are met:
(a) presence of the Ebola virus has been confirmed by laboratory testing;
(b) there are ongoing complications of the infection persisting beyond 30 days
from the onset of symptoms;
(c) the infection does not result in death; and
(d) provided that at the time of unequivocal diagnosis there exists no
effective cure.

6. Elephantiasis

Elephantiasis
The end-stage lesion of filariasis, characterised by massive swelling in the
tissues of the body as a result of obstructed circulation in the blood or
lymphatic vessels.
Unequivocal diagnosis of elephantiasis must be:
- clinically confirmed by a physician in the appropriate medical specialty; and
- supported by laboratory confirmation of microfilariae
Lymphedema caused by infection with any other disease(s), trauma, postoperative scarring, congestive heart failure, or congenital lymphatic system
abnormalities is excluded.

7. Idiopathic Pulmonary
Fibrosis

Idiopathic Pulmonary Fibrosis
Idiopathic pulmonary fibrosis is a chronic, progressive form of interstitial lung
disease characterised by fibrosis and worsening of lung function. It should
require extensive and permanent oxygen therapy of at least 8 hours per day.
Lung function test consistently showing FVC ≤50% and DLCO ≤35% of
predicted value.
The unequivocal diagnosis must be confirmed with lung biopsy and by a
specialist in respiratory medicine.

8. Infective Endocarditis

Infective Endocarditis
Inflammation of the inner lining of the heart caused by infectious organisms,
where all of the following criteria are met:
(a) Positive result of the blood culture proving presence of the infectious
organism(s);
(b) Presence of at least moderate heart valve incompetence (meaning
regurgitant fraction of 20% or above) or moderate heart valve stenosis
(resulting in heart valve area of 30% or less of normal value) attributable to
Infective Endocarditis; and
(c) The diagnosis of Infective Endocarditis and the severity of valvular
impairment are confirmed by a registered medical practitioner who is a
cardiologist.

9. Medullary Cystic
Disease

Medullary Cystic Disease
Medullary Cystic Disease where the following criteria are met:
- the presence in the kidney of multiple cysts in the renal medulla
accompanied by the presence of tubular atrophy and interstitial fibrosis;
- clinical manifestations of anaemia, polyuria, and progressive deterioration in
kidney function; and
- the diagnosis of Medullary Cystic Disease is confirmed by renal biopsy.
Isolated or benign kidney cysts are specifically excluded from this benefit.

10. Meningeal
Tuberculosis

Meningeal Tuberculosis
Meningitis caused by tubercle bacilli, resulting in permanent neurological
deficit. Such a diagnosis must be confirmed by a specialist in neurology and
confirmed by characteristic findings of M. tuberculosis infection in
cerebrospinal fluid by lumbar puncture and CSF culture.
Evidence of permanent clinical neurological deficit confirmed by a neurologist
at least 6 weeks after the event.

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Extended Advanced
Stage CI Conditions
11. Multiple Root
Avulsions of Brachial
Plexus

Definition
Multiple Root Avulsions of Brachial Plexus
The complete and permanent loss of use and sensory functions of an upper
extremity caused by avulsion of 2 or more nerve roots of the brachial plexus
through accident or injury. Complete injury of 2 or more nerve roots should be
confirmed by electrodiagnostic study done by a physiatrist or neurologist.

12. Necrotising Fasciitis

Necrotising Fasciitis
The occurrence of necrotising fasciitis where the following conditions are met:
- the usual clinical criteria of necrotising fasciitis are met;
- the bacteria identified is a known cause of necrotising fasciitis; and
- there is widespread destruction of muscle and other soft tissues that results
in a total and permanent loss of function of the affected body part.

13. Pheochromocytoma

Pheochromocytoma
Presence of a neuroendocrine tumour of the adrenal or extra-chromaffin
tissue that secretes excess catecholamines that has required the actual
undergoing of surgery to remove the tumour. The diagnosis of
Pheochromocytoma must be confirmed by a medical examiner who is an
endocrinologist and supported by a histopathological examination.

14. Progressive
Supranuclear Palsy

Progressive Supranuclear Palsy
Progressive Supranuclear Palsy occurring independently of all other causes
and resulting in a permanent neurological deficit, which is directly
responsible for a permanent inability to perform at least 3 of the 6 “Activities
of Daily Living”.
The diagnosis of Progressive Supranuclear Palsy must be confirmed by a
physician who is a neurologist.

15. Severe
Cardiomyopathy

Severe Cardiomyopathy
The unequivocal diagnosis of Cardiomyopathy which have resulted in the
presence of permanent and irreversible physical impairments of at least Class
IV of the New York Heart Association (NYHA) classification of Cardiac
Impairment and which is defined and assessable only after the provision of
maximal medical therapy according to treatment practice guidelines for at
least 6 months.
The diagnosis of Cardiomyopathy has to be supported by echocardiographic
findings of compromised ventricular performance.
Cardiomyopathy as a result of valvular heart disease or drug and alcohol
abuse is excluded. The diagnosis must be confirmed by a consultant
cardiologist.
The NYHA Classification of Cardiac Impairment (Source: "Current Medical
Diagnosis and Treatment - 39th Edition"):
Class I: No limitation of physical activity. Ordinary physical activity does not
cause undue fatigue, dyspnea, or anginal pain.
Class II: Slight limitation of physical activity. Ordinary physical activity results
in symptoms.
Class III: Marked limitation of physical activity. Comfortable at rest, but less
than ordinary activity causes symptoms.
Class IV: Unable to engage in any physical activity without discomfort.
Symptoms may be present even at rest.

16. Severe Crohn's
Disease

Severe Crohn's Disease
Crohn's disease is a chronic, transmural inflammatory disorder of the bowel.
To be considered as severe, there must be evidence of continued
inflammation in spite of optimal therapy, with all of the following having
occurred:
• Stricture formation causing intestinal obstruction requiring admission to
hospital;
• Fistula formation between loops of bowel; and

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Extended Advanced
Stage CI Conditions

Definition
• At least one (1) bowel segment resection.
The diagnosis must be based on histopathological features and confirmed by
a specialist in the relevant field.

17. Severe
Eisenmenger’s
Syndrome

Severe Eisenmenger’s Syndrome
The occurrence of a reversed or bidirectional shunt as a result of pulmonary
hypertension, caused by a heart disorder.
All of the following criteria must be met:
- Presence of permanent physical impairment classified as NYHA class IV*;
and
- The diagnosis of Eisenmenger Syndrome and the level of physical
impairment must be confirmed by a registered medical practitioner who is a
cardiologist.
*NYHA Class IV cardiac impairment means that the patient is symptomatic
during ordinary daily activities despite the use of medication and dietary
adjustment, and there is evidence of abnormal ventricular function on physical
examination and laboratory studies.

18. Surgery for
Idiopathic Scoliosis

Surgery for Idiopathic Scoliosis
The undergoing of spinal surgery to correct an abnormal curvature of the
spine from its normal straight line viewed from the back. The condition must
be present without an identifiable underlying cause and the curve of the spine
must be more than cobb angle 40 degree. Spinal deformity associated with
congenital defects and neuromuscular diseases are excluded.

19. Severe Myasthenia
Gravis

Severe Myasthenia Gravis
An acquired autoimmune disorder of neuromuscular transmission leading to
fluctuating muscle weakness and fatiguability, where all of the following
criteria are met:
- Presence of permanent muscle weakness categorized as Class III, IV or V
according to the Myasthenia Gravis Foundation of America Clinical
Classification below; and
- The diagnosis of Myasthenia Gravis and categorization are confirmed by a
physician who is a neurologist.
Myasthenia Gravis Foundation of America Clinical Classification:
Class I - Any eye muscle weakness, possible ptosis, no other evidence of
muscle weakness elsewhere
Class II - Eye muscle weakness of any severity, mild weakness of other
muscles
Class III - Eye muscle weakness of any severity, moderate weakness of other
muscles
Class IV - Eye muscle weakness of any severity, severe weakness of other
muscles
Class V - Intubation needed to maintain airway

20. Severe Ulcerative
Colitis

Severe Ulcerative Colitis
Means acute fulminant ulcerative colitis with life threatening electrolyte
disturbances, which all of the following criteria must be met:
(i) The entire colon is affected with severe bloody diarrhoea;
(ii) The necessary treatment is total colectomy and ileostomy; and
(iii) The unequivocal diagnosis must be based on histopathological features
and confirmed by a medical examiner who is a gastroenterologist.

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Appendix B
Special CI Conditions Definitions
No

Covered Special CI
Conditions

Definition

NON-JUVENILE SPECIFIC CONDITIONS
1

Angioplasty & Other Invasive
Treatment for Coronary Artery

The actual undergoing of balloon angioplasty or similar
intraarterial catheter procedure to correct a narrowing of
minimum 60% stenosis, of one or more major coronary arteries
as shown by angiographic evidence. The revascularisation must
be considered Medically Necessary by a Specialist. Coronary
arteries herein refer to left main stem, left anterior descending,
circumflex and right coronary artery.
Diagnostic angiography is excluded.

2

Chronic Adrenal Insufficiency
(Addison's Disease)

The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 85th birthday or the benefit
end date of this policy, whichever is earlier.
An autoimmune disorder causing a gradual destruction of the
adrenal gland resulting in the need for life long glucocorticoid
and mineral corticoid replacement therapy. The disorder must
be confirmed by a specialist in endocrinology through one of the
following:
• ACTH simulation tests;
• insulin-induced hypoglycemia test;
• plasma ACTH level measurement;
• Plasma Renin Activity (PRA) level measurement.
Only autoimmune cause of primary adrenal insufficiency is
included. All other causes of adrenal insufficiency are excluded.

3

Chronic Relapsing
Pancreatitis

The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 85th birthday or the benefit
end date of this policy, whichever is earlier.
More than 3 attacks of pancreatitis resulting in pancreatic
dysfunction causing malabsorption needing enzyme
replacement therapy.
The diagnosis must be made by a consultant gastroenterologist
and confirmed by Endoscopic Retrograde
Cholangiopancreatography (ERCP).
Chronic Relapsing Pancreatitis caused by alcohol use is
excluded.

4

Dengue Heamorrhagic Fever

The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 85th birthday or the benefit
end date of this policy, whichever is earlier.
Dengue Haemorrhagic Fever Stage 3 or Stage 4, based on the
World Health Organization case definition (1997), with
unequivocal evidence of the Dengue Shock Syndrome and
confirmation of dengue infection, with confirmatory serological
testing of dengue; and as exemplified by the following findings:
history of continuous high fever (for two (2) or more days),
• minor or major haemorrhagic manifestations,
• thrombocytopenia (less than or equal to 100000 per mm3)
• haemoconcentration (haemotocrit increased by 20% or more)
and
• evidence of plasma leakage (i.e. pleural effusion, ascites or
hypoproteinaemia, etc.)

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No

Covered Special CI
Conditions

Definition
• evidence of the Dengue Shock Syndrome (DSS), confirmed by
a Specialist, with the following criteria being met:
- hypotension (less than 80 mm Hg) or narrow pulse pressure
(20 mm Hg or less) and
- evidence of tissue hypoperfusion such as cold, clammy skin,
oliguria, or a metabolic acidosis.

5

Diabetic Complications

The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 85th birthday or the benefit
end date of this policy, whichever is earlier.
Diabetic Retinopathy with actual undergoing of laser treatment
certified to be Medically Necessary by a Specialist with support
of Fluorescent Fundus Angiography report and vision measured
at 6/18 or worse in the better eye using a Snellen eye chart
before the procedure.
A definite diagnosis of diabetic nephropathy by a Specialist and
is evident by permanent eGFR less than 30 ml/min/1.73 m2
with ongoing proteinuria greater than 300mg/24 hours.
The actual undergoing of amputation of a leg / foot / toe / arm /
hand / finger to treat gangrene that has occurred because of a
complication of diabetes.

6

Hysterectomy due to Cancer

The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 85th birthday or the benefit
end date of this policy, whichever is earlier.
The removal of the uterus (at least the corpus and cervix or
corpus only) with supporting evidence of Major Cancer* of the
uterus, fallopian tube, ovary, vagina or endometrium, advanced
cervical carcinoma. Diagnosis has to be confirmed by
appropriate specialist.
The coverage of this Special Benefit will be provided until the
day before the policy anniversary immediately after the life
insured's 85th birthday.

7

8

9

Mastectomy due to
Carcinoma-in-situ or
Cancer of the breast

Osteoporosis with
Fractures

Severe Rheumatoid
Arthritis

*Major Cancer here refers to the definition of Major Cancer as
specified by LIA.
Mastectomy means surgical removal of at least three quadrants
of the tissue of a breast due to Carcinoma-in-situ or Cancer.
The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 85th birthday or the benefit
end date of this policy, whichever is earlier..
Osteoporosis is a degenerative bone disease that results in loss
of bone. The diagnosis must be supported by a bone density
reading which satisfies the World Health Organisation (WHO)
definition of osteoporosis with a bone density reading T-score of
less than –2.5. There must also be a history of three (3) or more
osteoporotic fractures involving either femur, wrist or vertebrae.
These fractures must directly cause the life insured's
permanent inability to perform at least one (1) Activity of Daily
Living.
The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 85th birthday or the benefit
end date of this policy, whichever is earlier.
Widespread joint destruction with major clinical deformity of
three (3) or more of the following joint areas: hands, wrists,

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No

Covered Special CI
Conditions

Definition
elbows, spine, knees, ankles, feet. The diagnosis must be
supported by all of the following:
• Morning stiffness
• Symmetric arthritis
• Presence of rheumatoid nodules
• Elevated titres of rheumatoid factors
• Radiographic evidence of severe involvement
The diagnosis must be confirmed by a Specialist.

10

The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 85th birthday or the benefit
end date of this policy, whichever is earlier.
A potentially fatal disorder of copper toxicity characterized by
progressive liver disease and/or neurologic deterioration due to
copper deposit. The diagnosis must be confirmed by a
Specialist and the treatment with a chelating agent must be
documented for at least 6 months.

Wilson's Disease

The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 85th birthday or the benefit
end date of this policy, whichever is earlier.
JUVENILE SPECIFIC CONDITIONS
11

ADHD (Attentiondeficit/hyperactivity disorder)

A childhood-onset neurodevelopmental condition, which has
resulted in marked impairment in social or occupational
functioning with symptoms of both inattention and hyperactivityimpulsivity.
Benefit is payable upon meeting all of the following criteria:
• Conclusive diagnosis of ADHD using standardised tests
including DSM-5 criteria by a multi-disciplinary team of
developmental paediatrician, child psychologist, and clinical
psychologist.
• The life insured is currently on stimulants therapy without
interruption for a period of at least 6 months after diagnosis as
prescribed and recommended by the multidisciplinary team of
developmental paediatrician, child psychologist, and clinical
psychologist.
Symptoms of ADHD attributable to the physiological effects of a
substance or other medical or mental conditions are specifically
excluded.

12

Autism of Specified Severity

The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 18th birthday.
An unequivocal diagnosis of Autism of Specified Severity which
must have continued without interruption for a period of at least
6 months after diagnosis supported by 2 different assessments
performed at least 6 months apart; and the Life insured must
be undergoing treatment such as but not limited to behavioural
therapy, psychological interventions or special education at a
recognised institute.
Autism of Specified Severity must fulfil all of the following
diagnostic criteria and be classified as severity Level 3 (requiring
very substantial support assessed separately for each domain)
based on Diagnostic and Statistical Manual of Mental Disorders
(DSM-5), as certified by the attending registered specialist in
Paediatric Psychiatry or Paediatric Neurology:
(a) Persistent deficits in social communication and social

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No

Covered Special CI
Conditions

Definition
interaction across multiple contexts, as manifested by the
following:
• Severe deficits in verbal and nonverbal social communication
skills causing severe impairments in functioning, very limited
initiation of social interactions, and minimal response to social
overtures from others.
(b) Restricted, repetitive patterns of behaviour, interests, or
activities, as manifested by the following:
• Inflexibility of behaviour, extreme difficulty coping with change,
or other restricted/repetitive behaviours markedly interferes with
functioning in all spheres. Great distress/difficulty changing
focus or action.
(c) Symptoms must be present in the early developmental
period.
(d) Symptoms cause clinically significant impairment in social,
occupational, or other important areas of current functioning.
If the life insured is not residing in Singapore at claims stage,
the diagnosis needs to be certified by a registered specialist in
Singapore.

13

Dyslexia of Specified Severity

The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 18th birthday.
Dyslexia is a language-based learning disability. It is
characterized by difficulties on interpreting the sound
(phonological) components of language. All 3 of the following
criteria must be present and diagnostic of a dyslexia:
• Written evidence/report by a Singapore certified Educational
Psychologist stating the diagnosis of Dyslexia which require
intervention - reading, writing and spelling.
• Written confirmation of having Dyslexia by the school that the
life insured is attending.
• Must be enrolled and placed under Band A in a recognized
Dyslexia literacy program certified by Ministry of Education
(MOE) in Singapore.
Band A covers emergent literacy skills and students who are
assigned to be in this band typically have language or cognitive
weaknesses that co-occur with their dyslexia.

14

Generalised Tetanus

The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 18th birthday.
Tetanus is an illness characterised by an acute onset of
hypertonia, painful muscular contractions (usually including the
muscles of the jaw and neck), and generalised muscle spasms
caused by tetanus toxin that is produced by Clostridium tetani
bacterium infection. The diagnosis of generalized tetanus due
to tetanus toxin must be confirmed by a consultant physician.
Only cases with all the following criteria will qualify for this
benefit:
• Constant mechanical ventilation is instituted for at least three
(3) days as a medically necessary treatment for Generalized
Tetanus due to tetanus toxin; and
• Tetanus Immune Globulin is administered.

15

Glomerulonephritis with
Nephrotic Syndrome

The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 18th birthday.
A confirmed diagnosis of glomerulonephritis with nephrotic
syndrome by a nephrologist, evidenced by > 3.5 grams protein
in urine per day, low serum albumin value and peripheral

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No

Covered Special CI
Conditions

Definition
edema. The syndrome must have continued for a period of at
least 6 months with or without intervening periods of remission
and the insured must have received a treatment regimen
appropriate to the clinical presentation over this period of time.
Other forms of kidney disease are not covered.

16

17

18

19

Insulin Dependent Diabetes
Mellitus

Kawasaki Disease

Osteogenesis Imperfecta

Rabies

The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary immediately
after the life insured's 18th birthday.
This is characterised by polydipsia, polyuria, increased appetite,
weight loss, low plasma insulin levels, episodic ketoacidosis,
and immune mediated destruction of pancreatic beta cells.
Insulin therapy and dietary regulation are necessary.
Dependence on insulin therapy must persist for not less than
6months. Type II
Diabetes Mellitus is specifically excluded. Diagnosis must be
confirmed by a Specialist.
The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 18th birthday.
This is acute, febrile and multisystem disease of children,
characterised by nonsuppurative cervical adenitis, skin and
mucous membrane lesions. Diagnosis must be confirmed by a
Specialist and there must be echocardiograph evidence of
cardiac involvement manifested by dilatation or aneurysm
formation of at least 5mm in the coronary arteries which persists
for 12 months after the initial acute episode.
The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 18th birthday.
This is characterised by brittle, osteoporotic, easily fractured
bone. The life insured must be diagnosed as a type III
Osteogenesis Imperfecta confirmed by the occurrence of all of
the following conditions:• the result of physical examination of the life insured by a
Specialist that the life insured suffers from growth retardation
and hearing impairment; and
• the result of x-ray studies reveals multiple fracture of bones
and progressive kyphoscoliosis; and
• positive result of skin biopsy.
Diagnosis of Osteogenesis Imperfecta must be confirmed by a
Specialist. The coverage of this Special CI conditions benefit will
be provided until the day before the policy anniversary
immediately after the life insured's 18th birthday.
Rabies is an infectious disease of dogs, cats, and other animals,
transmitted to humans by the bite of an infected animal. It has to
be evidenced by:
• Typical symptoms of difficulty in swallowing, excessive
salivation, fear of water (hydrophobia) and hallucinations; and
• Presence of rabies virus antigen or rabies-neutralizing
antibody titer in the CSF.
Diagnosis must be confirmed by a specialist in the relevant field
and must occur within 90 days from the date that the life
insured was bitten by the infected animal.

20

Rheumatic Fever with
Valvular Impairment

The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 18th birthday.
A confirmed diagnosis by a Specialist of acute rheumatic fever
according to the revised Jones criteria. There must be

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No

Covered Special CI
Conditions

Definition
involvement of one or more heart valves with at least mild valve
incompetence attributable to rheumatic fever as confirmed by
quantitative investigations of the valve function by a Specialist.
The valve incompetence must persist for at least six months.

21

22

23

Severe Haemophilia

Severe Juvenile Rheumatoid
Arthritis

Type 1 Juvenile Spinal
Amyotrophy

The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 18th birthday.
The life insured must be suffering from severe hemophilia
associated with spontaneous haemorrhage and with a clotting
factor VIII or factor IX of less than one percent. Diagnosis must
be confirmed by a Specialist.
The coverage of this Special CI Conditions Benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 18th birthday.
A severe form of juvenile chronic arthritis characterised by high
fever and signs of systematic illness that can exist for months
before the onset of arthritis. The condition must be characterised
by cardinal manifestations which include high spiking, daily
(quotidian) fevers, evanescent rash, arthritis, splenomegaly,
lymphadenopathy, serositis, weight loss, neutrophilic
leukocytosis, increased acute Phase Proteins and usually
seronegative tests for Antinuclear Antibodies (ANA) and
Rheumatoid Factor (RF). The diagnosis must be backed by
adequate laboratory and other tests or investigations. The final
diagnosis must also be confirmed unequivocally by a
Specialist, and the condition has to be documented for at least 6
months.
The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 18th birthday.
The life insured must be diagnosed as a Type I Juvenile
Spinal Amyotrophy which is an infantile form of spinal muscular
atrophy characterised by progressive dysfunction of the anterior
horn cells in the spinal cord and brainstem cranial nerves with
profound weakness and bulbar dysfunction. Electromyography
and muscle biopsy are needed to confirm this diagnosis which
also need to be certified by a Specialist.
The coverage of this Special CI conditions benefit will be
provided until the day before the policy anniversary
immediately after the life insured's 18th birthday.

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