Lifecheque Definitions and Interpretations


	Lifecheque Definitions and Interpretations
	Condition	Definition (Policy Wording)	Interpretation (of Definition)

	Heart Attack (Myocardial Infarction)	The death of a portion of heart muscle as a result of inadequate blood supply to the relevant area. The diagnosis must be based on: - new electrocardiographic changes indicative of a myocardial infarction, and - elevation of cardiac enzymes	If you suffer a heart attack, you will have damage to the heart muscle, which causes changes in the electrocardiogram (ECG)and elevation of cardiac (heart) enzymes. The chance finding of ECG changes suggestive of a previous silent heart attack is not covered.


	Coronary Artery Disease Requiring Surgery (Coronary Bypass)	The undergoing of heart surgery to correct narrowing or blockage of one or more coronary arteries with bypass grafts. This excludes non-surgical techniques such as balloon angioplasty or laser relief of an obstruction.	Only artery bypass is covered. Since balloon angioplasty and laser relief do not require open heart surgery, these two techniques are not covered by Lifecheque.

	Cancer	A malignant tumour characterized by the uncontrolled growth and spread of malignant cells and the invasion of tissue. This includes leukemia and Hodgkin’s disease. Cancer in situ and any skin cancer, other than malignant melanoma into the dermis or deeper, is excluded. Stage A prostate cancer will be covered only if the diagnosis is made before the policy anniversary nearest to the Life Insured’s age 75. Subject to the above definition, no benefit under this covered condition will be payable if: 1) a diagnosis of any type of cancer is made within 90 days of the effective date of coverage or the date of the latest reinstatement, or 2) any symptoms of medical problems commence within 90 days of the effective date of the coverage or the date of the latest reinstatement that initiate any investigations that lead to a diagnosis of any type of cancer.	There are well over 300 different known types of cancer and this definition covers the vast majority of them. The main exclusions are for superficial types, such as skin cancer, which is not generally looked upon as life-threatening and is readily treatable. Without these limited exclusions, the cost of this benefit would be exorbitant because the plan might easily be subjected to abuse by overzealous sun worshippers.

	Stroke (Cerebrovascular Incident)	Any cerebrovascular incident producing neurological sequelae lasting more than twenty-four hours and including infarction of brain tissue, hemorrhage or embolism from an extra-cranial source. There must be evidence of permanent neurological deficit. Transient Ischemic Attacks are specifically excluded.	This definition covers all three mechanisms that cause strokes: Thrombosis, caused by a blockage by a thrombus (clot) that has built up on the wall of a brain artery; Embolization, caused by an embolus (usually a clot) that is swept into a brain artery causing blockage; Hemorrhage, which is caused by the rupture of a blood vessel in or near the brain’s surface. Any incident with symptoms lasting less than 24 hours is referred to as a TIA (Transient Ischemic Attack) and does not qualify for coverage under this definition.

	Multiple Sclerosis	Unequivocal diagnosis of definite Multiple Sclerosis by a consultant neurologist, holding an appointment as such in a major Canadian hospital of well-defined neurological abnormalities persisting for a continuous period of at least six months, and confirmed by modern investigational techniques such as image scanning. Neurological abnormalities in this context must be evidenced by the typical symptoms of demyelination with resultant impairment of the brain stem or spinal cord, but the Life Insured need not necessarily confined to a wheelchair.	Benign, chronic and acute forms of Multiple Sclerosis are all covered under this definition. Multiple Sclerosis is an extremely difficult condition to diagnose and usually takes a number of tests, to exclude other possibilities, before it is confirmed. Symptoms vary according to which part of the brain and spinal cord are affected; therefore, physical symptoms are very different amongst the different forms of Multiple Sclerosis. This definition has centered around the neurological abnormalities, as opposed to the degree of physical impairment. With Multiple Sclerosis, areas of the fatty myelin sheaths of the nerve fibers are destroyed, thus blocking nerve impulses to and from the brain. Demyelination is typical evidence of Multiple Sclerosis.

	Kidney Failure	End stage renal disease, due to whatever cause or causes, with the Life Insured undergoing regular peritoneal dialysis or hemodialysis or having had renal transplantation.	Chronic kidney failure patients require dialysis, either peritoneal dialysis or hemodialysis, for the rest of their lives or until they can be given a kidney transplant.

	Coma	A state of unconsciousness, with no reaction to external stimuli or response to internal needs, continuing for at least 7 days. Life support systems must be required throughout the period of unconsciousness.	A state of being incapable of responding to sensory stimuli and having subjective experiences, caused by disease or injury that continues a minimum of 7 days, requiring life support systems.

	Major Organ Transplantation	The actual undergoing as a recipient of a transplant of a: - Heart - Lung - Liver - Pancreas - Kidney - Bone Marrow	An extremely broad coverage of the major organ transplants is provided in this definition. This definition leaves no margin for doubt. If you undergo any of these six listed transplants you will be covered under Lifecheque. Bone marrow transplants are covered even if the patient’s own bone marrow is extracted, treated, and then reinfused into the patient.

	Paralysis	Complete and permanent loss of use of two or more limbs for a continuous period of 90 days following the precipitating event, during which time there has been no sign of improvement.	Any permanent type of paralysis, paraplegia or quadriplegia, whether it is caused by an accident, illness or disease is covered. This covered event has a waiting period to eliminate cases of temporary paralysis, but the waiting period is reasonable and shorter than many typical accidental coverage plans. A 90 day assessment period is quite normal to eliminate the possibility a condition is temporary.

	Severe Burns	The diagnosis by a doctor, who is a certified plastic surgeon, that the Life Insured has sustained third degree burns covering at least 20% of the surface area of the body.	There are three levels of burns. They are medically known as ‘first’, ‘second’ and ‘third degree’. ‘First degree’ burns damage the top layer of skin (ie. sunburn). ‘Second degree’ burns go deeper into the layers of skin. ‘Third degree’ burns are the most serious, as they destroy the full thickness of the skin. The 20% requirement of third degree burns is considered to be life threatening.

	Deafness	Total, permanent and profound loss of hearing in both ears, with an auditory threshold of more than 90 decibels, as confirmed by an otolaryngologist registered to practice in Canada.	You are covered if an accident, injury or illness causes you to totally and permanently lose your hearing in both ears. The amount of hearing loss required to qualify under this definition can be easily measured and accurately confirmed by professional testing.

	Blindness	Permanent loss of sight in both eyes, as confirmed by an ophthalmologist registered to practice in Canada. The corrected visual acuity must be worse than 20/200 in both eyes, or the field of vision must be less than 20 degrees in both eyes.	This definition is similar to the presumptive clauses in disability policies. The event can be the result of an accident, injury or illness. The benefit will be paid regardless of whether the cause is injury, disease, or degeneration of the eyeball, of the optic nerve or nerve pathways connecting the eye to the brain, or the brain itself.

	Loss of Limbs	The irreversible severance of two or more limbs from above the wrist or ankle joint as the result of an accident or medically required amputation.	Two or more limbs become severed above the wrist or ankle joint. The event can be the result of an accident, injury or illness.

	Loss of Speech	The total and irreversible loss of the ability to speak as the result of physical injury or disease which must be established for a continuous period of at least 180 days. All psychiatric related cases are specifically excluded.	The total and irreversible loss of the ability to express thoughts and ideas by vocal sounds. The event can be the result of an accident, injury or illness, but excludes psychiatric cases.

	Occupational HIV Injury	The diagnosis of Human Immunodeficiency Virus (HIV) resulting from accidental injury during the course of the Life Insured’s normal occupation, which exposed the Life Insured to HIV contaminated blood or body fluids. Payment under this Covered Condition requires satisfaction of all of the following: 1) the accidental injury must be reported to the Company within 14 days of its occurance, 2) an HIV test must be taken within 14 days of the accidental injury and the result must be negative, 3) an HIV test must be taken between 90 days and 180 days after the accidental injury and the result must be positive, 4) all HIV tests must be performed by facilities approved by the Company, 5) the accidental injury must have been reported, investigated and documented in accordance with Canadian workplace guidelines, 6) the accidental injury must have occured while the Life Insured was working in Canada or the United States. No payment will be made if: 1) the Life Insured has elected not to take any available licensed vaccine offering protection against HIV, or 2) a licensed cure for HIV infection has become available prior to the accidental injury, or 3) HIV infection has occurred as a result of non-accidental injury (including, but not limited to, sexual transmission or intravenous drug use).	This benefit would be of value to people who work in occupations where they may come in contact with blood or body fluids (physician, dentist, nurse, police officer etc.). The reporting procedures are necessary in order to ensure that HIV is contracted as a result of occupational exposure and not from drug use or sexually transmitted means. The accidental injury must occur in Canada or the United States.

	Motor Neuron Disease	An unequivocal diagnosis by a doctor who is a certified neurologist, of one of the following: amyotrophic lateral sclerosis (A.L.S. or Lou Gehrig’s Disease), primary lateral sclerosis, progressive spinal muscular atrophy, progressive bulbar palsy, or pseudo bulbar palsy, and limited to these entities. This condition will be covered only if the diagnosis is made before the policy anniversary nearest to the Life Insured’s age 75.	Motor Neuron Disease is a progressive degenerative disorder which affects the central nervous system characterized by muscular weakness and a wasting away of muscle without any sensory changes. As the nerves degenerate, the muscles weaken and deteriorate. The most frequently mentioned Motor Neuron Disease is Amyotrophic Lateral Sclerosis (ALS) which is more commonly known as ‘Lou Gehrig’s disease’. It usually occurs in middle life progressing to death due to respiratory paralysis in 2-5 years.

ltc.html ltc.html	Parkinson's Disease	The diagnosis by a doctor, who is a certified neurologist, that the Life Insured has primary idiopathic Parkinson’s Disease which is characterized by two or more of the following clinical manifestations: • muscle rigidity • tremor • bradykinesis (abnormal slowness of movement, sluggishness of physical and mental responses) All other types of Parkinsonism are specifically excluded. This condition will be covered only if the diagnosis is made before the policy anniversary nearest to the Life Insured’s age 75.	Parkinson’s Disease is a progressive, degenerative disease of the central nervous system. The disease is characterized by muscular rigidity, tremor and slow movements. This definition only covers ‘idiopathic’ Parkinson’s Disease. Idiopathic means that the disease must have originated from an unknown cause. Parkinson’s disease originating from taking certain drugs or toxic chemicals, etc. will not be covered.

	Alzheimer's Disease	The diagnosis by a doctor, who is either a certified neurologist or a certified psychiatrist, that the Life Insured has Alzheimer’s Disease, supported by evidence of a progressive degeneration of the brain, memory and the ability to reason and perceive. The Life Insured must exhibit the loss of intellectual capacity involving impairment of memory and judgement, which results in such a significant reduction of mental and social functioning, as to require continuous daily supervision. All other dementing organic brain disorders and psychiatric illnesses are specifically excluded. This condition will be covered only if the diagnosis is made before the policy anniversary nearest to the Life Insured’s age 75.	Alzheimer’s Disease is a progressive degenerative brain disease. The nerve cells in the brain deteriorate over time. Early symptoms are memory loss, disorientation, personality change and seizures. The disease progresses to severe loss of memory and death usually within 10 years. The disease is difficult to diagnose, and therefore the definition requires that the insured has reached the stage where continuous daily supervision is required.

	Exclusions and Limitations	No benefit will be paid if the Life Insured for this Provision, while sane or insane, suffers a Covered Condition as a result of any of the following: • intentional self-inflicted injuries, • the abuse of alcohol or drugs, • committing or attempting to commit a criminal offence, • operating a motor vehicle while the concentration of alcohol in 100 milliliters of blood exceeds 80 milligrams. No benefit will be paid unless the Life Insured for this Provision survives 30 days following the first diagnosis of a Covered Condition or such longer period as described under the Covered Conditions.	Exclusions are directed at self-inflicted injuries, which is a standard provision for policies of this nature. If you suffer a covered event and survive 30 days or longer period as described under the Covered Condition, and then die, you will receive the Lifecheque benefit. If you suffer a covered event and die within the first 30 days after the event, then only the death benefit (return of premium) will be paid.
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