Diseases that spread to other parts of the body through blood vessels, lymphatic vessels and body cavities. Pathological examination results confirmed the diagnosis, clinical
The diagnosis belongs to the category of malignant tumor in the International Statistical Classification of Diseases and Related Health Problems of the World Health Organization (ICD- 10).
The following diseases are not covered:
1. carcinoma in situ;
2. Chronic lymphoblastic leukemia equivalent to stage A of Binet staging scheme;
3. Hodgkin's disease equivalent to the first stage of Ann Arbor staging scheme;
4. Skin cancer (excluding malignant melanoma and metastatic skin cancer);
5. prostate cancer 5. T 1n0m 0≤TNM stage;
6. Malignant tumor during 6.HIV infection or AIDS.
2. Acute myocardial infarction: refers to partial myocardial necrosis caused by coronary artery obstruction and insufficient blood supply in the corresponding area. Xu Man
Meet at least the following three conditions:
1. Typical clinical manifestations, such as acute chest pain;
2. Recent ECG changes suggest acute myocardial infarction;
3. Myocardial enzymes or troponin increase in diagnosis, or show dynamic changes consistent with acute myocardial infarction;
4. 90 days after the onset, it is confirmed that the left ventricular function is reduced, such as the left ventricular ejection fraction is less than 50%.
Sequela of cerebral apoplexy: refers to cerebral vascular hemorrhage, embolism or infarction caused by sudden changes of cerebral vessels, and leads to nervous system.
Permanent sexual dysfunction. Permanent sexual dysfunction of nervous system means that one or more of the following items still exist after 80 days of diagnosis/kloc-0.
More than one obstacle:
1. One or more limbs completely lose limb function (note1);
2. Complete loss of language ability or chewing and swallowing ability (Note 2);
China Life Insurance Corning Lifelong critical illness insurance (Version 20 12) Benefit Clause (Page 2)
3. The ability to live independently is completely lost, and it is impossible to independently complete three or three of the six basic activities of daily life (Note 3).
Above.
Four, major organ transplantation or hematopoietic stem cell transplantation: major organ transplantation, refers to the corresponding organ failure, has been
Received an allogeneic kidney, liver, heart or lung transplant. Hematopoietic stem cell transplantation refers to hematopoietic dysfunction or
Hematopoietic malignant tumor, hematopoietic stem cells (including bone marrow hematopoietic stem cells, peripheral blood hematopoietic stem cells and umbilical cord blood) have been implemented.
Hematopoietic stem cells).
Five, coronary artery bypass grafting (or coronary artery bypass grafting): refers to the treatment of severe coronary heart disease, the actual implementation.
Open-chest coronary artery bypass grafting.
Non-thoracotomy interventional surgery and endoscopy such as coronary stent implantation, balloon dilatation of cardiac catheter, laser radio frequency technology, etc.
Surgery is not included.
Six, end-stage renal disease (or uremia stage of chronic renal failure): refers to chronic irreversible renal failure, to achieve
In uremia stage, regular dialysis treatment or kidney transplantation has been carried out for at least 90 days after diagnosis.
7. Multi-limb loss: refers to the loss of two or more limbs from the wrist joint or the proximal ankle joint due to illness or accidental injury.
Complete amputation above (near the trunk end).
Eight, acute or subacute severe hepatitis: refers to the diffuse necrosis of liver tissue caused by hepatitis virus infection, leading to acute liver failure.
Can be unqualified, and confirmed by serological or virological examination, and must meet all the following conditions:
1. Severe jaundice or jaundice increases rapidly;
2. Hepatic encephalopathy;
3.b-ultrasound or other imaging examination showed that the liver volume was rapidly shrinking;
4. Progressive deterioration of liver function indicators.
Nine, benign brain tumor: refers to the benign tumor of the brain, which has caused an increase in intracranial pressure, and the clinical manifestation is papilla edema.
Mental symptoms, epilepsy and dyskinesia, and life-threatening. It must be examined by head tomography (CT) and magnetic resonance imaging (MRI)
Or positron emission tomography (PET), and must meet at least one of the following conditions:
1. Complete or partial resection of brain tumor by craniotomy.
2. The radiotherapy for brain tumor was actually implemented.
Pituitary tumors, brain cysts and cerebrovascular diseases are not covered.
X. decompensated period of chronic liver failure: refers to liver failure caused by chronic liver disease. All the following conditions must be met:
1. Persistent jaundice;
2. Ascites;
3. Hepatic encephalopathy;
4. Congestive splenomegaly with hypersplenism or esophageal and gastric varices.
Liver failure caused by alcoholism or drug abuse is not covered.
Xi。 Encephalitis sequela's disease or sequelae of meningitis: refers to the permanent sexual dysfunction of the nervous system caused by encephalitis or meningitis.
Obstruct Permanent dysfunction of nervous system means that one or more of the following disorders still exist after 80 days of diagnosis/kloc-0:
1. One or more limbs completely lose limb function (note1);
2. Complete loss of language ability or chewing and swallowing ability (Note 2);
3. The ability to live independently is completely lost, and it is impossible to independently complete three or three of the six basic activities of daily life (Note 3).
Above.
Twelve, deep coma: refers to the loss of consciousness due to illness or accidental injury, unresponsive to external stimuli and internal needs, fainting.
According to Glasgow coma scale, the degree of obsession is below 5, and it has been used continuously.
Ventilators and other life support systems for more than 96 hours.
Deep coma caused by alcoholism or drug abuse is not covered.
13. Deafness in both ears at a specific age: refers to permanent deafness in both ears caused by illness or accidental injury after the insured reaches the age of 3.
Reversible (Note 4) loss, the average hearing threshold is greater than 90 dB at sound frequencies of 500 Hz, 1000 Hz and 2000 Hz, and
China Life Insurance Corning Lifelong critical illness insurance (Version 20 12) Benefit Clause (Page 3)
It was confirmed by pure tone hearing test, acoustic immittance test or auditory evoked potential test.
When applying for claims, evidence of hearing loss diagnosis and examination must be provided.
14. Binocular blindness at a specific age: refers to the permanent loss of binocular vision caused by illness or accidental injury after the insured reaches the age of 3.
Reversible loss (Note 4), the better eye in both eyes must meet at least one of the following conditions:
1. Loss or removal of eyeball;
2. The corrected visual acuity is less than 0.02 (international standard visual acuity chart is adopted, and it should be converted if other visual acuity charts are adopted);
3. The visual field radius is less than 5 degrees.
When applying for claims, you must provide proof of diagnosis and examination of vision loss at the time of claims.
Paralysis: refers to the permanent and complete loss of limb function of two or more limbs due to illness or accidental injury. Limb function
Permanent total loss means that two of the three main joints of each limb remain after 180 days of disease diagnosis or accidental injury 180 days.
Completely rigid, or unable to move with consciousness.
Sixteen, heart valve surgery: refers to the actual implementation of open heart valve replacement or repair for the treatment of heart valve diseases.
Reoperation
17. Severe Alzheimer's disease: refers to the serious decline or loss of intelligence due to progressive and irreversible changes in the brain.
Bed shows obvious cognitive impairment, abnormal behavior and decreased social ability, and its daily life must be continuously monitored by others.
It must be verified by head tomography (CT), nuclear magnetic resonance (MRI) or positron emission tomography (PET).
Real, and the ability to live independently is completely lost, and it is impossible to independently complete three or three of the six basic daily activities (Note 3)
Let's go
Neurosis and mental illness are not covered.
18. Severe craniocerebral injury: refers to the injury of important parts of the brain caused by mechanical external force on the head, resulting in permanent nervous system damage.
Sexual dysfunction. It must be examined by head tomography (CT), magnetic resonance (MRI) or positron emission tomography (PET).
Waiting for imaging examination to confirm. Permanent dysfunction of nervous system means that one or more of the following still exists after brain injury 180 days.
Upper obstacle:
1. One or more limbs completely lose limb function (note1);
2. Complete loss of language ability or chewing and swallowing ability (Note 2);
3. The ability to live independently is completely lost, and it is impossible to independently complete three or three of the six basic activities of daily life (Note 3).
Above.
19. Severe Parkinson's disease: It is a degenerative disease of the central nervous system with clinical manifestations of paralysis and economic loss.
Tune, etc. All the following conditions must be met:
1. Drug treatment can't control the disease;
2. Completely lost the ability to live independently, unable to independently complete three or three of the six basic activities of daily life (Note 3).
Above.
Secondary Parkinson's disease is not covered.
20. Severe third-degree burns: refers to third-degree burns, and the area of third-degree burns reaches 20% of the total body surface area or
Over 20%. The body surface area is calculated according to China's new nine-point method.
Twenty-one, severe primary pulmonary hypertension: refers to the unexplained pulmonary arterial pressure continues to increase, which is dominated by progressive development.
Chronic diseases have caused permanent irreversible (Note 4) limited physical activity, reaching the new york Heart Association.
The cardiac function status was classified as Grade IV, and the average resting pulmonary artery pressure was greater than 30mmHg.
22. Severe motor neuron disease: it is a group of progressive degenerative diseases of motor neurons in the central nervous system, including
Progressive spinal muscular atrophy, progressive bulbar palsy, primary lateral sclerosis, amyotrophic lateral sclerosis. Autonomy must be satisfied
The ability to live is completely lost, and it is impossible to independently complete three or more of the six basic activities of daily life (Note 3).
Loss of language ability: refers to the complete loss of language ability due to illness or accidental injury and at least after active treatment.
12 months (complete vocal cord resection is not limited by this time), and the existing medical means still cannot be restored.
The loss of language ability caused by mental and psychological factors is not covered.
China Life's Corning Lifelong critical illness insurance (Version 20 12) Benefit Clause (Page 4)
Twenty-four, severe aplastic anemia: refers to anemia and neutropenia caused by chronic continuous failure of bone marrow hematopoietic function.
Hemacytopenia and thrombocytopenia. All the following conditions must be met:
1. The results of bone marrow puncture or bone marrow biopsy support the diagnosis;
2. Peripheral blood pictures must meet the following three conditions:
(1) The absolute value of neutrophils is ≤ 0.5×109/L;
(2) Reticulocyte < 65438 0%;
(3) The absolute value of platelets is ≤ 20×109/L. ..
Twenty-five, aortic surgery: refers to the treatment of aortic diseases, the actual implementation of thoracotomy or laparotomy for resection, replacement,
Repair the damaged aorta. Aorta refers to thoracic aorta and abdominal aorta, excluding thoracic aorta and abdominal aorta.
Side auxiliary tube
Intra-arterial angioplasty is not covered.
Twenty-six, severe cardiomyopathy: refers to the chronic cardiac function damage caused by cardiomyopathy, which has caused permanent irreversibility (Note 4).
Heart failure, reaching Grade IV of new york Cardiology Association, must be permanent and irreversible (Note 4).
Physical activity is limited and physical activity is impossible.
Twenty-seven, myasthenia gravis: refers to an autoimmune disease of nerve and muscle joint transmission disorder, clinically.
Its characteristic is that the local or systemic striated muscles are prone to fatigue and weakness, and the extraocular muscles of the brain are most easily involved, which may also involve the respiratory muscles.
Proximal lower limb muscles and even whole body muscles. And all the following conditions must be met:
1. After medical treatment or thymus surgery for more than one year, the patient can't control his illness and lose his normal working ability;
2. Blepharoptosis, dysarthria caused by involvement of medullary muscles, eating cough, or involvement of medullary muscles due to muscle weakness,
The critical state of respiratory dysfunction caused by respiratory muscles is myasthenia crisis;
3. Symptom remission, recurrence and deterioration appear alternately, and there is a history of clinical treatment with anticholinesterase drugs such as neostigmine.
Twenty-eight, severe multiple sclerosis: refers to the demyelinating disease of the central nervous system, leading to irreversible movement or sensory work.
Dysfunction, clinical manifestations are visual impairment, paraplegia, imbalance, dysarthria, dysuria and other symptoms. inreversible
It means that motor or sensory dysfunction needs to last for more than 180 days after the initial diagnosis. It must be checked by CT and MRI.
Or positron emission tomography (PET), and all the following conditions must be met:
1. The above clinical symptoms caused by optic nerve, brain stem or spinal cord injury obviously exist;
2. Diverse nerve injuries;
3. The history of clinical symptoms, deterioration and nerve injury of the above-mentioned recurrent attacks.
Twenty-nine, severe polio: refers to the motor dysfunction or respiratory dysfunction caused by poliovirus infection.
If weakness lasts for more than three months, it will inevitably lead to permanent and complete loss of function of one or more limbs. Permanent total loss of limb function,
It means that after the diagnosis of 180 days, two of the three joints of each limb are still completely stiff or unable to move with consciousness.
30. Severe rheumatoid arthritis: refers to the widespread chronic progressive multi-joint disease, characterized by severe joint deformation.
Infringe on at least three major joints (wrist joint, elbow joint, shoulder joint, ankle joint, knee joint and hip joint) or joint groups (such as
Multiple interphalangeal joints and metacarpophalangeal joints of the hand, and multiple toes and metatarsophalangeal joints of the foot). Rheumatoid arthritis must be clearly diagnosed and achieved.
Permanent irreversible joint dysfunction (Note 4) reaches the functional grade IV of rheumatoid arthritis, and all the following conditions must be met.
Number of pieces:
1. morning stiffness;
2. Symmetric arthritis;
3. Rheumatoid subcutaneous nodules;
4. The titer of rheumatoid factor increased;
5.x-ray showed that the joints (cartilage and bone) were severely damaged and the joints were deformed.
Thirty-one, severe systemic lupus erythematosus nephropathy: systemic lupus erythematosus is a multi-system and multi-organ disease.
Autoantibody immune diseases. Systemic lupus erythematosus, also known as lupus nephritis, is related to systemic lupus erythematosus.
Kidney, causing renal function damage. Must be confirmed by renal pathological examination or clinical diagnosis, and meet the following WHO diagnostic criteria.
China Life Insurance Corning Lifelong critical illness insurance (Version 20 12) Benefit Clause (Page 5)
Quasi-defined type Ⅲ-ⅴ lupus nephritis.
World Health Organization (WHO) classification of lupus nephritis;
Type I (minimal lesion type): negative under microscope and normal urine;
Type ⅱ (mesangial lesion type): moderate proteinuria with occasional urinary sediment changes;
Type ⅲ (focal segmental hyperplasia): proteinuria and urinary sediment changes;
Type ⅳ (diffuse proliferative type): acute nephritis with urinary sediment change or nephrotic syndrome;
Type ⅴ (membranous type): nephrotic syndrome or severe proteinuria.
Other types of lupus erythematosus, such as discoid lupus erythematosus and systemic lupus erythematosus, only involve other systems, such as blood and joints.
Within the scope of protection.
32. End-stage lung disease: refers to chronic respiratory failure, which must meet all the following conditions:
1. FEV 1 of lung function test is continuously lower than 0.75 liters;
2. Patients with hypoxia must be given extensive and continuous oxygen therapy;
3. The arterial blood gas analysis showed that the oxygen partial pressure was lower than 55mmHg.
Severe Crohn's disease: refers to chronic granulomatous enteritis characterized by Crohn's disease.
It must be confirmed by pathological examination results, and it has caused intestinal fistula with intestinal obstruction or intestinal perforation.
34. Severe ulcerative colitis: refers to acute fulminant ulcerative colitis with fatal electrolyte disorder and pathological changes.
It has involved the whole colon, showing severe bloody stools and systemic symptoms and signs, which must be confirmed by pathological examination results and confirmed.
Perform colectomy or ileostomy.
Persistent vegetative state: refers to severe craniocerebral trauma, persistent hypoxia, severe encephalitis or some kind of spirit.
Toxins cause serious damage to the brain or brain stem, and lead to the loss of consciousness and central nervous system function, leaving only autonomic nerves.
Functional disease state, and vegetative state must last for more than 30 days.
Thirty-six, severe insulin-dependent diabetes: refers to the chronic blood sugar increase caused by absolute lack of insulin secretion.
The results of blood insulin determination, blood C-peptide determination or urine C-peptide determination confirmed that it has been continuously dependent on exogenous insulin to maintain 180.
More than days; At least one of the following conditions must be met:
1. proliferative retinopathy has appeared;
2. A pacemaker must be implanted to treat heart disease;
At least one toe needs to be removed because of gangrene.
37. Severe coronary heart disease: It refers to the severe stenosis of three major blood vessels clearly diagnosed according to the results of coronary angiography.
Sexual lesions (the lumen diameter of at least one blood vessel is reduced by more than 75%, and the lumen diameter of the other two blood vessels is reduced by more than 60%). Coronal motion
The main blood vessels of pulse refer to the left coronary artery trunk, anterior descending branch, circumflex branch and right coronary artery, excluding anterior descending branch, levorotatory branch and right coronary artery.
Branches of the coronary artery.
Thirty-eight, acute necrotizing pancreatitis laparotomy: refers to the actual implementation of laparotomy for the treatment of acute necrotizing pancreatitis.
Necrotic tissue resection, focal resection or partial pancreatectomy.
Open surgery for acute necrotizing pancreatitis caused by alcoholism is not covered.
39. Blood transfusion infected with HIV: the insured is infected with HIV,
And all the following conditions must be met:
1. Infection caused by blood transfusion;
2. The blood transfusion center or the hospital that provides blood transfusion treatment issues a report, is the blood transfusion infection a medical liability accident, or is it finally determined by the court?
The trial ruling belongs to medical responsibility and no appeal is allowed;
3. The infected insured is not a hemophiliac.
Any human immunodeficiency virus (HIV) infection caused by other modes of transmission (including sexual transmission or intravenous drug use)
Not covered by the warranty. The company has the right to obtain and use all blood samples of the insured and the ability to analyze these samples.
The right to conduct independent inspection.
40. Severe dementia caused by non-Alzheimer's Harmo's disease? Refers to the brain dysfunction caused by brain organic diseases other than Alzheimer's disease.
Energy failure leads to permanent irreversible severe dementia, with obvious cognitive impairment, behavioral and social abnormalities.
Ability to decline. The insured has completely lost the ability to live independently and cannot complete six basic daily activities independently (Note 3).
China Life Insurance Corning Lifelong critical illness insurance (Version 20 12) Benefit Clause (Page 6)
More than three, daily life must be continuously supervised by others. The diseases that lead to dementia must be diagnosed clearly and thoroughly.
The whole clinical, laboratory and imaging examination results confirmed.
Brain damage caused by neurosis, psychosis and alcoholism is not covered.