Definition
Cancer means a definite diagnosis of a malignant tumour. This tumour must be characterized by the uncontrolled growth and spread of malignant cells and the invasion of tissue. Types of cancer include carcinoma, melanoma, leukemia, lymphoma, and sarcoma.
The diagnosis of cancer must be made by a specialist and must be confirmed by a histopathology report or appropriate pathological testing in the case of non solid tumours.
Exclusions
No benefit will be payable for the following:
- lesions described as benign, pre malignant, uncertain, borderline, non invasive, carcinoma in situ (Tis), or tumors classified as Ta
- malignant melanoma skin cancer that is less than or equal to 1.0 mm in thickness, unless it is ulcerated or is accompanied by lymph node or distant metastasis
- any non melanoma skin cancer, without lymph node or distant metastasis
- prostate cancer classified as T1a or T1b, without lymph node or distant metastasis
- papillary thyroid cancer or follicular thyroid cancer, or both, that is less than or equal to 2.0 cm in greatest diameter and classified as T1, without lymph node or distant metastasis
- chronic lymphocytic leukemia classified less than Rai stage 1, or
- gastro-intestinal stromal tumours classified as AJCC Stage 1
- grade 1 neuroendocrine tumours (carcinoid) confined to the affected organ, treated with surgery alone and requiring no additional treatment, other than medication to counteract the effects from hormonal oversecretion by the tumour.
For purposes of the policy, the terms Tis, Ta, T1a, T1b, T1 and AJCC Stage 2 are to be applied as defined in the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, 7th Edition, 2010. For purposes of the policy, the term Rai staging is to be applied as set out in KR Rai, A Sawitsky, EP Cronkite, AD Chanana, RN Levy and BS Pasternack: Clinical staging of chronic lymphocytic leukemia. Blood 46:219, 1975.
90-day exclusion period for cancer
No benefit will be payable under this condition if within the first 90 days following the later of:
- the date the application for this policy was signed
- the underwriting decision date, but only if shown under the heading, Amendments to this policy
- the policy date, shown on the Policy summary, or
- the most recent date this policy was put back into effect (reinstatement),
the insured person has any of the following:
- signs, symptoms or investigations, that lead to a diagnosis of cancer (covered or excluded under the policy), regardless of when the diagnosis is made, or
- a diagnosis of cancer (covered or excluded under the policy).
Your responsibility to notify us about cancer
You have a responsibility to notify us about cancer, regardless of when a diagnosis is made:
- If we are notified within 6 months of the date of the diagnosis and the coverage for cancer is excluded based on the 90 day exclusion, coverage for all other covered critical illnesses will continue.
- If information is not provided within 6 months of the date of diagnosis, we have the right to deny a claim for cancer or any critical illness caused by any cancer or its treatment.
