Pukwana ya Kganya Terms & Conditions

64 DREAD DISEASE CATEGORIES EXCLUSION 3. Cancer Dread Disease description Where any malignant tumour occurs characterised by the uncontrolled growth of malignant cells and invasion of tissue. The term malignant tumour includes lymphoma and sarcoma. A tumour may be benign or malignant. A malignant tumour is cancer and can invade neighbouring tissue and organs through blood or lymph system. The following are excluded: • All tumours which are histologically classified as premalignant, as non-invasive or as cancer in situ including any CIN stage (cervical intraepithelial neoplasia); • Non-malignant conditions that can become malignant, including essential thrombocythemia and polycythaemia rubra vera; • All tumours of the prostate unless histologically classified as having a Gleason score greater than 6 or having progressed to at least clinical TNM classification T2nOMO; • All cancers arising in the skin other than malignant melanoma histologically classified as having progressed to at least Clark’s Level II; • Lymphoma limited to 1 (one) region of lymph nodes; and • Any cancer diagnosed and treated by primary biopsy only and does not require any additional surgical, medical, radiotherapy or other modalities, shall not qualify as “cancer”. 4. Coronary Artery (bypass) Surgery Dread Disease description The actual undergoing of heart surgery to correct narrowing or blockage of two or more coronary arteries with bypass grafts. The surgery must have been proven to be necessary by means of coronary angiography and the realisation of the surgery has to be confirmed by a Medical Practitioner. The following are excluded: • Angioplasty; Angioplasty is a minimally invasive endovascular procedure to widen narrowed or obstructed arteries or veins, typically to treat arterial atherosclerosis. • Any other intra-arterial procedures; • Key-hole surgery; No benefit is payable if a claim for a heart attack or heart transplant has been previously admitted in respect of the Policyholder. 5. Total Kidney Failure Dread Disease description The end stage renal function presenting as chronic irreversible failure of both kidneys to function as a result of which regular peritoneal dialysis or haemodialysis is instituted. No benefit is payable if a claim for a Kidney Transplant or Kidney Cancer has been previously admitted in respect of the Policyholder. 6. Major Organ Transplant Dread Disease description The actual undergoing as a recipient of a transplant of any one or more of a donor heart, liver, pancreas, bone marrow, kidney or lungs. Realisation of the transplantation has to be confirmed by a Medical Practitioner. No benefit is payable for a Heart Transplant if a claim for Coronary Artery (bypass) Surgery or a Heart Attack has been previously admitted in respect of the Policyholder. No benefit is payable for a Kidney Transplant if a claim for Total Kidney Failure has been previously admitted in respect of the Policyholder. No benefit is payable for any organ requiring transplant and for which organ a claim for Cancer has been previously admitted in respect of the Policyholder. 7. Blindness Dread Disease description The total, permanent and irreversible loss of sight in both eyes as a result of sickness or disease. Vision measured at 3/60 or worse in the better eye using a Snellen eye chart. No further exclusions apply. 8. Coma Dread Disease description A state of unconsciousness as a result of sickness with no reaction to external stimuli or internal needs persisting continuously for a period of at least 96 (ninety six) hours with the use of life support systems, resulting in permanent neurological deficit. The following are excluded: • A coma secondary to alcohol or drug misuse is not covered.