Diseases and Definition in Critical Illness Insurance
加拿大各保险公司的重病保险包括的重病种类及其定义常略有不同。以下是各公司最常见包括的 24种重病及其最常见的定义。资料来源是The Insurance Journal (August 2003)及(Sun Life Financial 2009 重大疾病保险介绍单张)。为了减少可能误差，我们这里以其英文原文列出。申请人在购买某一公司的重病保险产品时，应以其公司的保单条文中的重病定义和要求为准。一些公司也将其公司对重病的定义详细列在了网上，可参考相应的公司链节。
- Alzheimer's Disease(老年滞呆症): Progressive degeneration of the brain resulting in the reduction of mental and social functioning and requiring daily supervision. Some insurers do not cover other organic brain disorders and psychological illnesses while others require the client to need a minimum of eight hours of daily supervision.
- Aortic surgery (主动脉手术): Aortic surgery means the undergoing of surgery for disease of the aorta requiring excision and surgical replacement of the diseased aorta with a graft. Aorta refers to the thoracic and abdominal aorta but not its branches.
- Aplastic anaemia(再生障碍性贫血): Aplastic anemia means a definite diagnosis of a chronic persistent bone marrow failure, confirmed by biopsy, which results in anemia, neutropenia and thrombocytopenia requiring blood product transfusion, and treatment with at least one of the following: marrow stimulating agents， immunosuppressive agents，and bone marrow transplantation.
- Bacterial Meningitis (细菌性脑膜炎): Bacterial meningitis means a definite diagnosis of meningitis, confirmed by cerebrospinal fluid showing growth of pathogenic bacteria in culture, resulting in neurological deficit documented for at least 90 days from the date of diagnosis.
- Benign Brain Tumour(良性脑瘤): Permanent deficit of the neurological system such as impaired speech, sight or walking. Some insurers cover tumors of the bony cranium and pituitary microadenomas that are superior to 10mm in diameter and aortic surgery, heart valve replacement and loss of independent existence. For certain insurers, tumours or lesions in the pituitary gland are not covered and others exclude cysts, granulomas, meningiomas, malformations of the intracranial arteries or veins or tumours of the cranial nerves, pituitary gland or spinal cord.
- Blindness(失明): The permanent loss of sight in both eyes, with a corrected visual acuity worse than 20/200 in both eyes or a field of vision less than 20 degrees in both eyes.
- Cancer(癌症): A malignant tumour characterized by the uncontrolled growth and spread of mailignant cells and the invasion of tissue including leukemia and Hodgkin's disease, but excludes, in general, cancer in situ, Kaposi's sarcoma, skin cancer, except for those achieving greater depth than 0.70 mm, early prostate cancer, tumours in the presence of HIV, pre-malignant lesions, benign tumours and polyps.
- Coma(昏迷): State of deep unconsciousness, during which the person insured only shows signs of primary defensive reflexes to external stimuli for a continuous period of at least four days for most insurers.
- Coronary Artery Bypass Surgery (冠状动脉搭桥手术): To undergo heart surgery to correct narrowing or blockage of one or more coronary arteries with bypass grafts excluding any elective surgery or nonsurgical techniques such as balloon angioplasty or laser relief of an obstruction.
- Deafness (失聪): The permanent and profound loss of hearing in both ears with an auditory threshold of more than 90 decibels.
- Heart Attack (心脏病): The "death" of a portion of the heart as a result of inadequate blood supply as evidence by electrocardiographic (EGG) changes and an elevation in cardiac enzymes. Some insurers also base it on the elevation of biochemical markers.
- Heart Valve Replacement (心瓣置换): Heart valve replacement means the undergoing of surgery to replace any heart valve with either a natural or mechanical valve.
- HIV Infection (HIV病毒感染): Needs to have been contaminated accidentally during the course of normal occupation. Some insurers require blood tests to be taken within 14 days of the accidental injury and the result must be negative and another test must be taken between 90 and 180 days after the infection and the result must be positive.
- Kidney Failure (肾衰竭) : Failure of both kidneys needing treatment by regular dialysis or transplant in some case.
- Loss of Limbs (肢体分离): Total and permanent severance of two or more limbs from above the wrist or ankle joint. Some insurers add that the amputation can be the result of an accident or medically required amputation.
- Loss of Speech (哑症－失去语言能力) : For some insurers, the loss of speech must be at least 180 days or 12 months required by other insurers.
- Major Burns (严重烧伤) : Most insurers define this illness as third degree burns covering at least 20% of the body surface.
- Major Organ Transplant （主要器官移植） : See organ transplant.
- Major Organ Failure on Waiting List 轮后主要器官移植） : Major organ failure on waiting list means a definite diagnosis of the irreversible failure of the heart, both lungs, liver, both kidneys or bone marrow, and transplantation must be medically necessary. To qualify under major organ failure on waiting list, the insured person usually requires to become enrolled as the recipient in a recognized transplant centre in Canada or the United States that performs the required form of transplant surgery.
- Motor Neuron disease (ALS or Lou Gehrig's disease)(肌萎缩侧索硬化,ALS,或 运动神经元疾病) : Also called Amyotrophic Lateral Sclerosis, it is the unequivocal diagnoosis of motor neuron disease including primary lateral sclerosis, progressive spinal muscular atrophy, progressive bulbar palsy and pseudo bulbar palsy. Some insurers require that this disease be diagnosed prior to the age of 75.
- Multiple Sclerosis (多发性硬化症) : Neurological abnormalities persisting for a continuous period of at least 6 months and confirmed by modern investigational techniques (i.e. image scanning). Some insurers require typical symptoms of demyelination with resultant impairment of the brain stem or spinal cord. Some insurers require two episodes separated by at least one month.
- Organ Transplant (主要器官移植) : Generally of the heart, liver, lungs, kidneys, and bone marrow. In most cases, benefits are also offered to clients who are on a waiting list for transplant.
- Paralysis (瘫痪) : Complete and permanent loss of use of two or more limbs for a period of 90 days, during which time there has been no sign of improvement.
- Parkinson's Disease (柏氏金森症) : Characterized by two or more of the following symptoms: tremor, muscle rigidity and bradykinesia. Certain insurers require the insured to be in need of substantial physical assistance from another adult to perform two or more of six activities of daily living.
- Stroke (中风) : A neurological deficit persisting for at least 30 days. Most insurers exclude transient ischemic attacks while others have added to their definition of stroke "all episodes of ischemia by rupture of the thrombosis or embolism from extra-cranial source leading to permanent neurological sequelae."
- Coronary Angioplasty (冠状动脉成型手术)
- Ductal Carcinoma in Situ of the Breast（早期乳癌）
- Stage A Prostate Cancer (早期前列腺癌)
- Stage 1A Malignant Melanoma (早期皮肤癌)
- Cerebral Palsy(大脑性麻痹)：Cerebral palsy means a definite diagnosis of a non-progressive neurological defect affecting muscle control. This defect is characterized by spasticity and incoordination of movements.
- Congenital Heart Disease (先天性心脏病)：Congenital heart disease means a definite diagnosis of at least one of the covered heart conditions described below. It also means the specific conditions described below for which open heart surgery is performed to correct the condition.
- Cystic Fibrosis (囊性纤维化)：Cystic fibrosis means a definite diagnosis of cystic fibrosis where the insured person has chronic lung disease and pancreatic insufficiency.
- Muscular Dystrophy (肌肉萎缩症)：Muscular dystrophy means a definite diagnosis of muscular dystrophy where the insured person has well defined neurological abnormalities, confirmed by electromyography and muscle biopsy.
- Type 1 Diabetes Mellitus (1型糖尿病)：Type 1 diabetes mellitus means a definite diagnosis where the insured person has total insulin deficiency and continuous dependence on exogenous insulin for survival. Dependence on insulin must persist for a continuous period of at least three months.