008 DEFINITION OF CRITICAL ILLNESSES

DEFINITION OF CRITICAL ILLNESSES

36种严重疾病受保项目的定义



1.心脏病的发作 Heart Attack
The death of a portion of the heart muscle (myocardium) as a result of inadequate blood supply and being evidenced by:-
(a) A history of typical prolonged chest pain; and
(b) New electrocardiographic changes resulting from this occurrence; and
(c) Elevation of the cardiac enzyme (CPK-MB) above the generally accepted laboratory
levels of normal.
Diagnosis based on the elevation of Troponin T test alone shall not be considered diagnostic of a heart attack. Angina is specifically excluded.
心脏病的发作：
因血液供应不足导致部分心肌坏死，其诊断根据以下情形：
a) 典型的胸痛
b) 最近心电图异常显示新的梗塞
c) 心肌霉增高


2.中风 Stroke
Defined as a cerebrovascular accident or incident producing neurological sequelae of a
permanent nature, having lasted not less than six months. Infarction of brain tissue, hemorrhage and embolisation from an extra-cranial source are included. The diagnosis must be based on changes seen in a CT scan or MRI and certified by a Consultant Neurologist. Specifically excluded are cerebral symptoms due to transient ischaemic attacks, any reversible ischaemic neurological deficit, vertebrobasilar ischaemia, cerebral symptoms due to migraine, cerebral injury resulting from trauma or hypoxia and vascular disease affecting the eye or optic nerve or vestibular functions.
中风
任何脑血管的突发病变导致神经障碍包括脑出血，脑组织梗塞或源头于头颅外的因素造成的梗塞。脑神经专科会诊医师证实具备永久性神经机能障碍的证据。只有在发病六周后保险理赔才受理。本保险并不包括轻微症状如：短暂缺血性发作及因偏头痛而引起的脑部病变。

3.冠状动脉绕道手术 Coronary Artery Disease Requiring Surgery

"Coronary Artery Disease Requiring Surgery"
Refers to the actual undergoing of coronary artery by-pass surgery by way of thoracotomy to correct or treat coronary artery disease but not including angioplasty, other intra-arterial, keyhole or laser procedures.

冠状动脉绕道手术
确实进行心脏冠状动脉手术以矫正冠状动脉狭窄或阻塞，但不包含非开心性的手术如血管成形术，雷射治疗或其他非手术的治疗。

4. 癌症（恶性肿瘤）Cancer
Cancer is defined as the uncontrollable growth and spread of malignant cells and the invasion and destruction of normal tissue for which major interventionist treatment or surgery (excluding
endoscopic procedures alone) is considered necessary. The cancer must be confirmed by histological evidence of malignancy.
The following conditions are excluded:-
(a) Carcinoma in situ including of the cervix
(b) Ductal Carcinoma in situ of the breast
(c) Papillary Carcinoma of the bladder and Stage 1 Prostate Cancer
(d) All skin cancers except malignant melanoma
(e) Stage I Hodgkin’s disease
(f) Tumours manifesting as complications of Acquired Immune Deficiency Syndrome.
癌症（恶性肿瘤）
恶性肿瘤有明显病理性变化，其特征在恶性细胞不被控制的增殖及蔓延并侵犯组织。包括白血病（除了慢性淋巴细胞白血病），淋巴瘤，霍奇金氏病（恶性淋巴肉芽肿），恶性皮肤黑瘤。但不包括非侵犯性瘤及所有皮肤癌除了恶性肿瘤外。若被保人之HIV测验为阳性，恶性肿瘤为除外条件。

5.良性脑肿瘤Benign Brain Tumour
A life-threatening, non-cancerous tumour in the brain giving rise to characteristic signs of increased intra-cranial pressure such as papilloedema, mental symptoms, seizures and sensory impairment. The presence of the underlying tumour must be confirmed by imaging studies such as CT Scan or MRI. Cysts, granulomas, malformations in or of the arteries or veins of the brain, haematomas, tumours in the pituitary gland or spine and tumours of the acoustic nerve are excluded.
良性脑肿瘤
非恶性脑瘤，危及生命，引起颅内压增高的一系列症状如视神经乳头水肿，意识障碍，癫痫和感觉功能的损害。经影像检查如电脑断层摄影及核磁共振检查证实。囊肿，肉芽肿，脑动静脉畸形，血管瘤，脑下垂体腺瘤或脊髓肿瘤除外

6.肾衰竭 Kidney Failure
End stage kidney failure presenting as chronic irreversible failure of both kidneys to function, as a result of which regular renal dialysis is initiated or renal transplantation carried out.
肾衰竭
肾衰竭末期呈现两侧肾脏机能慢性不可复原的衰竭致使需定期长期的肾透析治疗或接受肾脏移植，须由肾脏专科医师证实是否需要持续的肾透析治疗。

7.猛暴性肝炎Fulminant Viral Hepatitis
This is defined as a sub massive to massive necrosis of the liver caused by any virus leading precipitously to liver failure.
The diagnostic criteria to be met are:
(a) A rapidly decreasing liver size as confirmed by abdominal ultrasound; and
(b) Necrosis involving entire lobules, leaving only a collapsed reticular framework; and
(c) Rapidly deteriorating liver functions tests; and
(d) Deepening jaundice.
Hepatitis B infection or carrier status alone does not meet the diagnostic criteria.
猛暴性肝炎
因肝炎病毒造成部分或大部分的肝坏死导致肝衰竭，诊断依据下列情况：
a) 急速肝脏缩小
b) 肝细胞破坏，整个架构萎缩
c) 肝功能测验急速增高
d) 严重的黄疸

直接或间接因自杀，中毒，药物过量，酒精过量造成的猛暴性肝炎除外。
须有下列事实证明：
a) 肝功能试验证实有大部分肝实质病变
b) 有关静脉系统肝性脑病变的主要表征

8.重大器官移植手术Major Organ Transplant
The actual undergoing of a transplant as a recipient of one of the following human organs:
(a) Kidney
(b) Lung(s)
(c) Liver
(d) Heart
(e) Bone marrow
重大器官移植手术
确实接受手术成为心，肺，肝，肾，胰脏或骨髓的接受者。

9.瘫痪（下肢瘫痪，四肢麻痹）Paralysis / Paraplegia
The complete and permanent loss of use of both arms or both legs, or one arm and one leg, through paralysis caused by illness or injury persisting for at least six (6) months from the date of trauma or illness.
瘫痪（下肢瘫痪，四肢麻痹）
因疾病或意外经临床证实瘫痪造成完全永久丧失两肢或多肢的功能，因自伤引起的伤害险除外。

10.多发性硬化症Multiple Sclerosis
Unequivocal diagnosis by a Consultant Neurologist confirming the following combination, which has persisted for at least a continuous period of six (6) months:
(a) Symptoms referable to tracts (white matter) involving the optic nerves, brain stem and spinal cord, producing well-defined neurological deficits; and
(b) A multiplicity or discrete lesions; and
(c) A well-documented history of exacerbation and remissions of said symptoms /
neurological deficits.
多发性硬化症
经权威性专科医师的诊断有典型髓鞘脱失症及永久性神经功能失调。
诊断须由神经科检查来确定（如脊椎穿刺引起的视觉反应，听觉反应和中枢神经系统NMR损坏的事实）。

11.肺动脉高血压 Primary Pulmonary Arterial Hypertension
"Primary Pulmonary Arterial Hypertension"
Means primary pulmonary hypertension with substantial right ventricular enlargement
established by investigations including cardiac catheterization, resulting in permanent
irreversible physical impairment to the degree of at least Class 3 of the New York Heart
Association Classification of cardiac impairment, and resulting in the Life Assured being
unable to perform his/her usual occupation.
肺动脉高血压
原发性肺动脉高血压经临床检验包括心导管检查证实。

12.全面永久失明Blindness

"Blindness"
The total, permanent and irrecoverable loss of the sight of both eyes. Certification by an ophthalmologist is necessary.
全面永久失明
经临床检验证实，因急性疾病或意外导致双眼全面、不可恢复的视力丧失。失明须由眼科医师的报告证明。

13.心瓣膜手术Heart Valve Replacement

"Heart Valve Replacement"
The actual undergoing of open-chest surgery to replace or repair cardiac valves as a consequence of heart valve defects or abnormalities that have occurred after Risk
Commencement Date or date of reinstatement of this contract. Repair, via valvotomy, intra-arterial procedure, key-hole surgery or similar techniques are specifically excluded.
心瓣膜手术
确实接受开心手术以更换或矫正心瓣膜。

14.全面永久失聪 Loss Of Hearing / Deafness

"Loss Of Hearing / Deafness"
Total, permanent and irreversible loss of hearing in both ears as a result of disease or accident. Medical evidence in the form of an audiometry and sound-threshold test must be provided.
全面永久失聪
因急性疾病或意外导致双耳全面、不可恢复的聋症。投保人必须提供经过听力测验及音国测验检验而获得的医药证明。

15.严重烧伤Major Burns

"Major Burns"
Third degree burns covering at least twenty percent (20%) of the Life Assured’s body surface area as measured by "The Rule of 9" of the Lund & Browder Body Surface Chart.
严重烧伤
第三度烧伤，至少20%的身体表皮面积受损。

16.主动脉外科手术Surgery To Aorta

"Surgery To Aorta"
The actual undergoing of surgery via a thoracotomy or laprotomy to repair or correct an aortic aneurysm, an obstruction of the aorta or a coarctation of the aorta. For the purpose of this definition, aorta shall mean the thoracic and abdominal aorta but not its branches.
主动脉外科手术
确实接受进行外科手术以矫正及移植患病的胸部或腹部主动脉。

17.丧失语言能力Loss of Speech

"Loss of Speech"
Total and irrecoverable loss of the ability to speak for a continuous period of 12 months. Medical evidence to confirm injury or illness to the vocal cords to support this disability must be supplied by an appropriate (Ear, Nose, Throat) specialist. All psychiatric related causes are excluded.
丧失语言能力
持续12个月完全不可恢复丧失语言能力，病况必须由神经专科会诊医生确认。

18.阿尔兹海默氏症 Alzheimer’s Disease / Irreversible Organic Degenerative Brain Disorders

"Alzheimer’s Disease / Irreversible Organic Degenerative Brain Disorders"
Deterioration or loss of intellectual capacity or abnormal behavior as evidenced by the clinical state and accepted standardized questionnaires or tests arising from Alzheimer’s Disease or irreversible organic degenerative brain disorders excluding neurosis, psychiatric illness, and any drug or alcohol related organic disorder, resulting in significant reduction in mental and social functioning requiring the continuous supervision of the Life Assured. The diagnosis must be clinically confirmed by an appropriate consultant.
阿尔兹海默氏症
经临床测验因患阿尔兹海默氏症造成不可恢复的功能性病变，使患者心智退化，行为失常，需依赖他人随时照料。诊断需来自权威的专科医生及保险公司的专科医生。

19.肌肉营养不良症Muscular Dystrophy

"Muscular Dystrophy"
The diagnosis of muscular dystrophy shall require a confirmation by a Consultant Neurologist of the combination of 3 out of 4 of the following conditions:
(a) Family history of other affected individuals
(b) Clinical presentation including absence of sensory disturbance, normal cerebro-spinal
fluid and mild tendon reflex reduction
(c) Characteristic electromyogram
(d) Clinical suspicion confirmed by muscle biopsy
No benefit will be payable under this Covered Event before the Life Assured had reached the age of 12 years next birthday.
肌肉营养不良症
神经专科会诊医师确认遗传性肌肉营养不良症导致在无人协助下无能力行使三、或更多下列的活动：
沐浴，更衣，如厕，饮食，上下床及起座的能力。

20.输血引起的人类免疫不全病毒感染 AIDS Due To Blood Transfusion

"AIDS Due To Blood Transfusion":
The Life Assured being infected by HIV virus or AIDS provided that:
(a) The infection is due to blood transfusion received in Malaysia or Singapore after the
commencement of this Policy; and
(b) The Life Assured is not a haemophiliac; and
(c) The Life Assured is not a member of any high risk groups such as but not limited to homosexuals, intravenous drug users or sex workers. Notification and proof of incident will be required via a statement from a statutory Health Authority that the infection is medically acquired.
输血引起的人类免疫不全病毒感染
假使被保人感染人类免疫不全病毒或后天免疫功能不全症候群:
a) 因于马来西亚，新加坡，文莱输血而感染
b) 公司在特许专科医师检认下，同意疾病是在保单生效后，在进行输血医疗过程时感染上的
c) 受感染的被保人非血友病患者
d) 状况需对生命造成威胁及无法救治

21.慢性肝病Chronic Liver Disease
"Chronic Liver Disease"
End stage liver failure evidenced by permanent jaundice, ascites, encephalopathy and portal hypertension. Wernicke’s encephalopathy and liver failure secondary to alcohol or drug misuse is excluded.
慢性肝病
肝衰竭末期，症状如下：
a) 持续性黄疸
b) 腹水或
c) 肝脑病
因酒精或药物导致的肝病除外。

22.运动神经病变（运动神经退化症）Motor Neurone Disease

"Motor Neurone Disease"
Motor neurone disease of unknown aetiology is characterized by progressive degeneration of corticospinal tracts and anterior horn cells or bulbar efferent neurons. These include spinalmuscular atrophy, progressive bulbar palsy, amyotrophic lateral sclerosis and primary lateral sclerosis. Diagnosis must be confirmed by a Consultant Neurologist.
运动神经病变（运动神经退化症）
原因不明的运动神经退化，特征为皮质脊径和前角细胞或延髓传出神经产生渐进性变化所致脊柱肌肉萎缩进行延髓瘫痪，肌肉萎缩性侧索硬化和原发性侧索硬化。理赔将只经由神经专科会诊医师认定症状进行性导致神经系统不可恢复的伤害。

23.再生不良性贫血Aplastic Anaemia

"Aplastic Anaemia"
Chronic persistent bone marrow failure which results in total aplasia of the bone marrow and requires treatment with at least one of the following:
(a) Regular blood product transfusion
(b) Marrow stimulating agents
(c) Immunosuppressive agents
(d) Bone marrow transplantation
再生不良性贫血
骨髓衰竭导致贫血，白血球减少症及血小板紫斑症需要至少下列其中之一的治疗：
a) 输血
b) 骨髓刺激因子
c) 免疫抑制剂
d) 骨髓移植

24.柏金森氏症Parkinson’s Disease
"Parkinson’s Disease"
Unequivocal diagnosis of Parkinson’s Disease by a Consultant Neurologist where the condition:
(a) Cannot be controlled with medication; and
(b) Shows signs of progressive impairment; and
(c) Activities of Daily Living assessment confirm the inability of the Life Assured to perform without assistance three (3) or more of the Activities of Daily Living. Only idiopathic Parkinson ’s disease is covered. Drug-induced or toxic causes of Parkinsonism are excluded.
柏金森氏症
柏金森氏症是一种因脑干神经，神经节变化而造成中枢系统渐进变性的疾病，经脑神经专科会诊医师给予绝对的诊断症状如下：
a) 药物无法控制
b) 有进行机能损害的迹象，及
c) 无他人协助被保人无法行驶下列项目中的三项或多项：如沐浴，穿衣，如厕，饮食，座椅起立或起床
本理赔仅适用特发柏金森氏症。药物引起或中毒导致的柏金森氏症除外。

25.临床全面发作的艾滋病Full Blown AIDS

"Full Blown AIDS"
The clinical manifestation of AIDS (Acquired Immune-deficiency Syndrome) must be supported by the results of a positive HIV (Human Immuno-deficiency Virus) antibody test and a confirmatory Western Blot test. In addition, the Life Assured must have a CD4 cell count of less than two hundred (200) and one or more of the following criteria are met:
(a) Weight loss of more than 10% of body weight over a period of six (6) months or less
(wasting syndrome)
(b) Kaposi Sarcoma
(c) Pneumocystic Carinii Pneumonia
(d) Progressive multifocal leukoencephalopathy
(e) Active Tuberculosis
(f) Less than one-thousand (1000) lymphocytes
(g) Malignant Lymphoma
临床全面发作的艾滋病
有明显后天免疫不全症候群的临床表征，并用西方点墨法作出有阳性艾滋病病毒抗体的检查报告，且生命受保必须有CD4细胞数量少于200的情况，证明是机会性感染以及或有和艾滋病相关性特有肿瘤的滋长。

26.医务人员的艾滋病保障AIDS Cover of Medical Staff

"AIDS Cover of Medical Staff"
Infection by any Human Immunodeficiency Virus (HIV) only if the Life Assured is a Medical Staff as defined below, and that such infection was considered by the medical authorities involved to be caused by a needlestick/sharp instrument injury or by exposure to blood or bloodstained body fluid which occurred after the commencement of this Policy. The accident
must have occurred whilst the Life Assured was following his normal occupational duties and reported in accordance with the eatablished occupational procedures for such accidents. The Life Assured must, within 5 days of the accident have undergone a blood test indicating the absense of HIV or its antibodies but a further blood test performed within 6 months of the accident must indicate the presense of HIV or its antibodies after the commencement of this Policy.
However, the benefit payable will not apply if any medical cure is found for Acquired Immune Deficiency Syndrome or the effects of the HIV virus or a medical treatment is developed which results in the prevention of the occurrence of AIDS.
"Medical Staff" is defined as Doctors (General Physicians and Specialists), nurses, laboratory
technicians, dentists (surgeons and nurses), ambulance workers who are working in the
medical centre or hospital or dental clinics/polyclinics in Malaysia.
医务人员的艾滋病保障
投保人身为医务人员（定义于后）而受到人类免疫系统缺乏病毒(HIV)的感染。并且，这项感染被相关的医药机构认为投保人是因为针筒或尖锐的器材所致，或与血液或染有血迹的身体接触而引起的。同时该项感染是在等候期结束后才发生。意外发生时，投保人必须是在执行其例常的职务，并且按照既定的防范意外的工作程序进行。投保人必须在意外发生的五天之内进行血液检验，以证明HIV或其抗体不存在。然而，在意外发生后的六个月内，投保人必须接受进行进一步的血液检验，以证实在保单开始生效之后，投保人受到HIV或其他抗体的感染。无论如何，倘若医学上新的发展发现有艾滋病和HIV病毒治疗药方，或阻止病症再度发作的方法，公司将不给付赔偿利益。“医务人员”被定义为在马来西亚的医疗中心、医院、牙科诊所或一般诊所服务的医生（普通医师或专科医师）、护士、实验室技术人员、牙医（外科医师及护士）及救护车人员。

27.振动缺失症候群Apallic Syndrome

"Apallic Syndrome"
Universal necrosis of the brain cortex, with the brainstem remaining intact. Diagnosis must be confirmed by a Consultant Neurologist and condition must be documented for at least one month.
振动缺失症候群
振动缺失症候群是一种脑皮质全部坏死，但脑干依然保持完整而产生的症候群。此诊断必须由合格的神经专科会诊医师确认。而需要有至少一个月以上的确实诊断治疗记录。

28.其他严重冠状动脉疾病 Other Serious Coronary Artery Disease
"Other Serious Coronary Artery Disease"
The narrowing of the lumen of at least three major arteries i.e. Circumflex, Right Coronary Artery (RCA), Left Anterior Descending Artery (LAD), by a minimum of 60 percent or more as proven by coronary arteriography. This benefit is payable regardless of whether or not any form of coronary artery surgery has been performed.
其他严重冠状动脉疾病
经冠状动脉摄影术证实三条主要冠状动脉都要超过至少75%管腔狭窄的情况。此检查诊断必须在马来西亚，新加坡或文莱进行的，但不限以何种冠状动脉手术来治疗。

29.细菌性脑脊膜炎Bacterial Meningitis

"Bacterial Meningitis"
Bacterial meningitis causing inflammation of the membranes of the brain or spinal cord resulting in permanent neurological deficit lasting for a minimum period of 30 days and resulting in a permanent inability to perform at least three (3) of the Activities of Daily Living either with or without the use of mechanical equipment, special devices or other aids and adaptations in use for disabled persons. For the purpose of this benefit, the word "permanent", shall mean beyond the hope of recovery with current medical knowledge and technology.
细菌性脑脊膜炎
细菌性脑脊膜炎引起脑膜和脊髓膜感染导致永久性神经系统功能障碍。此诊断必须由公司所认可神经专科会诊医师确认。艾滋病毒引起的细菌性脑脊膜除外。

30.脑部外科手术Brain Surgery

"Brain Surgery"
The actual undergoing of surgery to the brain under general anesthesia during which a craniotomy is performed. Bur Hole and brain surgery as a result of an accident is excluded.
脑部外科手术
在全身麻痹下进行了开颅式脑部外科手术。因意外而需要进行的脑部外科手术除外。

31.昏迷Coma
"Coma"
A state of unconsciousness with no reaction or response to external stimuli or internal needs, persisting continuously for at least 96 hours, requiring the use of life support systems and resulting in a neurological deficit, lasting more than 30 days. Confirmation by a Consultant Neurologist must be present. Coma resulting directly from self-inflicted injury, alcohol or drug misuse is excluded.
昏迷
因脑部功能衰竭造成陷入人事不醒的状态，对外界刺激无反应，至少使用生命维持系统96小时。因酒精或滥用药物的昏迷除外。

32.末期肺病Chronic Lung Disease

"Chronic Lung Disease"
End stage respiratory failure including chronic interstitial lung disease.
The following criteria must be met:
(a) Requiring permanent oxygen therapy as a result of a consistent FEV1 test value of less than one liter. (Forced Expiratory Volume during the first second of a forced exhalation); and
(b) Arterial Blood Gas analysis with partial oxygen pressures of 55mmHg or less; and
(c) Dyspnoea at rest.
末期肺病
末期肺病包括间质性肺病需要大量及永久的氧气治疗以及FEV测试结果小于一公升。

33.慢性肝病Chronic Liver Disease

"Chronic Liver Disease"
End stage liver failure evidenced by permanent jaundice, ascites, encephalopathy and portal hypertension. Wernicke’s encephalopathy and liver failure secondary to alcohol or drug misuse is excluded.
慢性肝病
肝衰竭末期，症状如下：
a) 持续性黄疸
b) 腹水或
c) 肝脑病
因酒精或药物导致的肝病除外。

34. 脊髓灰质炎Poliomyelitis
"Poliomyelitis"
Unequivocal diagnosis by a Consultant Neurologist of infection with the Poliovirus leading to paralytic disease as evidenced by impaired motor function or respiratory weakness. Cases not involving paralysis will not be eligible for this benefit. Other causes of paralysis (such as Guillain-Barre syndrome) are specifically excluded.
脊髓灰质炎
由神经科专科医师确认是由脊髓灰质炎病毒感染所致的瘫痪性疾病，以致表现出运动功能障碍或呼吸功能减弱。受保者若无瘫痪则理赔不予受理。其他原因所致的瘫痪是特别除外的。

35. 因意外导致头部重伤Major Head Trauma

"Major Head Trauma"
Physical head injury causing significant permanent functional impairment lasting for a minimum period of three (3) months from the date of the trauma or injury. The resultant permanent functional impairment is to be verified by a Consultant Neurologist and duly concurred by the Company's Medical Officer and must result in an inability to perform at least three (3) of the Activities of Daily Living either with or without the use of mechanical equipment, special devices or other aids and adaptations in use for disabled persons. For the purpose of this benefit, the word "permanent", shall mean beyond the hope of recovery with current medical knowledge and technology.
因意外导致头部重伤
因意外头部伤害致使神经受损造成永久的功能性障碍，此情况必须持续至少六周及脑神经专科会诊医师的认定。

36.末期疾病Terminal Illness

"Terminal Illness"
The Life Assured must be suffering from a condition, which in the opinion of an appropriate Medical Practitioner is highly likely to lead to death within 12 months. The Life Assured must no longer be receiving active treatment other than that for pain relief.
末期疾病

当死亡极可能於12个月来临、以医学观点而言放弃积极治疗以利减轻病患的痛苦及病患及家属的支持。须由保险公司的专属医师决定。