Professional Documents
Culture Documents
REFERENCE.
This document provides you with a history of critical illness
conditions and how they’ve changed over time. So you have all
the information you need to hand.
ENTER
WELCOME.
To navigate through the history use the summary table. You can either click on a tick to go directly to the defnition of a condition on a particular date, or click on the date
to see the full list of conditions changed/covered in that particular month/year.
Changes to the conditions covered have been grouped by the date changes were made. Where defnition names have changed, the most recent defnition name appears
in brackets below it.
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 3
*Paid out under full cover. **Paid out under additional cover.
1
Brain injury due to trauma, anoxia or hypoxia moved from Critical Illness Extra to Critical Illness Cover from 07/2019.
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 4
APRIL 2018
AORTIC ANEURYSM** The undergoing of endovascular repair of an aneurysm of the thoracic or abdominal aorta with a graft. APR 2018
– WITH ENDOVASCULAR REPAIR For the above defnition, the following are not covered:
NOV 2018
• procedures to any branches of the thoracic or abdominal aorta.
JUL 2019
APLASTIC ANAEMIA** A defnite diagnosis of severe aplastic anaemia by a consultant haematologist and evidenced by bone
– CATEGORISED AS SEVERE marrow histology. There must be an absolute neutrophil count of less than 0.5 x109/L and at least one
of the following:
• a platelet count of less than 20 x109/L.
• a reticulocyte count of less than 20 x109/L.
BENIGN SPINAL CORD TUMOUR* A non-malignant tumour originating from the spinal cord, spinal nerves or meninges within the spinal
– RESULTING IN EITHER SPECIFIED canal, resulting in either:
TREATMENT OR PERMANENT • surgical removal;
SYMPTOMS • radiotherapy;
• chemotherapy; or
• permanent neurological defcit with persisting clinical symptoms.
For the above defnition, the following are not covered:
• angiomas;
• cysts;
• granulomas;
• haematomas; or
• osteophytes.
BRAIN INJURY DUE TO ANOXIA Death of brain tissue due to inadequate oxygen supply resulting in permanent neurological defcit with
OR HYPOXIA* persisting clinical symptoms.
– RESULTING IN PERMANENT
SYMPTOMS
CAROTID ARTERY STENOSIS** The undergoing of endarterectomy or angioplasty on the advice of a hospital consultant to treat
– OF SPECIFIED SEVERITY RESULTING narrowing of at least 50% of the carotid artery.
IN SURGERY
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 5
APRIL 2018
CAUDA EQUINA SYNDROME* A defnite diagnosis of cauda equina syndrome (compression of the lumbosacral nerve roots) by a APR 2018
– RESULTING IN PERMANENT consultant neurologist resulting in all of the following:
SYMPTOMS NOV 2018
• permanent bladder dysfunction; and
• permanent weakness and loss of sensation in the legs. JUL 2019
CENTRAL RETINAL ARTERY OR Death of optic nerve or retinal tissue due to inadequate blood supply or haemorrhage within the central
VEIN OCCLUSION** retinal artery or vein, resulting in permanent visual impairment of the affected eye.
– RESULTING IN PERMANENT For the above defnition, the following are not covered:
SYMPTOMS • occlusion or haemorrhage of the branches of the retinal artery or vein only; or
• traumatic injury to tissue of the optic nerve or retina.
CEREBRAL OR SPINAL ANEURYSM** The undergoing of craniotomy, direct spinal surgery, endovascular repair or radiotherapy to treat a
– WITH SPECIFIED TREATMENT cerebral or spinal aneurysm.
CEREBRAL OR SPINAL The undergoing of craniotomy, direct spinal surgery, endovascular repair or radiotherapy to treat a
ARTERIOVENOUS MALFORMATION** cerebral or spinal arteriovenous fstula or malformation.
– WITH SPECIFIED TREATMENT
CROHN’S DISEASE** A defnite diagnosis of Crohn’s disease by a consultant gastroenterologist resulting in surgical intestinal
– TREATED WITH ONE SURGICAL resection to remove part of the small intestine or bowel.
INTESTINAL RESECTION For the above defnition, the following are not covered:
• surgical treatment for abscesses, fstulas or strictures.
DESMOID TYPE FIBROMATOSIS** A positive diagnosis with histological confrmation of non-malignant aggressive fbromatosis by a
– WITH SPECIFIED TREATMENT hospital consultant resulting in either:
• surgical removal;
• radiotherapy; or
• chemotherapy.
DIABETES MELLITUS TYPE 1** A defnite diagnosis of type 1 diabetes mellitus, requiring the permanent use of insulin injections.
– REQUIRING SPECIFIED TREATMENT The following are not covered:
• gestational diabetes
• type 2 diabetes (including type 2 diabetes treated with insulin).
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 6
APRIL 2018
APR 2018
DRUG RESISTANT EPILEPSY* The undergoing of invasive surgery to brain tissue in order to control epilepsy that cannot be controlled
– TREATED WITH INVASIVE SURGERY by oral medication.
NOV 2018
TO BRAIN TISSUE
JUL 2019
DRUG RESISTANT EPILEPSY** The undergoing of implantation under the skin of a stimulator, which is connected to the vagus nerve in
– TREATED WITH VAGUS NERVE order to control epilepsy that cannot be controlled by oral medication.
STIMULATION
GUILLAIN-BARRE SYNDROME** A defnite diagnosis of Guillain-Barre syndrome by a consultant neurologist. There must be ongoing clinical
– WITH PERSISTING CLINICAL impairment of motor or sensory function caused by Guillain-Barre Syndrome which must have persisted
SYMPTOMS for a continuous period of at least six months.
HEART FAILURE* A defnite diagnosis of failure of the heart to function as a pump by a consultant cardiologist which is
– OF SPECIFIED SEVERITY evidenced by all of the following:
• permanent and irreversible ejection fraction of 39% or less; and
• permanent loss of ability to perform physical activities to at least Class 3 of the New York Heart
Association classifcations of functional capacity*.
*NYHA Class 3. Heart disease resulting in marked limitation of physical activities where less than
ordinary activity causes fatigue, palpitation, breathlessness or chest pain.
INTENSIVE CARE* Sickness or injury resulting in continuous mechanical ventilation by means of tracheal intubation for
– REQUIRING MECHANICAL seven consecutive days (24 hours per day) or more in an intensive care unit in a UK hospital.
VENTILATION For the above defnition, the following is not covered:
FOR SEVEN DAYS • sickness or injury resulting in mechanical ventilation secondary to alcohol or drug intake.
INTERSTITIAL LUNG DISEASE* A defnite diagnosis of interstitial lung disease resulting in all of the following:
– OF SPECIFIED SEVERITY • radiological evidence of pulmonary fbrosis; and
• permanent and irreversible DLCO (diffusing capacity of the lung for carbon monoxide) below 40%
of predicted.
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 7
APRIL 2018
LESS ADVANCED CANCER** There must be a positive diagnosis with histological confrmation for any of the following: APR 2018
– OF NAMED SITES AND SPECIFIED Anus – treated by surgery
SEVERITY NOV 2018
The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ of the anus. JUL 2019
For the above defnition, the following is not covered:
• anal intraepithelial neoplasia (AIN) grade 1 or 2.
Appendix, colon or rectum – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ or neuroendocrine tumour (NET) of low malignant potential of the
appendix, colon or rectum.
Carcinoma in situ of the breast – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ of the breast.
For the above defnition, the following is not covered:
• any other type of treatment.
Cervix – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove the cervix (trachelectomy)
or hysterectomy on the advice of a hospital consultant following the diagnosis of carcinoma in situ of
the cervix.
For the above defnition, the following are not covered:
• loop excision;
• laser surgery;
• conisation and cryosurgery; or
• cervical intraepithelial neoplasia (CIN) grade 1 or 2.
Extrahepatic bile ducts – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ of the extrahepatic bile ducts.
Gallbladder – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ of the gallbladder.
Larynx – with specifed treatment
The undergoing of surgery, laser treatment or radiotherapy on the advice of a hospital consultant to
remove a tumour following the diagnosis of carcinoma in situ of the larynx.
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 8
APRIL 2018
LESS ADVANCED CANCER** Low grade prostate cancer – requiring treatment APR 2018
– OF NAMED SITES AND SPECIFIED The undergoing of treatment on the advice of a hospital consultant following diagnosis of a malignant
SEVERITY tumour of the prostate positively diagnosed and having a Gleason score between 2 and 6 inclusive NOV 2018
Continued and having progressed to a clinical TNM classifcation between T1N0M0 and T2aN0M0.
JUL 2019
For the above defnition, the following are not covered:
• prostatic intraepithelial neoplasia (PIN);
• observation or surveillance; or
• surgical biopsy.
Lung and bronchus – treated by surgery
The undergoing of wedge resection or lobectomy on the advice of a hospital consultant following
the diagnosis of carcinoma in situ or neuroendocrine tumour (NET) of low malignant potential of the
lung or bronchus.
Oesophagus – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ of the oesophagus.
Oral cavity or oropharynx – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ of the oral cavity or oropharynx. The oropharynx includes lips, inside
of cheeks, foor of the mouth, tongue, gums, hard palate, soft palate and tonsils.
For the above defnition, the following is not covered:
• any other type of treatment.
Ovary – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove an ovary following the
diagnosis of ovarian tumour of borderline malignancy/low malignant potential.
For the above defnition, the following is not covered:
• removal of an ovary due to a cyst.
Pancreas – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ or neuroendocrine tumour (NET) of low malignant potential of the
pancreas.
Renal pelvis (of the kidney) or ureter – of specifed severity
A positive diagnosis on the advice of a hospital consultant of carcinoma in situ of the renal pelvis
or ureter.
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 9
APRIL 2018
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 10
APRIL 2018
MYASTHENIA GRAVIS* A defnite diagnosis of myasthenia gravis by a consultant neurologist. There must have been clinical APR 2018
– WITH SPECIFIED SYMPTOMS impairment of motor function in parts of the body other than the eye muscles caused by myasthenia gravis.
NOV 2018
For the above defnition, the following is not covered:
• myasthenia gravis limited to eye muscles only. JUL 2019
NEUROMYELITIS OPTICA A defnite diagnosis of neuromyelitis optica by a consultant neurologist. There must have been
(FORMERLY DEVIC’S DISEASE)* clinical impairment of motor or sensory function caused by neuromyelitis optica.
– WHERE THERE HAVE BEEN
SYMPTOMS
NON-INVASIVE GASTRO A positive diagnosis with histological confrmation of non-invasive gastro intestinal stromal tumour by a
INTESTINAL STROMAL TUMOUR** hospital consultant.
OTHER CANCER IN SITU OR The undergoing of surgery on the advice of a hospital consultant following the diagnosis of carcinoma in
NEUROENDOCRINE TUMOUR (NET) situ or neuroendocrine tumour (NET) of low malignant potential.
OF LOW MALIGNANT POTENTIAL** For the above defnition, the following are not covered:
– WITH SURGERY • any skin cancer (including melanoma);
• tumours treated with radiotherapy, laser therapy, cryotherapy or diathermy treatment; or
• tumours already covered elsewhere in the policy.
PARKINSON’S PLUS SYNDROMES* A defnite diagnosis of one of the following Parkinson’s plus syndromes by a consultant neurologist:
– RESULTING IN PERMANENT • multiple system atrophy;
SYMPTOMS • progressive supranuclear palsy;
• Parkinsonism-dementia-amyotrophic lateral sclerosis complex;
• diffuse Lewy body disease; or
• corticobasal ganglionic degeneration.
There must also be permanent clinical impairment of at least one of the following:
• motor function;
• eye movement disorder;
• postural instability; or
• dementia.
For the above defnition, the following are not covered:
• other Parkinsonian syndromes
• Parkinsonism.
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 11
APRIL 2018
PERIPHERAL VASCULAR DISEASE* A defnite diagnosis of peripheral vascular disease by a consultant cardiologist or vascular surgeon with APR 2018
– REQUIRING BYPASS SURGERY objective evidence from imaging of obstruction in the arteries requiring bypass graft surgery to an artery
of the legs. NOV 2018
For the above defnition, the following is not covered:
JUL 2019
• any other surgical procedures or treatment.
PITUITARY GLAND TUMOUR** A non-malignant tumour originating from the pituitary gland resulting in either:
– WITH SPECIFIED TREATMENT • surgical removal;
OR RESULTING IN PERMANENT • radiotherapy;
SYMPTOMS • chemotherapy; or
• permanent neurological defcit with persisting clinical symptoms.
For the above defnition, the following are not covered:
• tumours originating from bone tissue; or
• angiomas and cholesteatoma.
PULMONARY ARTERY SURGERY* The undergoing of surgery to the pulmonary artery, on the advice of a consultant cardiologist, with
– REQUIRING SURGICAL excision and surgical replacement of a portion of the pulmonary artery with a graft.
REPLACEMENT
REMOVAL OF AN ENTIRE LUNG* The undergoing of surgery to remove an entire lung as a result of injury or disease.
– DUE TO INJURY OR DISEASE For the above defnition, the following are not covered:
• other forms of surgery to the lungs including removal of a lobe.
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 12
APRIL 2018
REMOVAL OF ONE OR MORE The undergoing of surgery to remove one or more lobe(s) of the lung as a result of injury or disease. APR 2018
LOBE(S) OF A LUNG** For the above defnition, the following are not covered:
– DUE TO INJURY OR DISEASE NOV 2018
• removal of a portion of a lobe of the lung only; or
• any other form of lung surgery. JUL 2019
REMOVAL OF URINARY BLADDER** The undergoing of surgery to remove the urinary bladder (total cystectomy).
– DUE TO INJURY OR DISEASE For the above defnition, the following is not covered:
• removal of a portion of the urinary bladder.
SEVERE CROHN’S DISEASE* A defnite diagnosis of Crohn’s disease by a consultant gastroenterologist resulting in either:
– TREATED WITH TWO SURGICAL • surgical intestinal resection to remove part of the small intestine or bowel on at least two separate
INTESTINAL RESECTIONS OR occasions; or
REMOVAL OF ENTIRE • removal of entire large bowel (total colectomy).
LARGE BOWEL
For the above defnition, the following are not covered:
• surgical treatment for abscesses, fstulas or strictures.
SIGNIFICANT VISUAL LOSS** Permanent and irreversible loss of sight to the extent that even when tested with the use of visual aids
– PERMANENT AND IRREVERSIBLE vision is measured at 6/24 or worse in the better eye using Snellen eye chart, or visual feld is reduced
to 45 degrees or less of an arc, as measured by an ophthalmologist.
SYRINGOMYELIA OR The undergoing of surgery to treat a syrinx in the spinal cord or brain stem.
SYRINGOBULBIA*
– WITH SURGERY
THIRD DEGREE BURNS** Burns that involve damage or destruction of the skin to its full depth through to the underlying tissue and
– COVERING 10% OF THE SURFACE covering at least 10% of the:
AREA OF THE BODY OR 10% OF • body’s surface area;
THE FACE OR HEAD • or face or head.
ULCERATIVE COLITIS* A defnite diagnosis of ulcerative colitis confrmed by a consultant gastroenterologist, resulting in a
– RESULTING IN THE REMOVAL removal of the entire large bowel (total colectomy).
OF THE ENTIRE LARGE BOWEL
NOVEMBER 2018
AORTIC ANEURYSM** The undergoing of endovascular repair of an aneurysm of the thoracic or abdominal aorta with a graft. APR 2018
– WITH ENDOVASCULAR REPAIR For the above defnition, the following are not covered:
NOV 2018
• procedures to any branches of the thoracic or abdominal aorta.
JUL 2019
APLASTIC ANAEMIA** A defnite diagnosis of severe aplastic anaemia by a consultant haematologist and evidenced by bone
– CATEGORISED AS SEVERE marrow histology. There must be an absolute neutrophil count of less than 0.5 x109/L and at least one
of the following:
• a platelet count of less than 20 x109/L.
• a reticulocyte count of less than 20 x109/L.
BENIGN SPINAL CORD TUMOUR* A non-malignant tumour originating from the spinal cord, spinal nerves or meninges within the spinal
– RESULTING IN EITHER SPECIFIED canal, resulting in either:
TREATMENT OR PERMANENT • surgical removal;
SYMPTOMS • radiotherapy;
• chemotherapy; or
• permanent neurological defcit with persisting clinical symptoms.
For the above defnition, the following are not covered:
• angiomas;
• cysts;
• granulomas;
• haematomas; or
• osteophytes.
BRAIN INJURY DUE TO ANOXIA Death of brain tissue due to inadequate oxygen supply resulting in permanent neurological defcit with
OR HYPOXIA* persisting clinical symptoms.
– RESULTING IN PERMANENT
SYMPTOMS
CAROTID ARTERY STENOSIS** The undergoing of endarterectomy or angioplasty on the advice of a hospital consultant to treat
– OF SPECIFIED SEVERITY RESULTING narrowing of at least 50% of the carotid artery.
IN SURGERY
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 14
NOVEMBER 2018
CAUDA EQUINA SYNDROME* A defnite diagnosis of cauda equina syndrome (compression of the lumbosacral nerve roots) by a APR 2018
– RESULTING IN PERMANENT consultant neurologist resulting in all of the following:
SYMPTOMS NOV 2018
• permanent bladder dysfunction; and
• permanent weakness and loss of sensation in the legs. JUL 2019
CENTRAL RETINAL ARTERY OR Death of optic nerve or retinal tissue due to inadequate blood supply or haemorrhage within the central
VEIN OCCLUSION** retinal artery or vein, resulting in permanent visual impairment of the affected eye.
– RESULTING IN PERMANENT For the above defnition, the following are not covered:
SYMPTOMS • occlusion or haemorrhage of the branches of the retinal artery or vein only; or
• traumatic injury to tissue of the optic nerve or retina.
CEREBRAL OR SPINAL ANEURYSM** The undergoing of craniotomy, direct spinal surgery, endovascular repair or radiotherapy to treat a
– WITH SPECIFIED TREATMENT cerebral or spinal aneurysm.
CEREBRAL OR SPINAL The undergoing of craniotomy, direct spinal surgery, endovascular repair or radiotherapy to treat a
ARTERIOVENOUS MALFORMATION** cerebral or spinal arteriovenous fstula or malformation.
– WITH SPECIFIED TREATMENT
CROHN’S DISEASE** A defnite diagnosis of Crohn’s disease by a consultant gastroenterologist resulting in surgical intestinal
– TREATED WITH ONE SURGICAL resection to remove part of the small intestine or bowel.
INTESTINAL RESECTION For the above defnition, the following are not covered:
• surgical treatment for abscesses, fstulas or strictures.
DESMOID TYPE FIBROMATOSIS** A positive diagnosis with histological confrmation of non-malignant aggressive fbromatosis by a
– WITH SPECIFIED TREATMENT hospital consultant resulting in either:
• surgical removal;
• radiotherapy; or
• chemotherapy.
DIABETES MELLITUS TYPE 1** A defnite diagnosis of type 1 diabetes mellitus, requiring the permanent use of insulin injections.
– REQUIRING SPECIFIED TREATMENT The following are not covered:
• gestational diabetes
• type 2 diabetes (including type 2 diabetes treated with insulin).
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 15
NOVEMBER 2018
APR 2018
DRUG RESISTANT EPILEPSY* The undergoing of invasive surgery to brain tissue in order to control epilepsy that cannot be controlled
– TREATED WITH INVASIVE SURGERY by oral medication.
NOV 2018
TO BRAIN TISSUE
JUL 2019
DRUG RESISTANT EPILEPSY** The undergoing of implantation under the skin of a stimulator, which is connected to the vagus nerve in
– TREATED WITH VAGUS NERVE order to control epilepsy that cannot be controlled by oral medication.
STIMULATION
GUILLAIN-BARRE SYNDROME** A defnite diagnosis of Guillain-Barre syndrome by a consultant neurologist. There must be ongoing clinical
– WITH PERSISTING CLINICAL impairment of motor or sensory function caused by Guillain-Barre Syndrome which must have persisted
SYMPTOMS for a continuous period of at least six months.
HEART FAILURE* A defnite diagnosis of failure of the heart to function as a pump by a consultant cardiologist which is
– OF SPECIFIED SEVERITY evidenced by all of the following:
• permanent and irreversible ejection fraction of 39% or less; and
• permanent loss of ability to perform physical activities to at least Class 3 of the New York Heart
Association classifcations of functional capacity*.
*NYHA Class 3. Heart disease resulting in marked limitation of physical activities where less than
ordinary activity causes fatigue, palpitation, breathlessness or chest pain.
INTENSIVE CARE* Sickness or injury resulting in continuous mechanical ventilation by means of tracheal intubation for
– REQUIRING MECHANICAL seven consecutive days (24 hours per day) or more in an intensive care unit in a UK hospital.
VENTILATION For the above defnition, the following is not covered:
FOR SEVEN DAYS • sickness or injury resulting in mechanical ventilation secondary to alcohol or drug intake.
INTERSTITIAL LUNG DISEASE* A defnite diagnosis of interstitial lung disease resulting in all of the following:
– OF SPECIFIED SEVERITY • radiological evidence of pulmonary fbrosis; and
• permanent and irreversible DLCO (diffusing capacity of the lung for carbon monoxide) below 40%
of predicted.
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 16
NOVEMBER 2018
LESS ADVANCED CANCER** There must be a positive diagnosis with histological confrmation for any of the following: APR 2018
– OF NAMED SITES AND SPECIFIED Anus – treated by surgery
SEVERITY NOV 2018
The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ of the anus. JUL 2019
For the above defnition, the following is not covered:
• anal intraepithelial neoplasia (AIN) grade 1 or 2.
Appendix, colon or rectum – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ or neuroendocrine tumour (NET) of low malignant potential of the
appendix, colon or rectum.
Carcinoma in situ of the breast – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ of the breast.
For the above defnition, the following is not covered:
• any other type of treatment.
Cervix – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove the cervix (trachelectomy)
or hysterectomy on the advice of a hospital consultant following the diagnosis of carcinoma in situ of
the cervix.
For the above defnition, the following are not covered:
• loop excision;
• laser surgery;
• conisation and cryosurgery; or
• cervical intraepithelial neoplasia (CIN) grade 1 or 2.
Extrahepatic bile ducts – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ of the extrahepatic bile ducts.
Gallbladder – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ of the gallbladder.
Larynx – with specifed treatment
The undergoing of surgery, laser treatment or radiotherapy on the advice of a hospital consultant to
remove a tumour following the diagnosis of carcinoma in situ of the larynx.
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 17
NOVEMBER 2018
LESS ADVANCED CANCER** Low grade prostate cancer – requiring treatment APR 2018
– OF NAMED SITES AND SPECIFIED The undergoing of treatment on the advice of a hospital consultant following diagnosis of a malignant
SEVERITY tumour of the prostate positively diagnosed and having a Gleason score between 2 and 6 inclusive NOV 2018
Continued and having progressed to a clinical TNM classifcation between T1N0M0 and T2aN0M0.
JUL 2019
For the above defnition, the following are not covered:
• prostatic intraepithelial neoplasia (PIN);
• observation or surveillance; or
• surgical biopsy.
Lung and bronchus – treated by surgery
The undergoing of wedge resection or lobectomy on the advice of a hospital consultant following
the diagnosis of carcinoma in situ or neuroendocrine tumour (NET) of low malignant potential of the
lung or bronchus.
Oesophagus – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ of the oesophagus.
Oral cavity or oropharynx – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ of the oral cavity or oropharynx. The oropharynx includes lips, inside
of cheeks, foor of the mouth, tongue, gums, hard palate, soft palate and tonsils.
For the above defnition, the following is not covered:
• any other type of treatment.
Ovary – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove an ovary following the
diagnosis of ovarian tumour of borderline malignancy/low malignant potential.
For the above defnition, the following is not covered:
• removal of an ovary due to a cyst.
Pancreas – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ or neuroendocrine tumour (NET) of low malignant potential of the
pancreas.
Renal pelvis (of the kidney) or ureter – of specifed severity
A positive diagnosis on the advice of a hospital consultant of carcinoma in situ of the renal pelvis
or ureter.
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 18
NOVEMBER 2018
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 19
NOVEMBER 2018
MYASTHENIA GRAVIS* A defnite diagnosis of myasthenia gravis by a consultant neurologist. There must have been clinical APR 2018
– WITH SPECIFIED SYMPTOMS impairment of motor function in parts of the body other than the eye muscles caused by myasthenia gravis.
NOV 2018
For the above defnition, the following is not covered:
• myasthenia gravis limited to eye muscles only. JUL 2019
NEUROMYELITIS OPTICA A defnite diagnosis of neuromyelitis optica by a consultant neurologist. There must have been
(FORMERLY DEVIC’S DISEASE)* clinical impairment of motor or sensory function caused by neuromyelitis optica.
– WHERE THERE HAVE BEEN
SYMPTOMS
NON-INVASIVE GASTRO A positive diagnosis with histological confrmation of non-invasive gastro intestinal stromal tumour by a
INTESTINAL STROMAL TUMOUR** hospital consultant.
OTHER CANCER IN SITU OR The undergoing of surgery on the advice of a hospital consultant following the diagnosis of carcinoma in
NEUROENDOCRINE TUMOUR (NET) situ or neuroendocrine tumour (NET) of low malignant potential.
OF LOW MALIGNANT POTENTIAL** For the above defnition, the following are not covered:
– WITH SURGERY • any skin cancer (including melanoma);
• tumours treated with radiotherapy, laser therapy, cryotherapy or diathermy treatment; or
• tumours already covered elsewhere in the policy.
PARKINSON’S PLUS SYNDROMES* A defnite diagnosis of one of the following Parkinson’s plus syndromes by a consultant neurologist:
– RESULTING IN PERMANENT • multiple system atrophy;
SYMPTOMS • progressive supranuclear palsy;
• Parkinsonism-dementia-amyotrophic lateral sclerosis complex;
• diffuse Lewy body disease; or
• corticobasal ganglionic degeneration.
There must also be permanent clinical impairment of at least one of the following:
• motor function;
• eye movement disorder;
• postural instability; or
• dementia.
For the above defnition, the following are not covered:
• other Parkinsonian syndromes
• Parkinsonism.
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 20
NOVEMBER 2018
PERIPHERAL VASCULAR DISEASE* A defnite diagnosis of peripheral vascular disease by a consultant cardiologist or vascular surgeon with APR 2018
– REQUIRING BYPASS SURGERY objective evidence from imaging of obstruction in the arteries requiring bypass graft surgery to an artery
of the legs. NOV 2018
For the above defnition, the following is not covered:
JUL 2019
• any other surgical procedures or treatment.
PITUITARY GLAND TUMOUR** A non-malignant tumour originating from the pituitary gland resulting in either:
– WITH SPECIFIED TREATMENT • surgical removal;
OR RESULTING IN PERMANENT • radiotherapy;
SYMPTOMS • chemotherapy; or
• permanent neurological defcit with persisting clinical symptoms.
For the above defnition, the following are not covered:
• tumours originating from bone tissue; or
• angiomas and cholesteatoma.
PULMONARY ARTERY SURGERY* The undergoing of surgery to the pulmonary artery, on the advice of a consultant cardiologist, with
– REQUIRING SURGICAL excision and surgical replacement of a portion of the pulmonary artery with a graft.
REPLACEMENT
REMOVAL OF AN ENTIRE LUNG* The undergoing of surgery to remove an entire lung as a result of injury or disease.
– DUE TO INJURY OR DISEASE For the above defnition, the following are not covered:
• other forms of surgery to the lungs including removal of a lobe.
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 21
NOVEMBER 2018
REMOVAL OF ONE OR MORE The undergoing of surgery to remove one or more lobe(s) of the lung as a result of injury or disease. APR 2018
LOBE(S) OF A LUNG** For the above defnition, the following are not covered:
– DUE TO INJURY OR DISEASE NOV 2018
• removal of a portion of a lobe of the lung only; or
• any other form of lung surgery. JUL 2019
REMOVAL OF URINARY BLADDER** The undergoing of surgery to remove the urinary bladder (total cystectomy).
– DUE TO INJURY OR DISEASE For the above defnition, the following is not covered:
• removal of a portion of the urinary bladder.
SEVERE CROHN’S DISEASE* A defnite diagnosis of Crohn’s disease by a consultant gastroenterologist resulting in either:
– TREATED WITH TWO SURGICAL • surgical intestinal resection to remove part of the small intestine or bowel on at least two separate
INTESTINAL RESECTIONS OR occasions; or
REMOVAL OF ENTIRE • removal of entire large bowel (total colectomy).
LARGE BOWEL
For the above defnition, the following are not covered:
• surgical treatment for abscesses, fstulas or strictures.
SIGNIFICANT VISUAL LOSS** Permanent and irreversible loss of sight to the extent that even when tested with the use of visual aids
– PERMANENT AND IRREVERSIBLE vision is measured at 6/24 or worse in the better eye using Snellen eye chart, or visual feld is reduced
to 45 degrees or less of an arc, as measured by an ophthalmologist.
SYRINGOMYELIA OR The undergoing of surgery to treat a syrinx in the spinal cord or brain stem.
SYRINGOBULBIA*
– WITH SURGERY
THIRD DEGREE BURNS** Burns that involve damage or destruction of the skin to its full depth through to the underlying tissue and
– COVERING 10% OF THE SURFACE covering at least 10% of the:
AREA OF THE BODY OR 10% OF • body’s surface area;
THE FACE OR HEAD • or face or head.
ULCERATIVE COLITIS* A defnite diagnosis of ulcerative colitis confrmed by a consultant gastroenterologist, resulting in a
– RESULTING IN THE REMOVAL removal of the entire large bowel (total colectomy).
OF THE ENTIRE LARGE BOWEL
JULY 2019
BENIGN SPINAL CORD TUMOUR* A non-malignant tumour or cyst originating from the spinal cord, spinal nerves or meninges within the
– RESULTING IN EITHER SPECIFIED spinal canal, resulting in either:
TREATMENT OR PERMANENT • surgical removal;
SYMPTOMS • radiotherapy;
• chemotherapy; or
• permanent neurological defcit with persisting clinical symptoms.
For the above defnition, the following are not covered:
• angiomas;
• granulomas;
• haematomas; or
• osteophytes.
BRAIN ABSCESS DRAINED VIA The undergoing of craniotomy to drain an intracerebral abscess within the brain tissue by a consultant
CRANIOTOMY** neurosurgeon.
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 23
JULY 2019
APR 2018
CEREBRAL OR SPINAL ANEURYSM** No change
– WITH SPECIFIED TREATMENT
NOV 2018
CORONARY ANGIOPLASTY** The undergoing of percutaneous coronary intervention (PCI) to correct narrowing or blockages of either:
• two or more main coronary arteries, or
• the left main stem artery.
The main coronary arteries for this purpose are defned as right coronary artery, left main stem, left
anterior descending artery, and circumfex artery, or their branches. Multiple arteries must be treated at
the same time or as part of a planned staged procedure within 60 days of the frst PCI. PCI is defned as
any therapeutic intra-arterial catheter procedure including balloon angioplasty and/or stenting.
The following are not covered:
• angiography; and
• two procedures to a single main artery or branches of the same.
DRUG RESISTANT EPILEPSY** The undergoing of any of the following in order to control epilepsy that cannot be controlled by oral
– REQUIRING SPECIFIED SURGERY medication:
• invasive surgery to the brain tissue; or
• implantation under the skin of a stimulator, which is connected to the vagus nerve.
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 24
JULY 2019
LESS ADVANCED CANCER** There must be a positive diagnosis with histological confrmation for any of the following:
– OF NAMED SITES AND SPECIFIED Carcinoma in situ of the breast – treated by surgery
SEVERITY The undergoing of surgery on the advice of a hospital consultant to remove a tumour following the
diagnosis of carcinoma in situ of the breast.
For the above defnition, the following is not covered:
• any other type of treatment.
Cervix – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove the cervix (trachelectomy)
or hysterectomy on the advice of a hospital consultant following the diagnosis of carcinoma in situ of
the cervix.
For the above defnition, the following are not covered:
• loop excision;
• laser surgery;
• conisation and cryosurgery; or
• cervical intraepithelial neoplasia (CIN) grade 1 or 2.
Larynx – with specifed treatment
The undergoing of surgery, laser treatment or radiotherapy on the advice of a hospital consultant to
remove a tumour following the diagnosis of carcinoma in situ of the larynx.
Low grade prostate cancer – requiring treatment
The undergoing of treatment on the advice of a hospital consultant following diagnosis of a malignant
tumour of the prostate positively diagnosed and having a Gleason score between 2 and 6 inclusive
and having progressed to a clinical TNM classifcation between T1N0M0 and T2aN0M0.
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 25
JULY 2019
LESS ADVANCED CANCER** For the above defnition, the following are not covered: APR 2018
– OF NAMED SITES AND SPECIFIED • prostatic intraepithelial neoplasia (PIN);
SEVERITY NOV 2018
• observation or surveillance; or
Continued • surgical biopsy. JUL 2019
Ovary – treated by surgery
The undergoing of surgery on the advice of a hospital consultant to remove an ovary following the
diagnosis of ovarian tumour of borderline malignancy/low malignant potential.
For the above defnition, the following is not covered:
• removal of an ovary due to a cyst.
Renal pelvis (of the kidney) or ureter – of specifed severity
A positive diagnosis on the advice of a hospital consultant of carcinoma in situ of the renal pelvis
or ureter.
Urinary bladder – of specifed severity
A positive diagnosis of carcinoma in situ of the urinary bladder.
For the above defnition, the following are not covered:
• non-invasive papillary carcinoma
• TNM classifcation stage Ta bladder cancer.
Uterus – treated by surgery
The undergoing of hysterectomy on the advice of your hospital consultant following the diagnosis of
carcinoma in situ of the lining of the uterus (endometrium).
NECROTISING FASCIITIS* The undergoing of surgery to treat life threatening necrotising fasciitis or gas gangrene to remove
necrotic tissue and intravenous antibiotic treatment to prevent immediate death.
For the above defnition, the following are not covered:
• all other forms of gangrene or cellulitis.
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 26
JULY 2019
PARKINSON PLUS SYNDROMES* A defnite diagnosis of one of the following Parkinson plus syndromes by a consultant neurologist:
– RESULTING IN PERMANENT • multiple system atrophy;
SYMPTOMS • progressive supranuclear palsy;
• Parkinsonism-dementia-amyotrophic lateral sclerosis complex;
• diffuse Lewy body disease; or
• corticobasal ganglionic degeneration.
There must also be permanent clinical impairment of at least one of the following:
• motor function;
• eye movement disorder;
• postural instability; or
• dementia.
PERIPHERAL VASCULAR DISEASE* A defnite diagnosis of peripheral vascular disease by a consultant cardiologist or vascular surgeon with
– REQUIRING BYPASS SURGERY objective evidence from imaging of obstruction in the arteries requiring bypass graft surgery to an artery
of the legs.
PRIMARY SCLEROSING A defnite diagnosis of primary sclerosing cholangitis as evidenced by imaging confrmation of typical
CHOLANGITIS* multifocal formation of bile duct strictures and dilation of intrahepatic or extrahepatic bile ducts.
The following are not covered:
• all other causes of bile duct stricture formation and dilation.
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 27
JULY 2019
JUL 2019
REMOVAL OF AN ENTIRE LUNG* No change
– DUE TO INJURY OR DISEASE
REMOVAL OF ONE OR MORE The undergoing of surgery to remove one or more lobe(s) of the lung as a result of injury or disease.
LOBE(S) OF A LUNG**
– DUE TO INJURY OR DISEASE
REMOVAL OF URINARY BLADDER** The undergoing of surgery to remove the urinary bladder (total cystectomy) due to injury or disease.
– DUE TO INJURY OR DISEASE
SEVERE CROHN’S DISEASE* A defnite diagnosis of Crohn’s disease by a consultant gastroenterologist resulting in either:
– TREATED WITH TWO SURGICAL • surgical intestinal resection to remove part of the small intestine or bowel on at least two separate
INTESTINAL RESECTIONS OR occasions; or
REMOVAL OF ENTIRE • removal of entire large bowel (total colectomy).
LARGE BOWEL
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 28
JULY 2019
APR 2018
SYRINGOMYELIA OR No change
SYRINGOBULBIA* NOV 2018
– WITH SURGERY
JUL 2019
THIRD DEGREE BURNS** No change
– COVERING 10% OF THE SURFACE
AREA OF THE BODY OR 10% OF
THE FACE OR HEAD
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 30
*Terminal Illness Cover is listed as a separate beneft and is no longer defned as a critical illness.
**HIV infection had 3 separate defnitions from 01/2004 until 03/2007.
SURGICAL TREATMENT
We will make an advanced payment if the life insured is placed on an NHS waiting list for one of the following surgical treatments and meets the full defnitions:
Aorta graft surgery – requiring surgical replacement
Heart valve replacement or repair – with surgery
Specifed heart surgery
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 31
4 FEBRUARY 1996
FEB 1996
Summary – CIC introduced as a rider available on Level Term Assurance, Convertible Term Assurance and Decreasing Term
Assurance plans. JUN 1996
JUL 1997
ANGIOPLASTY The undergoing of balloon angioplasty to correct the narrowing or blockage of two or more arteries,
when the Life Assured has limiting anginal symptoms. Any claim must be supported by: evidence JUN 1999
of prior treatment (on appropriate medication) from an appropriate registered medical practitioner
holding an appointment at a hospital in the UK or Republic of Ireland; and evidence of signifcant OCT 2002
electrocardiogram changes; and evidence of angiography showing 70% obstruction of two or more
coronary arteries. JAN 2004
JUL 2004
AORTA SURGERY The actual undergoing of surgery for a disease of the aorta needing excision and surgical replacement
(AORTA GRAFT SURGERY) of aportion of the diseased aorta with a graft. For the purposes of this defnition aorta shall mean the MAR 2007
thoracic and abdominal aorta but not its branches.
MAY 2010
BENIGN BRAIN TUMOUR This means a non malignant tumour within the cranium, and does not include cysts, granulomas,
JAN 2011
malformations in, or of, the arteries or veins of the brain, haematomas or tumours in the pituitary gland
or spine.
NOV 2011
BLINDNESS Total and irreversible loss of sight in both eyes. Total is defned as a corrected visual acuity of 3/60 or less AUG 2012
in each eye.
APR 2013
BURNS This means third degree burns covering at least 20% of the surface area of the body of the Life Assured, SEP 2014
(THIRD DEGREE BURNS) as certifed by a specialist consultant.
DEC 2015
CANCER A malignant tumour characterised by the uncontrolled growth and spread of malignant cells and the MAR 2016
invasion of tissue. This includes leukaemia and Hodgkin’s disease but excludes:
1. non-invasive cancer in situ, FEB 2018
2. tumours in the presence of HIV,
APR 2018
3. any skin cancer other than invasive malignant melanoma.
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 32
4 FEBRUARY 1996
FEB 1996
COMA This means unconsciousness, with no reaction to stimuli continuing for at least 96 hours. Life support
systems must be required throughout the period of unconsciousness.
JUN 1996
CORONARY ARTERY DISEASE The undergoing of open heart surgery on the advice of a consultant cardiologist to correct narrowing or JUL 1997
SURGERY (CORONARY ARTERY blockage of one or more coronary arteries with by-pass grafts but excluding balloon angioplasty (except
BY-PASS GRAFTS) as defned in Angioplasty) laser or any other procedures. JUN 1999
OCT 2002
HEART ATTACK The death of a portion of the heart muscle as a result of inadequate blood supply as evidenced by an
episode of typical chest pain, new electrocardiographic change and by the elevation of cardiac enzymes. JAN 2004
JUL 2004
HEART VALVE SURGERY The undergoing of open-heart surgery to correct valvular abnormalities.
(HEART VALVE REPLACEMENT MAR 2007
OR REPAIR)
MAY 2010
HIV/AIDS COVER FOR MEDICAL The Life Assured being infected by Human Immuno-defciency Virus (HIV), or, suffering from Acquired JAN 2011
STAFF AND OTHER SPECIFIED Immune Defciency Syndrome only if the Life Assured’s occupation is in the list below and providing that
GROUPS (HIV INFECTION) all of the following are satisfed: NOV 2011
(i) The infection arose in the course of the Life Assured’s normal duties and has been acquired as a
result of contact with an HIV infected person involving passing of blood or body fuid from an HIV AUG 2012
infected person or with an HIV infected medical instrument.
(ii) The incident that results in such contact must have occurred after the Policy Date and must have APR 2013
been reported, investigated and documented in accordance with established procedures for such an
accident. SEP 2014
(iii) The Life Assured must have been tested within fve days of the incident and shown not to have
DEC 2015
antibodies of HIV.
(iv) Within 10 days of the incident, the circumstances were reported in full to Legal & General Assurance MAR 2016
Society Ltd at its Principal Offce and, it was reported that the Life Assured underwent the blood test,
referred to in (iii) above. FEB 2018
(v) A further blood test within 12 months of the incident indicated the presence of HIV or antibodies to
such a virus. APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 33
4 FEBRUARY 1996
FEB 1996
HIV/AIDS COVER FOR MEDICAL The list of occupations referred to above comprises:
STAFF AND OTHER SPECIFIED – Hospital Doctors, Surgeons and Consultants JUN 1996
GROUPS (HIV INFECTION)
– Hospital Nurses
Continued
– Hospital Porters JUL 1997
– Hospital Caterers
JUN 1999
– Hospital Cleaners
– General Practitioners and nurses employed by them OCT 2002
– Dental Surgeons
JAN 2004
– Dental Nurses
– District Nurses JUL 2004
– Midwives
– Paramedics MAR 2007
– Ambulance Workers
MAY 2010
– Hospital Laundry Workers
– Fire Brigade Fire-fghters JAN 2011
– Policemen and Policewomen
NOV 2011
– Laboratory technicians in a medical facility
– Prison Staff AUG 2012
APR 2013
KIDNEY FAILURE End stage renal failure presenting as chronic irreversible failure of both kidneys to function, as a result of
which either regular renal dialysis or renal transplant is initiated.
SEP 2014
LOSS OF HEARING Total and irreversible loss of hearing in both ears which must be established for a continuous period of DEC 2015
(DEAFNESS) 12 months, as confrmed by an appropriate consultant physician holding an appointment in a hospital in
the UK or Republic of Ireland. MAR 2016
FEB 2018
LOSS OF SPEECH Total and irreversible loss of the ability to speak because of physical injury or disease, which must be
established for a continuous period of 12 months, as confrmed by an appropriate consultant physician APR 2018
holding an appointment in a hospital in the UK or Republic of Ireland.
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 34
4 FEBRUARY 1996
The total and irrecoverable loss of two or more limbs. A limb is defned as an arm above the wrist joint or FEB 1996
LOSS OF TWO OR
MORE LIMBS a leg above the ankle joint.
JUN 1996
(LOSS OF HAND OR FOOT)
JUL 1997
MAJOR ORGAN The actual undergoing as a recipient of, or confrmation of acceptance on to the offcial
TRANSPLANT United Kingdom programme waiting list for, a transplant of a heart, liver, lung, pancreas or bone marrow. JUN 1999
OCT 2002
MOTOR NEURONE DISEASE Motor neurone disease as diagnosed by a consultant neurologist holding an appointment in a hospital in
the UK or Republic of Ireland. JAN 2004
JUL 2004
MULTIPLE SCLEROSIS Confrmation by a consultant neurologist of defnite diagnosis of multiple sclerosis producing at least
moderate neurological abnormalities which have persisted for a continuous period of six months. MAR 2007
MAY 2010
PARALYSIS/PARAPLEGIA The total and irrecoverable loss of the use of two or more limbs.
(PARALYSIS OF A LIMB)
JAN 2011
PARKINSON’S DISEASE An unequivocal diagnosis of Parkinson’s disease made by a consultant neurologist holding an NOV 2011
appointment in a hospital in the UK or Republic of Ireland. Only idiopathic Parkinson’s disease is covered.
All other forms of Parkinsonism are excluded. AUG 2012
APR 2013
PRE SENILE DEMENTIA BEFORE A diagnosis, before the 65th birthday of the Life Assured, by a consultant neurologist holding an
AGE 65 appointment in a hospital in the UK or Republic of Ireland of pre senile dementia such as that caused by SEP 2014
(DEMENTIA) Alzheimer’s disease. The diagnosis must, at the time it is made, be supported by evidence of progressive
deterioration of memory and of the ability to reason and to perceive, understand, express and give effect DEC 2015
to ideas.
MAR 2016
STROKE A cerebrovascular incident resulting in permanent neurological damage. Transient ischaemic attacks are FEB 2018
specifcally excluded.
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 35
3 JUNE 1996
Summary – CIC introduced as a standalone product and Permanent and Total Disability added. FEB 1996
JUN 1996
ANGIOPLASTY No change
JUL 1997
AORTA SURGERY No change
JUN 1999
JAN 2004
BLINDNESS No change
JUL 2004
BURNS No change
MAR 2007
(THIRD DEGREE BURNS)
MAY 2010
CANCER No change
JAN 2011
AUG 2012
CORONARY ARTERY DISEASE No change
SURGERY (CORONARY ARTERY APR 2013
BY-PASS GRAFTS)
SEP 2014
HEART ATTACK No change
DEC 2015
APR 2018
HIV/AIDS COVER FOR MEDICAL No change
STAFF AND OTHER SPECIFIED NOV 2018
GROUPS (HIV INFECTION)
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 36
3 JUNE 1996
FEB 1996
KIDNEY FAILURE No change
JUN 1996
JUN 1999
LOSS OF TWO OR MORE LIMBS No change
(LOSS OF HAND OR FOOT) OCT 2002
JAN 2004
LOSS OF SPEECH No change
JUL 2004
MAY 2010
MOTOR NEURONE DISEASE No change
JAN 2011
NOV 2011
MULTIPLE SCLEROSIS No change
AUG 2012
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 37
3 JUNE 1996
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 38
28 JULY 1997
Summary – Changes to Cancer defnition. Permanent and Total Disability defnition added to term + CIC. FEB 1996
JUN 1996
ANGIOPLASTY No change
JUL 1997
AORTA GRAFT SURGERY No change
JUN 1999
JAN 2004
BLINDNESS No change
JUL 2004
BURNS (THIRD DEGREE BURNS) No change
MAR 2007
CANCER A malignant tumour characterised by the uncontrolled growth and spread of malignant cells and invasion MAY 2010
of tissue. The term cancer includes leukaemia but the following cancers are excluded:
JAN 2011
1. Non-invasive cancer in situ,
2. All forms of lymphoma in the presence of any Human Immunodefciency virus, NOV 2011
3. Kaposi’s sarcoma in the presence of any Human Immunodefciency virus,
4. Any skin cancer other than invasive malignant melanoma AUG 2012
APR 2013
COMA No change
SEP 2014
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 39
28 JULY 1997
OCT 2002
KIDNEY FAILURE No change
JAN 2004
AUG 2012
MAJOR ORGAN TRANSPLANT No change
APR 2013
DEC 2015
MULTIPLE SCLEROSIS No change
MAR 2016
PARALYSIS/PARAPLEGIA No change
(PARALYSIS) FEB 2018
APR 2018
PARKINSON’S DISEASE No change
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 40
28 JULY 1997
FEB 1996
PERMANENT AND TOTAL No change
DISABILITY (TOTAL AND JUN 1996
PERMANENT DISABILITY)
JUL 1997
JUL 2004
MAR 2007
MAY 2010
JAN 2011
NOV 2011
AUG 2012
APR 2013
SEP 2014
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 41
26 JUNE 1999
Summary – Changes to most defnitions and Alzheimer’s Disease added. FEB 1996
JUN 1996
ALZHEIMER’S DISEASE BEFORE A diagnosis, before the 65th birthday of the Life Assured by a consultant neurologist of Alzheimer’s
AGE 65 (ALZHEIMER’S DISEASE) disease. The diagnosis must, at the time it is made, be supported by evidence of progressive
JUL 1997
deterioration of memory and of the ability to reason and to perceive, understand, express and give effect
to ideas.
JUN 1999
ANGIOPLASTY The undergoing of balloon angioplasty to correct the narrowing or blockage of two or more arteries, OCT 2002
when the Life Assured has limiting anginal symptoms. Any claim must be supported by:
JAN 2004
• Evidence of prior treatment (on appropriate medication) from an appropriate registered medical
practitioner holding such an appointment at a hospital in the UK and;
JUL 2004
• Evidence of signifcant electrocardiogram changes and;
• Evidence of angiography showing 70% obstruction of two or more coronary arteries. MAR 2007
MAY 2010
AORTA GRAFT SURGERY Undergoing surgery for disease of the aorta needing excision and surgical replacement of a portion of
the diseased aorta with a graft. For this defnition, aorta means the thoracic and abdominal aorta but not JAN 2011
its branches.
NOV 2011
BENIGN BRAIN TUMOUR A non malignant tumour in the brain resulting in permanent defcit to the neurological system. Tumours
AUG 2012
or lesions in the pituitary gland are not covered.
APR 2013
BLINDNESS Total, permanent and irreversible loss of all sight in both eyes.
SEP 2014
CANCER (MOST MALIGNANT TYPES) A malignant tumour characterised by the uncontrolled growth and spread of malignant cells and invasion DEC 2015
(CANCER) of tissue. The term cancer includes leukaemia and Hodgkin’s disease but the following are excluded:
• All tumours which are histologically described as pre-malignant, as non-invasive or as cancer in situ, MAR 2016
• All forms of lymphoma in the presence of any Human Immunodefciency Virus,
FEB 2018
• Kaposi’s sarcoma in the presence of any Human Immunodefciency Virus,
• Any skin cancer other than malignant melanoma. APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 42
26 JUNE 1999
COMA A state of unconsciousness with no reaction to external stimuli or internal needs persisting continuously FEB 1996
with the use of life support systems for a period of at least 96 hours and resulting in permanent
neurological defcit. Coma secondary to alcohol or drug misuse is not covered. JUN 1996
JUL 1997
CORONARY ARTERY BY-PASS The undergoing of open heart surgery on the advice of a consultant cardiologist to correct narrowing or
SURGERY (CORONARY ARTERY blockage of one or more coronary arteries with by-pass grafts but excluding balloon angioplasty (except JUN 1999
BY-PASS GRAFTS) as defned in Angioplasty), laser relief or any other procedures.
OCT 2002
DEAFNESS Total permanent and irreversible loss of all hearing in both ears. JAN 2004
JUL 2004
HEART ATTACK The death of a portion of the heart muscle as a result of inadequate blood supply as evidenced by an
episode of typical chest pain, new electrocardiograph changes and by the elevation of cardiac enzymes.
MAR 2007
The evidence must be consistent with the diagnosis of heart attack.
MAY 2010
HEART VALVE REPLACEMENT OR Undergoing open-heart surgery from medical necessity to replace or repair one or more heart valves.
REPAIR JAN 2011
NOV 2011
HIV/AIDS COVER FOR MEDICAL No change
STAFF AND OTHER SPECIFIED AUG 2012
GROUPS (HIV INFECTION)
APR 2013
DEC 2015
LOSS OF LIMBS The permanent physical severance of two or more limbs from above the wrist or ankle joint.
(LOSS OF HAND OR FOOT)
MAR 2016
LOSS OF SPEECH Total, permanent and irreversible loss of the ability to speak as a result of physical injury or disease. FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 43
26 JUNE 1999
FEB 1996
MAJOR ORGAN The actual undergoing as a recipient of, or inclusion on an offcial UK waiting list for, a transplant of a
TRANSPLANT heart, liver, lung, pancreas or bone marrow.
JUN 1996
MOTOR NEURONE DISEASE Confrmation by a consultant neurologist of a defnite diagnosis of motor neurone disease before the JUL 1997
BEFORE AGE 65 65th birthday of the life assured.
(MOTOR NEURONE DISEASE) JUN 1999
OCT 2002
MULTIPLE SCLEROSIS A defnite diagnosis by a consultant neurologist of multiple sclerosis which satisfes all of the following
criteria: JAN 2004
There must be current impairment of motor or sensory function which must have persisted for a
continuous period of at least six months. JUL 2004
The diagnosis must be confrmed by diagnostic techniques current at the time of the claim.
MAR 2007
PARALYSIS/PARAPLEGIA Total and irreversible loss of muscle function or sensation to the whole of any two limbs as a result of MAY 2010
(PARALYSIS OF A LIMB) injury or disease. The disability must be permanent and supported by appropriate neurological evidence.
JAN 2011
PARKINSON’S DISEASE Confrmation by a consultant neurologist of a defnite diagnosis of Parkinson’s disease before the 65th NOV 2011
BEFORE AGE 65 birthday of the life assured. Parkinson’s disease secondary to alcohol or drug misuse is not covered.
(PARKINSON’S DISEASE) AUG 2012
APR 2013
PERMANENT AND TOTAL The Guaranteed Sum Assured will be payable:
DISABILITY BEFORE AGE 65 (a) If the Life Assured is not in any gainful occupation immediately before the onset of disability and SEP 2014
(TOTAL AND PERMANENT DISABILITY) suffers, through illness or accident, a mental or physical irreversible disability before the 65th birthday
of the Life Assured which, in the opinion of the Chief Medical Offcer of Legal & General, results in the DEC 2015
Life Assured being permanently unable to perform, without the direct assistance of another person,
four or more of the following functions: MAR 2016
(i) mobility – the ability to move from one room to another adjoining room or from one side of
a room to another to get in and out of bed or a chair without requiring physical assistance of FEB 2018
another person.
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 44
26 JUNE 1999
(ii) continence – the ability to voluntarily control bowel and bladder functions such as to maintain FEB 1996
PERMANENT AND TOTAL
DISABILITY BEFORE AGE 65 personal hygiene.
JUN 1996
(TOTAL AND PERMANENT DISABILITY) (iii) dressing or undressing self – putting on or taking off all necessary items of clothing without
Continued requiring assistance of another person.
JUL 1997
(iv) washing and bathing self – washing or bathing to the extent needed to maintain personal
cleanliness without requiring assistance of another person. JUN 1999
(v) eating – all tasks of getting food into the body once it has been prepared.
(vi) toileting – getting to and from the toilet, transferring on or off the toilet and associated personal OCT 2002
hygiene.
JAN 2004
OR
(b) One of the Any Occupation defnition or Own Occupation defnition wordings below. JUL 2004
Any Occupation defnition
If the Life Assured is engaged in gainful occupation immediately before the onset of disability before MAR 2007
the 65th birthday of the Life Assured and is, by reason of sickness or accident, totally unable to follow
any occupation and in the opinion of the Chief Medical Offcer of Legal & General is likely to remain so MAY 2010
permanently. Such decision will be based on all of the medical evidence available.
Own Occupation defnition JAN 2011
If the Life Assured is engaged in gainful occupation immediately before the onset of disability before
the 65th birthday of the Life Assured and is, by reason of sickness or accident, totally unable to follow NOV 2011
his/her occupation and in the opinion of the Chief Medical Offcer of Legal & General is likely to
remain so permanently. Such decision will be based on all of the medical evidence available. AUG 2012
APR 2013
PRE SENILE DEMENTIA BEFORE A diagnosis, before the 65th birthday of the Life Assured, by a consultant neurologist of presenile
AGE 65 (DEMENTIA) dementia. The diagnosis must, at the time it is made, be supported by evidence of progressive SEP 2014
deterioration of memory and of the ability to reason and to perceive, understand, express and give effect
to ideas. DEC 2015
MAR 2016
STROKE No change
FEB 2018
THIRD DEGREE BURNS Third degree burns covering at least 20% of the body surface area.
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 45
20 OCTOBER 2002
JUN 1996
ALZHEIMER’S DISEASE No change
JUL 1997
ANGIOPLASTY No change
JUN 1999
JAN 2004
BENIGN BRAIN TUMOUR No change
JUL 2004
BLINDNESS No change
MAR 2007
CANCER (MOST Any malignant tumour characterised by the uncontrolled growth and spread of malignant cells and MAY 2010
MALIGNANT TYPES) invasion of tissue. The term cancer includes leukaemia and Hodgkin’s disease but the following are
(CANCER) excluded: JAN 2011
• All tumours which are histologically described as pre-malignant, as non-invasive or as cancer in situ,
NOV 2011
• All tumours of the prostrate unless histologically classifed as having a Gleason score greater than 6 or
having progressed to at least TNM classifcation T2N0M0, AUG 2012
• All forms of lymphoma in the presence of any Human Immunodefciency Virus,
• Kaposi’s sarcoma in the presence of any Human Immunodefciency Virus, APR 2013
• Any skin cancer other than invasive malignant melanoma.
SEP 2014
MAR 2016
CORONARY ARTERY No change
BY-PASS SURGERY FEB 2018
(CORONARY ARTERY
BY-PASS GRAFTS) APR 2018
NOV 2018
DEAFNESS No change
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 46
20 OCTOBER 2002
FEB 1996
HEART ATTACK The death of a portion of the heart muscle, due to inadequate blood supply, that has resulted in all of the
following evidence of acute myocardial infarction:
JUN 1996
• typical chest pain,
• new characteristic electrocardiograph changes, JUL 1997
• the characteristic rise of cardiac enzymes, troponins or other biochemical markers, where all of the
above shows a defnite acute myocardial infarction. Other acute coronary syndromes, including but not JUN 1999
limited to angina, are not covered under this defnition.
OCT 2002
JAN 2011
KIDNEY FAILURE No change
NOV 2011
LOSS OF LIMBS No change
(LOSS OF HAND OR FOOT) AUG 2012
APR 2013
LOSS OF SPEECH No change
SEP 2014
MAR 2016
MOTOR NEURONE DISEASE No change
FEB 2018
MULTIPLE SCLEROSIS No change
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 47
20 OCTOBER 2002
JUN 1999
PERMANENT AND TOTAL No change
DISABILITY (TOTAL AND OCT 2002
PERMANENT DISABILITY)
JAN 2004
PRESENILE DEMENTIA No change
JUL 2004
BEFORE AGE 65
(DEMENTIA)
MAR 2007
JAN 2011
THIRD DEGREE BURNS No change
NOV 2011
AUG 2012
APR 2013
SEP 2014
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 48
18 JANUARY 2004
FEB 1996
Summary – Changes to Alzheimer’s Disease, Dementia, HIV infection through blood transfusion, HIV infection through assault,
Kidney Failure, Motor Neurone Disease and Parkinson’s Disease. Aplastic Anaemia, Bacterial Meningitis, Cardiomyopathy, Chronic JUN 1996
Lung Disease, CJD, End Stage Liver Failure, Progressive Supranuclear Palsy added. Angioplasty removed.
JUL 1997
ALZHEIMER’S DISEASE A diagnosis by a consultant neurologist of Alzheimer’s disease. The diagnosis must, at the time it is JUN 1999
made, be supported by evidence of progressive deterioration of memory and of the ability to reason and
to perceive, understand, express and give effect to ideas. OCT 2002
JAN 2004
AORTA GRAFT SURGERY No change
JUL 2004
APLASTIC ANAEMIA Permanent bone marrow failure which results in anaemia, neutropenia and thrombocytopenia requiring
treatment with at least one of the following: MAR 2007
• blood transfusion
MAY 2010
• marrow stimulating agents
• immunosuppresive agents JAN 2011
• bone marrow transplant.
NOV 2011
BACTERIAL MENINGITIS Bacterial meningitis causing infammation of the membranes of the brain or spinal cord resulting in AUG 2012
permanent neurological defcit. The diagnosis must be confrmed by a consultant neurologist. Bacterial
meningitis in the presence of HIV infection is excluded. All other forms of meningitis including viral are APR 2013
not covered.
SEP 2014
MAR 2016
BLINDNESS No change
FEB 2018
CANCER No change
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 49
18 JANUARY 2004
FEB 1996
CARDIOMYOPATHY A defnite diagnosis of cardiomyopathy made by a consultant cardiologist resulting in permanent
impaired left ventricular function such that the ejection fraction is never greater than 40%. The diagnosis
JUN 1996
must also be evidenced by:
• electrocardiographic changes; JUL 1997
• echocardiographic abnormalities;
both of which must be consistent with the diagnosis of cardiomyopathy. All other forms of heart disease, JUN 1999
heart enlargement and myocarditis are specifcally excluded. Cardiomyopathy related to alcohol or drug
misuse is excluded. OCT 2002
JAN 2004
CHRONIC LUNG DISEASE Confrmation by a consultant physician of end stage emphysema or other chronic lung disease, which
(RESPIRATORY FAILURE) requires regular oxygen treatment on a permanent basis. JUL 2004
MAR 2007
COMA No change
MAY 2010
CORONARY ARTERY BY-PASS No change
JAN 2011
SURGERY (CORONARY ARTERY
BY-PASS GRAFTS)
NOV 2011
CREUTZFELDT-JAKOB DISEASE Diagnosis of Creutzfeldt-Jakob disease or New variant CJD made by a consultant neurologist, evidenced AUG 2012
(CJD) by a signifcant reduction in mental and social functioning so that permanent supervision or assistance
by a third party is required. APR 2013
SEP 2014
DEAFNESS No change
DEC 2015
DEMENTIA A diagnosis by a consultant neurologist of dementia. The diagnosis must, at the time it is made, be MAR 2016
supported by evidence of progressive deterioration of memory and the ability to reason and to perceive,
understand, express and give effect to ideas. FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 50
18 JANUARY 2004
End stage liver failure due to cirrhosis and resulting in all of the following: FEB 1996
END STAGE LIVER FAILURE
(LIVER FAILURE) • permanent jaundice
JUN 1996
• ascites
• encephalopathy. JUL 1997
Liver disease in the presence of HIV infection is excluded. Liver disease secondary to alcohol or drug
misuse is excluded. JUN 1999
OCT 2002
HEART ATTACK No change
JAN 2004
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 51
18 JANUARY 2004
End stage renal failure presenting as chronic irreversible failure of both kidneys to function, as a result of FEB 1996
KIDNEY FAILURE
which regular renal dialysis is initiated or renal transplant is initiated.
JUN 1996
JAN 2004
MAJOR ORGAN TRANSPLANT No change
JUL 2004
MOTOR NEURONE DISEASE Confrmation by a consultant neurologist of a defnite diagnosis of motor neurone disease.
MAR 2007
JAN 2011
PARALYSIS/PARAPLEGIA No change
(PARALYSIS OF A LIMB) NOV 2011
AUG 2012
PARKINSON’S DISEASE Confrmation by a consultant neurologist of a defnite diagnosis of Parkinson’s disease. Parkinson’s
disease secondary to alcohol or drug misuse is not covered.
APR 2013
MAR 2016
PROGRESSIVE SUPRANUCLEAR The defnite diagnosis of progressive supranuclear palsy by a consultant neurologist.
PALSY FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 52
18 JANUARY 2004
JUN 1999
OCT 2002
JAN 2004
JUL 2004
MAR 2007
MAY 2010
JAN 2011
NOV 2011
AUG 2012
APR 2013
SEP 2014
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 53
25 JULY 2004
Summary – PTD changed to TPD and ADLs replaced by FATs. FEB 1996
JUN 1996
ALZHEIMER’S DISEASE No change
JUL 1997
AORTA GRAFT SURGERY No change
JUN 1999
JAN 2004
BACTERIAL MENINGITIS No change
JUL 2004
BENIGN BRAIN TUMOUR No change
MAR 2007
JAN 2011
CANCER No change
NOV 2011
APR 2013
CHRONIC LUNG DISEASE No change
(RESPIRATORY FAILURE)
SEP 2014
MAR 2016
CORONARY ARTERY No change
BY-PASS SURGERY FEB 2018
(CORONARY ARTERY
BY-PASS GRAFTS) APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 54
25 JULY 2004
JUN 1999
DEMENTIA No change
OCT 2002
HEART ATTACK No change
JAN 2004
SEP 2014
HIV/AIDS THROUGH ASSAULT No change
DEC 2015
(HIV INFECTION)
MAR 2016
KIDNEY FAILURE No change
FEB 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 55
25 JULY 2004
JUN 1999
MAJOR ORGAN TRANSPLANT No change
OCT 2002
JUL 2004
MULTIPLE SCLEROSIS No change
MAR 2007
PARALYSIS/PARAPLEGIA No change
(PARALYSIS OF A LIMB) MAY 2010
JAN 2011
PARKINSON’S DISEASE No change
NOV 2011
PERMANENT AND TOTAL The Guaranteed Sum Assured will be payable: AUG 2012
DISABILITY (TOTAL AND (a) If the Life Assured is not in gainful occupation immediately before the onset of disability, and suffers
PERMANENT DISABILITY) through illness or accident, a mental or physical irreversible disability, which in the opinion of The APR 2013
Chief Medical Offcer of Legal & General, results in the Life Assured being permanently unable to
perform, without the direct assistance of another person, four or more of the following functions: SEP 2014
(i) mobility – the ability to move from one room to another adjoining room or from one side of a
room to another to get in and out of a bed or a chair without requiring physical assistance of DEC 2015
another person.
MAR 2016
(ii) continence – the ability to voluntarily control bowel and bladder functions such as to maintain
personal hygiene.
FEB 2018
(iii) dressing or undressing self – putting on and taking off of all necessary items of clothing without
requiring assistance of another person. APR 2018
(iv) washing and bathing self – washing or bathing to the extent needed to maintain personal
cleanliness without requiring assistance of another person. NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 56
25 JULY 2004
(v) eating – all tasks of getting food into the body once it has been prepared. FEB 1996
PERMANENT AND TOTAL
DISABILITY (TOTAL AND (vi) toileting – getting to and from the toilet, transferring on or off the toilet and associated personal
JUN 1996
PERMANENT DISABILITY) hygiene.
Continued OR
JUL 1997
(b) If the Life Assured is engaged in a gainful occupation immediately before the onset of disability and
is, by reason of sickness or accident, totally unable follow his/her own/any occupation and in the JUN 1999
opinion of Legal & General is likely to remain so permanently. Such decision will be based on all the
medical evidence available. OCT 2002
JAN 2004
PROGRESSIVE No change
SUPRANUCLEAR PALSY
JUL 2004
MAY 2010
THIRD DEGREE BURNS No change
JAN 2011
NOV 2011
AUG 2012
APR 2013
SEP 2014
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 57
18 MARCH 2007
FEB 1996
Summary – ABI Statement of Best Practice 2006 changes – new headings and wordings, Encephalitis, Primary Pulmonary
Hypertension, Systemic Lupus Erythematosus, Terminal Illness and Traumatic Head Injury added. HIV infection defnitions JUN 1996
combined. Note: Chronic Lung Disease renamed Respiratory Failure.
JUL 1997
JUN 1999
ALZHEIMER’S DISEASE A defnite diagnosis of Alzheimer’s disease by a consultant neurologist, psychiatrist or geriatrician. There
– RESULTING IN PERMANENT must be permanent clinical loss of the ability to do all of the following: OCT 2002
SYMPTOMS • remember;
JAN 2004
• reason; and
• perceive, understand, express and give effect to ideas. JUL 2004
For the above defnition, the following are not covered:
• Other types of dementia. MAR 2007
MAY 2010
AORTA GRAFT SURGERY The undergoing of surgery to the aorta with excision and surgical replacement of a portion of the aorta
– REQUIRING SURGICAL with a graft. The term aorta includes the thoracic and abdominal aorta but not its branches. For the JAN 2011
REPLACEMENT above defnition, the following are not covered:
• Any other surgical procedure, for example the insertion of stents or endovascular repair. NOV 2011
AUG 2012
APLASTIC ANAEMIA A defnite diagnosis of aplastic anaemia by a consultant haematologist. There must be permanent bone
– WITH PERMANENT BONE MARROW marrow failure with anaemia, neutropenia and thrombocytopenia. APR 2013
FAILURE
SEP 2014
BACTERIAL MENINGITIS A defnite diagnosis of bacterial meningitis resulting in permanent neurological defcit with persisting DEC 2015
– RESULTING IN PERMANENT clinical symptoms.
SYMPTOMS For the above defnition, the following are not covered: MAR 2016
• All other forms of meningitis other than those caused by bacterial infection.
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 58
18 MARCH 2007
A non-malignant tumour or cyst in the brain, cranial nerves or meninges within the skull, resulting in FEB 1996
BENIGN BRAIN TUMOUR
– RESULTING IN PERMANENT permanent neurological defcit with persisting clinical symptoms.
JUN 1996
SYMPTOMS For the above defnition, the following are not covered:
• Tumours in the pituitary gland JUL 1997
• Angiomas.
JUN 1999
BLINDNESS Permanent and irreversible loss of sight to the extent that even when tested with the use of visual aids, OCT 2002
– PERMANENT AND IRREVERSIBLE vision is measured at 3/60 or worse in the better eye using a Snellen eye chart.
JAN 2004
CANCER Any malignant tumour positively diagnosed with histological confrmation and characterised by the
uncontrolled growth of malignant cells and invasion of tissue. JUL 2004
– EXCLUDING LESS ADVANCED
CASES The term malignant tumour includes leukaemia, lymphoma and sarcoma.
MAR 2007
For the above defnition, the following are not covered:
• All cancers which are histologically classifed as any of the following: MAY 2010
– pre-malignant;
– non-invasive; JAN 2011
– cancer in situ;
– having either borderline malignancy; or NOV 2011
– having low malignant potential.
AUG 2012
• All tumours of the prostate unless histologically classifed as having a Gleason score greater than 6 or
having progressed to at least clinical TNM classifcation T2N0M0. APR 2013
• Chronic lymphocytic leukaemia unless histologically classifed as having progressed to at least Binet
Stage A. SEP 2014
• Any skin cancer other than malignant melanoma that has been histologically classifed as having
caused invasion beyond the epidermis (outer layer of skin). DEC 2015
MAR 2016
CARDIOMYOPATHY A defnite diagnosis of cardiomyopathy by a consultant cardiologist. There must be clinical impairment of
– OF SPECIFIED SEVERITY heart function resulting in the permanent loss of ability to perform physical activities to at least Class 3 of
FEB 2018
the New York Heart Association classifcations of functional capacity*.
For the above defnition, the following are not covered: APR 2018
• Cardiomyopathy secondary to alcohol or drug abuse.
• All other forms of heart disease, heart enlargement and myocarditis. NOV 2018
*NYHA Class 3. Heart disease resulting in marked limitation of physical activities where less than
ordinary activity causes fatigue, palpitation, breathlessness or chest pain. JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 59
18 MARCH 2007
CORONARY ARTERY The undergoing of surgery requiring median sternotomy (surgery to divide the breastbone) on the OCT 2002
BY-PASS GRAFTS advice of a consultant cardiologist to correct narrowing or blockage of one or more coronary arteries
– WITH SURGERY TO DIVIDE with by-pass grafts. JAN 2004
THE BREASTBONE
JUL 2004
CREUTZFELDT-JAKOB A defnite diagnosis of Creutzfeldt-Jakob disease made by a consultant neurologist. There must be MAR 2007
DISEASE (CJD) permanent clinical loss of the ability in mental and social functioning to the extent that permanent
– RESULTING IN PERMANENT supervision or assistance by a third party is required. MAY 2010
SYMPTOMS
JAN 2011
DEAFNESS Permanent and irreversible loss of hearing to the extent that the loss is greater than 95 decibels across all
NOV 2011
– PERMANENT frequencies in the better ear using a pure tone audiogram.
AND IRREVERSIBLE
AUG 2012
DEMENTIA A defnite diagnosis of dementia by a consultant neurologist, psychiatrist or geriatrician. The diagnosis APR 2013
– RESULTING IN PERMANENT must be supported by evidence of progressive loss of ability to do all of the following:
SYMPTOMS SEP 2014
• remember;
• to reason; and DEC 2015
• to perceive, understand, express and give effect to ideas.
For the above defnition, the following are not covered: MAR 2016
• Dementia secondary to alcohol or drug abuse.
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 60
18 MARCH 2007
A defnite diagnosis of encephalitis by a consultant neurologist resulting in permanent neurological FEB 1996
ENCEPHALITIS
– RESULTING IN PERMANENT defcit with persisting clinical symptoms.
JUN 1996
SYMPTOMS
JUL 1997
HEART ATTACK Death of heart muscle, due to inadequate blood supply, that has resulted in all of the following evidence
– OF SPECIFIED SEVERITY of acute myocardial infarction: JUN 1999
• New characteristic electrocardiographic changes.
OCT 2002
• The characteristic rise of cardiac enzymes or Troponins recorded at the following levels or higher;
– Troponin T > 1.0 ng/ml JAN 2004
– AccuTnI > 0.5 ng/ml or equivalent threshold with other Troponin I methods.
The evidence must show a defnite acute myocardial infarction. JUL 2004
For the above defnition, the following are not covered:
MAR 2007
• Other acute coronary syndromes including but not limited to angina.
MAY 2010
HEART VALVE REPLACEMENT OR The undergoing of surgery requiring median sternotomy (surgery to divide the breastbone) on the advice
REPAIR of a consultant cardiologist to replace or repair one or more heart valves. JAN 2011
– WITH SURGERY TO DIVIDE
THE BREASTBONE NOV 2011
AUG 2012
HIV INFECTION Infection by Human Immunodefciency Virus resulting from:
– CAUGHT FROM A BLOOD • a blood transfusion given as part of medical treatment in the European Union, the Channel Islands or APR 2013
TRANSFUSION, PHYSICAL ASSAULT the Isle of Man;
OR ACCIDENT AT WORK SEP 2014
• a physical assault; or
• an incident occurring during the course of performing normal duties of employment; DEC 2015
after the start of the policy and satisfying all of the following:
• The incident must have been reported to appropriate authorities and have been investigated in MAR 2016
accordance with the established procedures.
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 61
18 MARCH 2007
• Where HIV infection is caught through a physical assault or as a result of an incident occurring during FEB 1996
HIV INFECTION
– CAUGHT FROM A BLOOD the course of performing normal duties of employment, the incident must be supported by a negative
HIV antibody test taken within fve days of the incident. JUN 1996
TRANSFUSION, PHYSICAL ASSAULT
OR ACCIDENT AT WORK • There must be a further HIV test within 12 months confrming the presence of HIV or antibodies to the
JUL 1997
Continued virus.
For the above defnition, the following is not covered: JUN 1999
• HIV infection resulting from any other means, including sexual activity or drug abuse.
OCT 2002
KIDNEY FAILURE Chronic and end stage failure of both kidneys to function, as a result of which regular dialysis is JAN 2004
– REQUIRING DIALYSIS necessary.
JUL 2004
LIVER FAILURE Liver failure due to cirrhosis and resulting in all of the following:
MAR 2007
– OF ADVANCED STAGE • permanent jaundice
• ascites MAY 2010
• encephalopathy.
JAN 2011
For the above defnition, the following are not covered:
• Liver disease secondary to alcohol or drug abuse. NOV 2011
AUG 2012
LOSS OF HANDS OR FEET Permanent physical severance of any combination of two or more hands or feet at or above the wrist or
– PERMANENT PHYSICAL SEVERANCE ankle joints.
APR 2013
(LOSS OF HAND OR FOOT)
SEP 2014
LOSS OF SPEECH Total permanent and irreversible loss of the ability to speak as a result of physical injury or disease.
– PERMANENT AND IRREVERSIBLE DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
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18 MARCH 2007
The undergoing as a recipient of a transplant of bone marrow or of a complete heart, kidney, liver, lung, or FEB 1996
MAJOR ORGAN TRANSPLANT
pancreas, or inclusion on an offcial UK waiting list for such a procedure.
JUN 1996
For the above defnition, the following is not covered:
• Transplant of any other organs, parts of organs, tissues or cells. JUL 1997
JUN 1999
MOTOR NEURONE DISEASE A defnite diagnosis of motor neurone disease by a consultant neurologist. There must be permanent
– RESULTING IN PERMANENT clinical impairment of motor function.
OCT 2002
SYMPTOMS
JAN 2004
MULTIPLE SCLEROSIS A defnite diagnosis of multiple sclerosis by a consultant neurologist. There must be current clinical
– WITH PERSISTING SYMPTOMS impairment of motor or sensory function, which must have persisted for a continuous period of at least six JUL 2004
months.
MAR 2007
PARALYSIS OF LIMBS Total and irreversible loss of muscle function to the whole of any two limbs. MAY 2010
– TOTAL AND IRREVERSIBLE
(PARALYSIS OF A LIMB) JAN 2011
NOV 2011
PARKINSON’S DISEASE A defnite diagnosis of Parkinson’s disease by a consultant neurologist. There must be permanent clinical
– RESULTING IN PERMANENT impairment of motor function with associated tremor, rigidity of movement and postural instability. AUG 2012
SYMPTOMS For the above defnition, the following is not covered:
• Parkinson’s disease secondary to drug abuse. APR 2013
SEP 2014
PRIMARY PULMONARY A defnite diagnosis of primary pulmonary hypertension. There must be clinical impairment of heart
HYPERTENSION function resulting in the permanent loss of ability to perform physical activities to at least Class 3 of the DEC 2015
– OF SPECIFIED SEVERITY New York Heart Association classifcations of functional capacity*.
*NYHA Class 3. Heart disease resulting in marked limitation of physical activities where less than ordinary MAR 2016
activity causes fatigue, palpitation, breathlessness or chest pain.
FEB 2018
For the above defnition, the following are not covered:
• Pulmonary hypertension secondary to any other known cause i.e. not Primary. APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
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18 MARCH 2007
A defnite diagnosis of progressive supranuclear palsy by a consultant neurologist. There must be FEB 1996
PROGRESSIVE
SUPRANUCLEAR PALSY permanent clinical impairment of eye movements and motor function.
JUN 1996
– RESULTING IN PERMANENT
SYMPTOMS
JUL 1997
RESPIRATORY FAILURE Advanced stage emphysema or other chronic lung disease, resulting in all of the following: JUN 1999
– OF ADVANCED STAGE • The need for regular oxygen treatment on a permanent basis.
OCT 2002
• The permanent impairment of lung function tests as follows;
Forced Vital Capacity (FVC) and Forced Expiratory Volume at 1 second (FEV1) being less than 50% of JAN 2004
normal.
JUL 2004
STROKE Death of brain tissue due to inadequate blood supply or haemorrhage within the skull resulting in MAR 2007
– RESULTING IN PERMANENT permanent neurological defcit with persisting clinical symptoms.
SYMPTOMS For the above defnition, the following are not covered: MAY 2010
• Transient ischaemic attack.
JAN 2011
• Traumatic injury to brain tissue or blood vessels.
NOV 2011
SYSTEMIC LUPUS A defnite diagnosis of systemic lupus erythematosus by a consultant rheumatologist resulting in either
ERYTHEMATOSUS of the following: AUG 2012
– WITH SEVERE COMPLICATIONS • Permanent neurological defcit with persisting clinical symptoms; or
APR 2013
• The permanent impairment of kidney function tests as follows;
Glomerular Filtration Rate (GFR) below 30 ml/min. SEP 2014
DEC 2015
TERMINAL ILLNESS Advanced or rapidly progressing incurable illness where, in the opinions of an attending consultant and
our Chief Medical Offcer, the life expectancy is no greater than 12 months for the above defnition, the MAR 2016
following is not covered:
• Terminal Illness as defned above during the last eighteen months of the policy. FEB 2018
APR 2018
THIRD DEGREE BURNS Burns that involve damage or destruction of the skin to its full depth through to the underlying tissue and
– COVERING 20% OF THE covering at least 20% of the body’s surface area. NOV 2018
BODY’S SURFACE AREA
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 64
18 MARCH 2007
FEB 1996
TOTAL AND PERMANENT The Guaranteed Sum Assured will be payable:
DISABILITY (a) If the Life Assured is not in gainful occupation immediately before the onset of disability, and suffers JUN 1996
through illness or accident, a mental or physical irreversible disability, which in the opinion of The
Chief Medical Offcer of Legal & General, results in the Life Assured being permanently unable to JUL 1997
perform, without the direct assistance of another person, three or more of the following functions:
1. Walking: The ability to walk a distance of 200 metres on fat ground with or without the aid of a JUN 1999
walking stick and without stopping or experiencing discomfort.
2. Bending: The ability to get into or out of a standard saloon car, and the ability to bend or kneel to OCT 2002
pick up an object from the foor and straighten up again.
JAN 2004
3. Communicating: The ability to answer a telephone and to take a message.
4. Reading: Having the required eyesight (corrected if necessary) to be able to read a daily newspaper. JUL 2004
5. Writing: Having the physical ability to write legibly using a pen or a pencil without aid.
6. Climbing: Having the ability to climb up a fight of 12 stairs without stopping or suffering severe MAR 2007
discomfort.
MAY 2010
OR
(b) If the Life Assured is engaged in a gainful occupation immediately before the onset of disability and is, JAN 2011
by reason of sickness or accident, totally unable to follow his/her own occupation and in the opinion
of Legal & General is likely to remain so permanently. Such decision will be based on all the medical NOV 2011
evidence available. If in gainful employment the claim will be assessed on the occupation followed
immediately before the onset of disability. AUG 2012
APR 2013
TRAUMATIC HEAD INJURY Death of brain tissue due to traumatic injury resulting in permanent neurological defcit with persisting
– RESULTING IN PERMANENT clinical symptoms.
SEP 2014
SYMPTOMS
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 65
23 MAY 2010
Summary – Changes to Benign Brain Tumour, Coma, Coronary Artery By-pass Grafts, Heart Valve Replacement or Repair, HIV FEB 1996
infection, Loss of hand or foot, Paralysis of a limb, Parkinson’s Disease and Third Degree Burns. Mastectomy, Multiple System JUN 1996
Atrophy, Open Heart Surgery and Removal of an Eyeball added.
JUL 1997
OCT 2002
AORTA GRAFT SURGERY No change
JAN 2004
APLASTIC ANAEMIA No change
JUL 2004
MAY 2010
BENIGN BRAIN TUMOUR A non-malignant tumour or cyst in the brain, cranial nerves or meninges within the skull, resulting in
– RESULTING IN EITHER SURGICAL either surgical removal or permanent neurological defcit with persisting clinical symptoms. JAN 2011
REMOVAL OR PERMANENT For the above defnition, the following are not covered:
SYMPTOMS NOV 2011
• Tumours in the pituitary gland.
• Angiomas.
AUG 2012
SEP 2014
CANCER No change
DEC 2015
FEB 2018
COMA A state of unconsciousness with no reaction to external stimuli or internal needs which results in
– RESULTING IN permanent neurological defcit with persisting clinical symptoms.
APR 2018
PERMANENT SYMPTOMS For the above defnition, the following is not covered:
• Coma secondary to alcohol or drug abuse. NOV 2018
JUL 2019
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23 MAY 2010
FEB 1996
CORONARY ARTERY The undergoing of surgery requiring anterolateral thoracotomy on the advice of a consultant cardiologist
BY-PASS GRAFTS to correct narrowing or blockage of one or more coronary arteries with by-pass grafts.
JUN 1996
– WITH SURGICAL THORACOTOMY For the above defnition the following are not covered:
• balloon angioplasty JUL 1997
• atherectomy
JUN 1999
• rotablation
• insertion of stents, and OCT 2002
• laser treatment.
JAN 2004
NOV 2011
ENCEPHALITIS No change
AUG 2012
SEP 2014
HEART VALVE The undergoing of surgery requiring anterolateral thoracotomy on the advice of a consultant cardiologist
REPLACEMENT OR REPAIR to replace or repair one or more heart valves.
DEC 2015
– WITH SURGICAL THORACOTOMY
MAR 2016
HIV INFECTION Infection by Human Immunodefciency Virus resulting from:
– CAUGHT FROM A BLOOD FEB 2018
• a blood transfusion given as part of medical treatment
TRANSFUSION, PHYSICAL
• a physical assault; or APR 2018
ASSAULT OR ACCIDENT
AT WORK • an incident occurring during the course of performing normal duties of employment;
after the start of the policy and satisfying all of the following: NOV 2018
JUL 2019
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23 MAY 2010
• The incident must have been reported to appropriate authorities and have been investigated in FEB 1996
HIV INFECTION
– CAUGHT FROM A BLOOD accordance with the established procedures.
JUN 1996
TRANSFUSION, PHYSICAL • Where HIV infection is caught through a physical assault or as a result of an incident occurring during
ASSAULT OR ACCIDENT the course of performing normal duties of employment, the incident must be supported by a negative
JUL 1997
AT WORK HIV antibody test taken within fve days of the incident.
Continued • There must be a further HIV test within 12 months confrming the presence of HIV or antibodies to the JUN 1999
virus.
• The incident causing infection must have occurred in one of the following countries: Australia, Austria, OCT 2002
Belgium, Bulgaria, Canada, the Channel Islands, Cyprus, the Czech Republic, Denmark, Estonia, Finland,
France, Germany, Gibraltar, Greece, Hong Kong, Hungary, Iceland, the Isle of Man, Italy, Japan, Latvia, JAN 2004
Liechtenstein, Lithuania, Luxembourg, Malta, the Netherlands, New Zealand, Norway, Poland, Portugal,
Republic of Ireland, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland, the United Kingdom and JUL 2004
the United States of America.
For the above defnition, the following is not covered: MAR 2007
• HIV infection resulting from any other means, including sexual activity or drug abuse.
MAY 2010
NOV 2011
LIVER FAILURE No change
AUG 2012
LOSS OF HAND OR FOOT Permanent physical severance of a hand or foot at or above the wrist or ankle joints. APR 2013
– PERMANENT PHYSICAL SEVERANCE
SEP 2014
LOSS OF SPEECH No change
DEC 2015
FEB 2018
APR 2018
NOV 2018
JUL 2019
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23 MAY 2010
The undergoing of a mastectomy operation (total removal of all the tissue of at least one breast) on the FEB 1996
MASTECTOMY FOR DUCTAL
CARCINOMA IN SITU advice of your hospital consultant following the diagnosis of ductal carcinoma in situ of the breast.
JUN 1996
(DUCTAL CARCINOMA IN For the above defnition, the following are not covered:
SITU OF THE BREAST) • Prophylactic mastectomy without histological evidence of ductal carcinoma in situ, and JUL 1997
– REQUIRING TOTAL REMOVAL
• Any other surgical procedures such as lumpectomy, partial mastectomy and partial or total sub
OF THE BREAST
cutaneous mastectomy. JUN 1999
OCT 2002
MOTOR NEURONE DISEASE No change
JAN 2004
MULTIPLE SCLEROSIS No change
JUL 2004
MULTIPLE SYSTEM ATROPHY A defnite diagnosis of multiple system atrophy by a consultant neurologist. There must be evidence of MAR 2007
– RESULTING IN PERMANENT permanent clinical impairment of either:
SYMPTOMS MAY 2010
• motor function with associated rigidity of movement or
• the ability to coordinate muscle movement or JAN 2011
• bladder control and postural hypotension.
NOV 2011
OPEN HEART SURGERY The undergoing of surgery requiring median sternotomy (surgery to divide the breastbone) on the advice AUG 2012
– WITH MEDIAN STERNOTOMY of a consultant cardiologist to correct any structural abnormality of the heart.
APR 2013
PARALYSIS OF A LIMB Total and irreversible loss of muscle function to the whole of any one limb.
SEP 2014
– TOTAL AND IRREVERSIBLE
DEC 2015
PARKINSON’S DISEASE A defnite diagnosis of Parkinson’s disease by a consultant neurologist. There must be permanent clinical
– RESULTING IN PERMANENT impairment of motor function with associated tremor, rigidity of movement and postural instability. MAR 2016
SYMPTOMS
FEB 2018
APR 2018
NOV 2018
JUL 2019
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23 MAY 2010
FEB 1996
PRIMARY PULMONARY No change
HYPERTENSION JUN 1996
JUL 1997
PROGRESSIVE No change
SUPRANUCLEAR PALSY JUN 1999
OCT 2002
REMOVAL OF AN EYEBALL Surgical removal of an eyeball as a result of injury or disease.
– DUE TO INJURY OR DISEASE For the above defnition the following is not covered: JAN 2004
• Self inficted injuries.
JUL 2004
MAY 2010
SYSTEMIC LUPUS No change
ERYTHEMATOSUS JAN 2011
NOV 2011
STROKE No change
AUG 2012
SEP 2014
THIRD DEGREE BURNS Burns that involve damage or destruction of the skin to its full depth through to the underlying tissue and
– COVERING 20% OF THE covering at least 20% of the body’s surface area or covering 50% of the area of the face or head. DEC 2015
SURFACE AREA OF THE BODY
OR 50% OF THE FACE/HEAD MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
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23 MAY 2010
JUN 1999
OCT 2002
JAN 2004
JUL 2004
MAR 2007
MAY 2010
JAN 2011
NOV 2011
AUG 2012
APR 2013
SEP 2014
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 71
9 JANUARY 2011
JUN 1996
ALZHEIMER’S DISEASE No change
JUL 1997
OCT 2002
APLASTIC ANAEMIA No change
JAN 2004
JUL 2004
BACTERIAL MENINGITIS No change
MAR 2007
JAN 2011
BLINDNESS No change
NOV 2011
APR 2013
CARDIOMYOPATHY No change
SEP 2014
DEC 2015
COMA No change
MAR 2016
NOV 2018
JUL 2019
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9 JANUARY 2011
FEB 1996
CREUTZFELDT- JAKOB No change
DISEASE (CJD) JUN 1996
JUL 1997
DEAFNESS No change
JUN 1999
JAN 2004
ENCEPHALITIS No change
JUL 2004
MAR 2007
HEART ATTACK No change
MAY 2010
APR 2013
DEC 2015
END STAGE LIVER FAILURE No change
MAR 2016
FEB 2018
LOSS OF HAND OR FOOT No change
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 73
9 JANUARY 2011
FEB 1996
LOSS OF SPEECH No change
JUN 1996
JUN 1999
MASTECTOMY FOR DUCTAL No change
CARCINOMA IN SITU OCT 2002
(DUCTAL CARCINOMA IN
SITU OF THE BREAST) JAN 2004
JUL 2004
MOTOR NEURONE DISEASE No change
MAR 2007
MAY 2010
MULTIPLE SCLEROSIS No change
JAN 2011
AUG 2012
OPEN HEART SURGERY No change
APR 2013
SEP 2014
PARALYSIS OF A LIMB No change
DEC 2015
FEB 2018
PRIMARY PULMONARY No change
HYPERTENSION APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
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9 JANUARY 2011
FEB 1996
PROGRESSIVE SUPRANUCLEAR No change
PALSY
JUN 1996
JUN 1999
RESPIRATORY FAILURE No change
OCT 2002
JAN 2011
THIRD DEGREE BURNS Burns that involve damage or destruction of the skin to its full depth through to the underlying tissue
– COVERING 20% OF THE SURFACE and covering at least 20% of the body’s surface area or covering 20% of the area of the face or head. NOV 2011
AREA OF THE BODY OR 20% OF
THE FACE/HEAD AUG 2012
APR 2013
TOTAL AND PERMANENT No change
DISABILITY SEP 2014
DEC 2015
TRAUMATIC HEAD INJURY No change
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 75
27 NOVEMBER 2011
Summary – Coma and Coronary artery by-pass grafts defnitions clarifed. FEB 1996
JUN 1996
ALZHEIMER’S DISEASE No change
JUL 1997
AORTA GRAFT SURGERY No change
JUN 1999
JAN 2004
BACTERIAL MENINGITIS No change
JUL 2004
BENIGN BRAIN TUMOUR No change
MAR 2007
JAN 2011
CANCER No change
NOV 2011
APR 2013
COMA A state of unconsciousness with no reaction to external stimuli or internal needs which:
– RESULTING IN • Requires the use of life support systems; and SEP 2014
PERMANENT SYMPTOMS
• Results in permanent neurological defcit with persisting clinical symptoms.
For the above defnition, the following is not covered: DEC 2015
• Coma secondary to drug or alcohol abuse
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 76
27 NOVEMBER 2011
The undergoing of surgery requiring median sternotomy (surgery to divide the breastbone) or FEB 1996
CORONARY ARTERY
BY-PASS GRAFTS anterolateral thoracotomy on the advice of a Consultant Cardiologist to correct narrowing or blockage
of one or more coronary arteries with by-pass grafts. JUN 1996
– WITH SURGERY TO DIVIDE THE
BREASTBONE OR ANTEROLATERAL For the above defnition the following are not covered:
JUL 1997
THORACTOMY • Any other surgical procedure or treatment
JUN 1999
CREUTZFELDT- JAKOB DISEASE No change
OCT 2002
(CJD)
JAN 2004
DEAFNESS No change
JUL 2004
MAY 2010
ENCEPHALITIS No change
JAN 2011
HEART ATTACK No change
NOV 2011
DEC 2015
KIDNEY FAILURE No change
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 77
27 NOVEMBER 2011
OCT 2002
MAJOR ORGAN TRANSPLANT No change
JAN 2004
MASTECTOMY FOR DUCTAL No change
JUL 2004
CARCINOMA IN SITU (DUCTAL
CARCINOMA IN SITU OF THE
MAR 2007
BREAST)
MAY 2010
MOTOR NEURONE DISEASE No change
JAN 2011
AUG 2012
MULTIPLE SYSTEM ATROPHY No change
APR 2013
OPEN HEART SURGERY No change
SEP 2014
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 78
27 NOVEMBER 2011
JUN 1999
PROGRESSIVE SUPRANUCLEAR No change
PALSY OCT 2002
JAN 2004
REMOVAL OF AN EYEBALL No change
JUL 2004
RESPIRATORY FAILURE No change
MAR 2007
AUG 2012
TERMINAL ILLNESS No change
APR 2013
THIRD DEGREE BURNS No change
SEP 2014
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 79
05 AUGUST 2012
Summary – Changes to Cancer, Ductal carcinoma in situ of the breast, Heart valve replacement or repair, Multiple sclerosis, FEB 1996
Parkinson’s disease, Stroke, Terminal illness, Total and Permanent Disability. Low grade prostate cancer added. JUN 1996
JUL 1997
ALZHEIMER’S DISEASE No change
JUN 1999
JAN 2004
AORTA GRAFT SURGERY No change
JUL 2004
MAR 2007
APLASTIC ANAEMIA No change
MAY 2010
NOV 2011
BENIGN BRAIN TUMOUR No change
AUG 2012
APR 2013
BLINDNESS No change
SEP 2014
CANCER Any malignant tumour positively diagnosed with histological confrmation and characterised by the DEC 2015
– EXCLUDING LESS ADVANCED uncontrolled growth of malignant cells and invasion of tissue.
CASES MAR 2016
The term malignant tumour includes leukaemia, sarcoma and lymphoma except cutaneous lymphoma
(lymphoma confned to the skin).
FEB 2018
For the above defnition, the following are not covered:
• All cancers which are histologically classifed as any of the following: APR 2018
CONTINUE OVER
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05 AUGUST 2012
MAR 2007
CARDIOMYOPATHY No change
MAY 2010
COMA No change JAN 2011
NOV 2011
CORONARY ARTERY No change
BY-PASS GRAFTS
AUG 2012
MAR 2016
DEMENTIA No change
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
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05 AUGUST 2012
FEB 1996
DUCTAL CARCINOMA The undergoing of surgery on the advice of your hospital consultant following the diagnosis of ductal
IN SITU OF THE BREAST carcinoma in situ of the breast.
JUN 1996
– TREATED BY SURGERY For the above defnition the following is not covered:
• Any other type of treatment. JUL 1997
Only one claim per policy can be made.
JUN 1999
JAN 2004
HEART ATTACK No change
JUL 2004
HEART VALVE REPLACEMENT OR The undergoing of surgery on the advice of a consultant cardiologist to replace or repair one or more
MAR 2007
REPAIR – WITH SURGERY heart valves.
MAY 2010
HIV INFECTION No change
JAN 2011
AUG 2012
LIVER FAILURE No change
APR 2013
LOSS OF HANDS OR FEET No change
SEP 2014
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 82
05 AUGUST 2012
MAY 2010
MULTIPLE SCLEROSIS A defnite diagnosis of multiple sclerosis by a consultant neurologist.
There must be current clinical impairment of motor or sensory function caused by multiple sclerosis. JAN 2011
NOV 2011
MULTIPLE SYSTEM ATROPHY No change
AUG 2012
OPEN HEART SURGERY No change APR 2013
SEP 2014
PARALYSIS OF LIMBS No change
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 83
05 AUGUST 2012
FEB 1996
PARKINSON’S DISEASE A defnite diagnosis of Parkinson’s disease by a consultant neurologist. There must be permanent
clinical impairment of motor function with associated tremor, muscle rigidity and postural instability. JUN 1996
For the above defnition the following are not covered:
• Other Parkinsonian syndromes. JUL 1997
JUN 1999
PRIMARY PULMONARY No change
OCT 2002
HYPERTENSION
JAN 2004
PROGRESSIVE SUPRANUCLEAR No change JUL 2004
PALSY
MAR 2007
JAN 2011
RESPIRATORY FAILURE No change
NOV 2011
Death of brain tissue due to inadequate blood supply or haemorrhage within the skull resulting in AUG 2012
STROKE
– RESULTING IN PERMANENT permanent neurological deficit with persisting clinical symptoms.
APR 2013
SYMPTOMS For the above definition, the following is not covered:
• Transient ischaemic attack. SEP 2014
DEC 2015
SYSTEMIC LUPUS No change
ERYTHEMATOSUS MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 84
05 AUGUST 2012
FEB 1996
TERMINAL ILLNESS A defnite diagnosis by your hospital consultant of an illness that satisfes both of the following:
• The illness either has no known cure or has progressed to the point where it cannot be cured; and JUN 1996
• In the opinion of your hospital consultant and our Medical Offcer, the illness is expected to lead to
death within 12 months. JUL 1997
No terminal illness claim can be made after the death of the life assured or within the 12 months
immediately before the policy expiry date. JUN 1999
If decreasing cover is shown in the policy schedule, the amount payable will be the amount of cover
OCT 2002
calculated on the date we receive confrmation of the diagnosis.
JAN 2004
THIRD DEGREE BURNS No change JUL 2004
MAR 2007
TOTAL AND PERMANENT Your policy schedule will show which of the following total and permanent disability definitions applies
DISABILITY to you: MAY 2010
– OF SPECIFIED SEVERITY Total and permanent disability – unable to do your own occupation ever again.
JAN 2011
Loss of the physical or mental ability through an illness or injury to the extent that the life assured is
unable to do the material and substantial duties of their own occupation ever again. The material and
NOV 2011
substantial duties are those that are normally required for, and/or form a significant and integral part of,
the performance of the life assured’s own occupation that cannot reasonably be omitted or modified.
AUG 2012
Own occupation means your trade, profession or type of work you do for profit or pay. It is not a specific
job with any particular employer and is irrespective of location and availability. APR 2013
The relevant specialists must reasonably expect that the disability will last throughout life with no
prospect of improvement, irrespective of when the cover ends or the life assured expects to retire. SEP 2014
For the above definition, disabilities for which the relevant specialists cannot give a clear prognosis are
not covered. DEC 2015
Total and permanent disability – unable to do three specified work tasks ever again.
MAR 2016
Loss of the physical ability through an illness or injury to do at least three of the six work tasks listed
below ever again. FEB 2018
The relevant specialists must reasonably expect that the disability will last throughout life with no
prospect of improvement, irrespective of when the cover ends or the life assured expects to retire. APR 2018
The life assured must need the help or supervision of another person and be unable to perform the task
on their own, even with the use of special equipment routinely available to help and having taken any NOV 2018
appropriate prescribed medication.
JUL 2019
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05 AUGUST 2012
NOV 2011
TRAUMATIC HEAD INJURY No change
AUG 2012
APR 2013
SEP 2014
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 86
14 APRIL 2013
Summary – Changes to Major Organ Transplant and Total and Permanent Disability. Cardiac Arrest added. FEB 1996
JUN 1996
ALZHEIMER’S DISEASE No change
JUL 1997
OCT 2002
AORTA GRAFT SURGERY No change
JAN 2004
JUL 2004
APLASTIC ANAEMIA No change
MAR 2007
BACTERIAL MENINGITIS No change MAY 2010
JAN 2011
BENIGN BRAIN TUMOUR No change
NOV 2011
APR 2013
CANCER No change
SEP 2014
DEC 2015
CARDIAC ARREST Sudden loss of heart function with interruption of blood circulation around the body resulting in
– WITH INSERTION OF A unconsciousness, requiring resuscitation and resulting in either of the following devices being MAR 2016
DEFIBRILLATOR surgically implanted:
• Implantable cardioverter-defbrillator (ICD); or FEB 2018
• Cardiac resynchronisation therapy with defbrillator (CRT-D).
For the above defnition the following are not covered: APR 2018
• Insertion of a pacemaker.
NOV 2018
• Insertion of a defbrillator without cardiac arrest.
• Cardiac arrest secondary to illegal drug abuse.
JUL 2019
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14 APRIL 2013
FEB 1996
CARDIOMYOPATHY No change
JUN 1996
JUN 1999
CORONARY ARTERY No change
BY-PASS GRAFTS OCT 2002
JAN 2004
CREUTZFELDT-JAKOB DISEASE No change
(CJD) JUL 2004
MAR 2007
DEAFNESS No change MAY 2010
JAN 2011
DEMENTIA No change
NOV 2011
SEP 2014
ENCEPHALITIS No change
DEC 2015
HEART ATTACK No change MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
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14 APRIL 2013
FEB 1996
HEART VALVE REPLACEMENT OR No change
REPAIR JUN 1996
JUL 1997
HIV INFECTION No change
JUN 1999
JAN 2004
LIVER FAILURE No change
JUL 2004
MAR 2007
LOSS OF HANDS OR FEET No change
MAY 2010
NOV 2011
LOW GRADE PROSTATE CANCER No change
AUG 2012
APR 2013
MAJOR ORGAN TRANSPLANT The undergoing as a recipient of a transplant of bone marrow or of a complete heart, kidney, lung,
pancreas, liver or lobe of liver, or inclusion on an offcial UK, Channel Islands or Isle of Man waiting
SEP 2014
list for such a procedure.
For the above defnition, the following is not covered: DEC 2015
• Transplant of any other organs, parts of organs, tissues or cells.
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
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14 APRIL 2013
FEB 1996
MOTOR NEURONE DISEASE No change
JUN 1996
JUN 1999
MULTIPLE SYSTEM ATROPHY No change
OCT 2002
JUL 2004
PARALYSIS OF LIMBS No change
MAR 2007
MAY 2010
PARKINSON’S DISEASE No change
JAN 2011
DEC 2015
REMOVAL OF AN EYEBALL No change
MAR 2016
RESPIRATORY FAILURE No change FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
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14 APRIL 2013
FEB 1996
STROKE No change
JUN 1996
JUL 1997
SYSTEMIC LUPUS No change
ERYTHEMATOSUS JUN 1999
OCT 2002
TERMINAL ILLNESS No change
JAN 2004
JUL 2004
THIRD DEGREE BURNS No change
MAR 2007
TOTAL AND PERMANENT We define total and permanent disability in two ways. The definition we apply to you will depend on MAY 2010
DISABILITY what kind of job you do and if you’re paid for the work you do.
– OF SPECIFIED SEVERITY Your Policy Schedule will show if total and permanent disability is included in your policy and which of JAN 2011
the following definitions apply to you:
1. Total and permanent disability – unable to do your own occupation ever again. NOV 2011
Loss of the physical or mental ability through an illness or injury to the extent that the life assured is
AUG 2012
unable to do the material and substantial duties of their own occupation ever again. The material and
substantial duties are those that are normally required for, and/or form a significant and integral part of,
APR 2013
the performance of the life assured’s own occupation that cannot reasonably be omitted or modified.
Own occupation means your trade, profession or type of work you do for profit or pay. It is not a specific SEP 2014
job with any particular employer and is irrespective of location and availability.
The relevant specialists must reasonably expect that the disability will last throughout life with no DEC 2015
prospect of improvement, irrespective of when the cover ends or the life assured expects to retire.
For the above definition, disabilities for which the relevant specialists cannot give a clear prognosis are MAR 2016
not covered.
FEB 2018
2. Total and permanent disability – unable to do three specified work tasks ever again.
Loss of the physical ability through an illness or injury to do at least three of the six work tasks listed APR 2018
below ever again.
The relevant specialists must reasonably expect that the disability will last throughout life with no NOV 2018
prospect of improvement, irrespective of when the cover ends or the life assured expects to retire.
JUL 2019
CONTINUE OVER
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14 APRIL 2013
The life assured must need the help or supervision of another person and be unable to perform the task FEB 1996
TOTAL AND PERMANENT
DISABILITY on their own, even with the use of special equipment routinely available to help and having taken any
appropriate prescribed medication. JUN 1996
– OF SPECIFIED SEVERITY
Continued The specified work tasks are: JUL 1997
Walking:
The ability to walk more than 200 metres on a level surface. JUN 1999
Climbing:
The ability to climb up a flight of 12 stairs and down again, using the handrail if needed. OCT 2002
Lifting:
JAN 2004
The ability to pick up an object weighing 2kg at table height and hold for 60 seconds before replacing the
object on the table.
JUL 2004
Bending:
The ability to bend or kneel to touch the floor and straighten up again. MAR 2007
Getting in and out of a car:
The ability to get into a standard saloon car, and out again. MAY 2010
Writing:
The manual dexterity to write legibly using a pen or pencil, or type using a desktop personal computer JAN 2011
keyboard.
NOV 2011
APR 2013
SEP 2014
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 92
21 SEPTEMBER 2014
Summary – Enhancements to Blindness, Cancer, Deafness, Heart attack, Multiple sclerosis and Stroke defnitions. Ductal carcinoma FEB 1996
in situ of the breast changed to Carcinoma in situ of the breast. JUN 1996
JUL 1997
ALZHEIMER’S DISEASE No change
JUN 1999
JAN 2004
AORTA GRAFT SURGERY No change
JUL 2004
MAR 2007
APLASTIC ANAEMIA No change
MAY 2010
NOV 2011
BENIGN BRAIN TUMOUR No change
AUG 2012
APR 2013
BLINDNESS Permanent and irreversible loss of sight to the extent that even when tested with the use of visual
– PERMANENT AND IRREVERSIBLE aids, vision is measured at 6/60 or worse in the better eye using a Snellen eye chart.
SEP 2014
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 93
21 SEPTEMBER 2014
FEB 1996
CANCER Any malignant tumour positively diagnosed with histological confrmation and characterised by the
– EXCLUDING LESS ADVANCED uncontrolled growth of malignant cells and invasion of tissue.
JUN 1996
CASES The term malignant tumour includes leukaemia, sarcoma and lymphoma except cutaneous lymphoma
(lymphoma confned to the skin). JUL 1997
For the above defnition, the following are not covered:
• All cancers which are histologically classifed as any of the following: JUN 1999
– pre-malignant;
OCT 2002
– non-invasive;
– cancer in situ; JAN 2004
– having either borderline malignancy; or
JUL 2004
– having low malignant potential.
• All tumours of the prostate unless histologically classifed as having a Gleason score greater than 6 MAR 2007
or having progressed to at least clinical TNM classifcation T2N0M0.
• Malignant melanoma unless it has been histologically classifed as having caused invasion beyond MAY 2010
the epidermis (outer layer of the skin).
• Any other skin cancer (including cutaneous lymphoma) unless it has been histologically classifed JAN 2011
as having caused invasion in the lymph glands or spread to distant organs.
NOV 2011
AUG 2012
CARCINOMA IN SITU OF THE The undergoing of surgery on the advice of your hospital consultant following the diagnosis of
BREAST carcinoma in situ of the breast.
APR 2013
– TREATED BY SURGERY For the above defnition the following is not covered:
• Any other type of treatment. SEP 2014
DEC 2015
CARDIAC ARREST No change
MAR 2016
FEB 2018
CARDIOMYOPATHY No change
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 94
21 SEPTEMBER 2014
FEB 1996
COMA No change
JUN 1996
JUL 2004
Permanent and irreversible loss of hearing to the extent that the loss is greater than 70 decibels across
DEAFNESS
all frequencies in the better ear using a pure tone audiogram.
– PERMANENT AND IRREVERSIBLE MAR 2007
MAY 2010
DEMENTIA No change JAN 2011
NOV 2011
No change
ENCEPHALITIS
AUG 2012
APR 2013
SEP 2014
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 95
21 SEPTEMBER 2014
FEB 1996
HEART ATTACK Death of heart muscle, due to inadequate blood supply, that has resulted in all of the following evidence
– OF SPECIFIED SEVERITY of acute myocardial infarction: JUN 1996
• New characteristic electrocardiographic changes.
• The characteristic rise of biochemical cardiac specifc markers such as troponins or enzymes. JUL 1997
The evidence must show a defnite acute myocardial infarction.
JUN 1999
For the above defnition, the following are not covered:
• Other acute coronary syndromes including but not limited to angina. OCT 2002
JAN 2004
HEART VALVE REPLACEMENT OR No change
REPAIR JUL 2004
MAR 2007
HIV INFECTION No change
MAY 2010
JAN 2011
KIDNEY FAILURE No change
NOV 2011
APR 2013
LOSS OF HANDS OR FEET No change
SEP 2014
DEC 2015
LOSS OF SPEECH No change
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 96
21 SEPTEMBER 2014
FEB 1996
LOW GRADE PROSTATE CANCER No change
JUN 1996
JUN 1999
MOTOR NEURONE DISEASE No change
OCT 2002
JAN 2004
MULTIPLE SCLEROSIS A defnite diagnosis of multiple sclerosis by a consultant neurologist. There must have been clinical
– WHERE THERE HAVE BEEN impairment of motor or sensory function caused by multiple sclerosis.
JUL 2004
SYMPTOMS
MAR 2007
MULTIPLE SYSTEM ATROPHY No change MAY 2010
JAN 2011
OPEN HEART SURGERY No change
NOV 2011
APR 2013
PARKINSON’S DISEASE No change
SEP 2014
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 97
21 SEPTEMBER 2014
STROKE Death of brain tissue due to inadequate blood supply or haemorrhage within the skull resulting in JUL 2004
– RESULTING IN SYMPTOMS neurological defcit with persisting clinical symptoms lasting at least 24 hours.
LASTING AT LEAST 24 HOURS MAR 2007
For the above defnition, the following is not covered:
• Transient ischaemic attack. MAY 2010
6 DECEMBER 2015
Summary – Changes to Benign brain tumour, Cancer, Coma, Heart attack, Kidney failure, Loss of speech, Low grade prostate cancer, FEB 1996
Major organ transplant, Motor neurone disease, Parkinson’s disease, Stroke, Traumatic brain injury. Added in Spinal stroke. JUN 1996
JUL 1997
ALZHEIMER’S DISEASE No change
JUN 1999
ANGIOPLASTY No change
OCT 2002
JUL 2004
APLASTIC ANAEMIA No change
MAR 2007
BACTERIAL MENINGITIS No change MAY 2010
JAN 2011
BENIGN BRAIN TUMOUR A non-malignant tumour or cyst originating from the brain, cranial nerves or meninges within the skull,
– RESULTING IN EITHER resulting in either surgical removal or permanent neurological defcit with persisting clinical symptoms.
NOV 2011
SURGICAL REMOVAL OR For the above defnition, the following are not covered:
PERMANENT SYMPTOMS
• Tumours in the pituitary gland. AUG 2012
• Tumours originating from bone tissue.
APR 2013
• Angiomas and cholesteatoma.
SEP 2014
BLINDNESS No change
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 99
6 DECEMBER 2015
Any malignant tumour positively diagnosed with histological confrmation and characterised by the FEB 1996
CANCER
– EXCLUDING LESS ADVANCED uncontrolled growth of malignant cells and invasion of tissue.
JUN 1996
CASES The term malignant tumour includes leukaemia, sarcoma and lymphoma except cutaneous lymphoma
(lymphoma confned to the skin).
JUL 1997
For the above defnition, the following are not covered:
• All cancers which are histologically classifed as any of the following: JUN 1999
– pre-malignant;
OCT 2002
– non-invasive;
– cancer in situ; JAN 2004
– having either borderline malignancy; or
– having low malignant potential. JUL 2004
• All tumours of the prostate unless histologically classifed as having a Gleason score of 7 or above
MAR 2007
or having progressed to at least clinical TNM classifcation T2bN0M0.
• Malignant melanoma unless it has been histologically classifed as having caused invasion beyond MAY 2010
the epidermis (outer layer of the skin).
• Any other skin cancer (including cutaneous lymphoma) unless it has been histologically classifed JAN 2011
as having caused invasion in the lymph glands or spread to distant organs.
NOV 2011
DEC 2015
CARDIOMYOPATHY No change
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 100
6 DECEMBER 2015
MAY 2010
DEAFNESS No change
JAN 2011
DEMENTIA No change NOV 2011
AUG 2012
ENCEPHALITIS No change
APR 2013
SEP 2014
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 101
6 DECEMBER 2015
FEB 1996
HEART ATTACK Death of heart muscle, due to inadequate blood supply, that has resulted in all of the following evidence
– OF SPECIFIED SEVERITY of acute myocardial infarction:
JUN 1996
• New characteristic electrocardiographic changes.
• The characteristic rise of biochemical cardiac specifc markers such as troponins or enzymes. JUL 1997
The evidence must show a defnite acute myocardial infarction.
JUN 1999
For the above defnition, the following are not covered:
• Other acute coronary syndromes. OCT 2002
• Angina without myocardial infarction.
JAN 2004
KIDNEY FAILURE Chronic and end stage failure of both kidneys to function, as a result of which regular dialysis is JAN 2011
– REQUIRING PERMANENT DIALYSIS permanently required.
NOV 2011
APR 2013
LOSS OF HANDS OR FEET No change
SEP 2014
LOSS OF SPEECH Total permanent and irreversible loss of the ability to speak as a result of physical injury or disease.
DEC 2015
– TOTAL PERMANENT AND
IRREVERSIBLE
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 102
6 DECEMBER 2015
JAN 2011
MOTOR NEURONE DISEASE A defnite diagnosis of one of the following motor neurone diseases by a Consultant Neurologist:
– RESULTING IN PERMANENT • Amyotrophic lateral sclerosis (ALS) NOV 2011
SYMPTOMS
• Primary lateral sclerosis (PLS)
• Progressive bulbar palsy (PBP) AUG 2012
• Progressive muscular atrophy (PMA)
APR 2013
• Spinal muscular atrophy (SMA)
There must also be permanent clinical impairment of motor function. SEP 2014
DEC 2015
MULTIPLE SCLEROSIS No change
MAR 2016
MULTIPLE SYSTEM ATROPHY No change
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 103
6 DECEMBER 2015
PARKINSON’S DISEASE A defnite diagnosis of Parkinson’s disease by a Consultant Neurologist. There must be permanent JUN 1999
– RESULTING IN PERMANENT clinical impairment of motor function with associated tremor and muscle rigidity.
SYMPTOMS For the above defnition the following are not covered: OCT 2002
• Other Parkinsonian syndromes/Parkinsonism.
JAN 2004
AUG 2012
RESPIRATORY FAILURE No change
APR 2013
SPINAL STROKE Death of spinal cord tissue due to inadequate blood supply or haemorrhage within the spinal canal
– RESULTING IN SYMPTOMS resulting in neurological defcit with persisting clinical symptoms lasting at least 24 hours. SEP 2014
LASTING AT LEAST 24 HOURS
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 104
6 DECEMBER 2015
FEB 1996
STROKE Death of brain tissue due to inadequate blood supply or haemorrhage within the skull resulting in
– RESULTING IN SYMPTOMS neurological defcit with persisting clinical symptoms lasting at least 24 hours.
JUN 1996
LASTING AT LEAST 24 HOURS For the above defnition, the following are not covered:
• Transient ischaemic attack. JUL 1997
• Death of tissue of the optic nerve or retina/eye stroke.
JUN 1999
MAR 2007
THIRD DEGREE BURNS No change
MAY 2010
TOTAL AND PERMANENT No change
DISABILITY JAN 2011
NOV 2011
TRAUMATIC BRAIN INJURY Death of brain tissue due to traumatic injury resulting in permanent neurological defcit with persisting
– RESULTING IN PERMANENT clinical symptoms. AUG 2012
SYMPTOMS
APR 2013
SEP 2014
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 105
13 MARCH 2016
JUN 1996
ALZHEIMER’S DISEASE No change
JUL 1997
OCT 2002
AORTA GRAFT SURGERY No change
JAN 2004
APLASTIC ANAEMIA No change
JUL 2004
MAY 2010
BENIGN BRAIN TUMOUR No change
– RESULTING IN EITHER JAN 2011
SURGICAL REMOVAL OR
PERMANENT SYMPTOMS NOV 2011
AUG 2012
BLINDNESS No change
APR 2013
SEP 2014
DEC 2015
MAR 2016
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 106
13 MARCH 2016
OCT 2002
CARDIAC ARREST No change
JAN 2004
JUL 2004
CARDIOMYOPATHY No change
MAR 2007
COMA No change
MAY 2010
– WITH ASSOCIATED PERMANENT
SYMPTOMS
JAN 2011
MAR 2016
DEMENTIA No change
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 107
13 MARCH 2016
JUN 1999
HEART VALVE REPLACEMENT OR No change
REPAIR OCT 2002
JAN 2004
HIV INFECTION No change
JUL 2004
KIDNEY FAILURE No change
MAR 2007
– REQUIRING PERMANENT DIALYSIS
MAY 2010
LIVER FAILURE No change
JAN 2011
AUG 2012
LOSS OF SPEECH No change
– TOTAL PERMANENT AND APR 2013
IRREVERSIBLE
SEP 2014
LOW GRADE PROSTATE CANCER No change
DEC 2015
– REQUIRING TREATMENT
MAR 2016
MAJOR ORGAN TRANSPLANT No change
– FROM ANOTHER DONOR FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 108
13 MARCH 2016
FEB 1996
MOTOR NEURONE DISEASE No change
– RESULTING IN PERMANENT JUN 1996
SYMPTOMS
JUL 1997
MULTIPLE SCLEROSIS No change
JUN 1999
JAN 2004
OPEN HEART SURGERY No change
JUL 2004
PARALYSIS OF LIMBS No change MAR 2007
MAY 2010
PARKINSON’S DISEASE No change
– RESULTING IN PERMANENT
JAN 2011
SYMPTOMS
NOV 2011
PRIMARY PULMONARY No change
HYPERTENSION AUG 2012
APR 2013
PROGRESSIVE SUPRANUCLEAR No change
PALSY SEP 2014
DEC 2015
REMOVAL OF AN EYEBALL No change
MAR 2016
RESPIRATORY FAILURE No change
FEB 2018
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 109
13 MARCH 2016
FEB 1996
SPINAL STROKE No change
– RESULTING IN SYMPTOMS JUN 1996
LASTING AT LEAST 24 HOURS
JUL 1997
JAN 2004
SYSTEMIC LUPUS No change
ERYTHEMATOSUS JUL 2004
MAR 2007
TERMINAL ILLNESS A defnite diagnosis by your hospital consultant of an illness that satisfes both of the following:
MAY 2010
• The illness either has no known cure or has progressed to the point where it cannot be cured; and
• In the opinion of your hospital consultant and our medical offcer, the illness is expected to lead to JAN 2011
death within 12 months.
No terminal illness claim can be made after the death of the life assured. NOV 2011
If decreasing cover is shown in your Policy Schedule, the amount payable will be the amount of
AUG 2012
cover calculated on the date that it is established that the life assured has met our defnition of
terminal illness.
APR 2013
SEP 2014
THIRD DEGREE BURNS No change
DEC 2015
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 110
22 APRIL 2018
FEB 1996
Summary – Enhancements and amendments made to a number of illnesses. Alzheimer’s disease is now covered as part of
‘Dementia including Alzheimer’s disease’ condition. Removal of an eyeball defnition is now only available under Critical Illness JUN 1996
Extra. Progressive supranuclear palsy is now only available under Critical Illness Extra and is now covered as part of the ‘Parkinson’s
plus symdrome’ condition. JUL 1997
JUN 1999
ALZHEIMER’S DISEASE Incorporated in to ‘Dementia including Alzheimer’s disease’ defnition. See below for full defnition.
OCT 2002
JUL 2004
AORTA GRAFT SURGERY No change
MAR 2007
MAY 2010
APLASTIC ANAEMIA A defnite diagnosis of very severe aplastic anaemia by a consultant haematologist and evidenced
– CATEGORISED AS VERY SEVERE by bone marrow histology. There must be permanent bone marrow failure with: anaemia, JAN 2011
thrombocytopenia and an absolute neutrophil count of less than 0.2 x 109/L.
NOV 2011
APR 2013
BENIGN BRAIN TUMOUR A non-malignant tumour or cyst originating from the brain, cranial nerves or meninges within the
– RESULTING IN EITHER SPECIFIED skull, resulting in either: SEP 2014
TREATMENT OR PERMANENT • surgical removal;
SYMPTOMS DEC 2015
• radiotherapy;
• chemotherapy; or MAR 2016
• permanent neurological defcit with persisting clinical symptoms.
FEB 2018
For the above defnition, the following are not covered:
• tumours in the pituitary gland; APR 2018
• tumours originating from bone tissue; or
• angioma and cholesteatoma. NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 111
22 APRIL 2018
BLINDNESS Permanent and irreversible loss of sight to the extent that even when tested with the use of visual FEB 1996
– PERMANENT AND IRREVERSIBLE aids, vision is measured at 6/60 or worse in the better eye using a Snellen eye chart or visual feld is
reduced to 20 degrees or less of an arc, as measured by an ophthalmologist. JUN 1996
Any malignant tumour positively diagnosed with histological confrmation and characterised by the JUL 1997
CANCER
– EXCLUDING LESS ADVANCED uncontrolled growth of malignant cells and invasion of tissue.
JUN 1999
CASES The term malignant tumour includes leukaemia, sarcoma, pseudomyxoma peritonei, merkel cell cancer
and lymphoma except cutaneous lymphoma (lymphoma confned to the skin).
OCT 2002
For the above defnition, the following are not covered:
• All cancers which are histologically classifed as any of the following: JAN 2004
– pre-malignant;
– non-invasive; JUL 2004
– cancer in situ;
MAR 2007
– having either borderline malignancy; or
– having low malignant potential. MAY 2010
• All tumours of the prostate unless histologically classifed as having a Gleason score of 7 or above or
having progressed to at least clinical TNM classifcation T2bN0M0. JAN 2011
• Malignant melanoma unless it has been histologically classifed as having caused invasion beyond
the epidermis (outer layer of skin). NOV 2011
• Any other skin cancer (including cutaneous lymphoma) unless it has been histologically classifed as
having caused invasion in the lymph glands or spread to distant organs. AUG 2012
APR 2013
CARCINOMA IN SITU OF THE No change
BREAST SEP 2014
CARDIAC ARREST Sudden loss of heart function with interruption of blood circulation around the body resulting in DEC 2015
– WITH INSERTION OF unconsciousness, requiring resuscitation and resulting in either of the following devices being
A DEFRIBRILLATOR surgically implanted: MAR 2016
• implantable cardioverter-defbrillator (ICD); or
• cardiac resynchronisation therapy with defbrillator (CRT-D). FEB 2018
For the above defnition, the following are not covered:
APR 2018
• insertion of a pacemaker;
• insertion of a defbrillator without cardiac arrest; or NOV 2018
• cardiac arrest secondary to drug intake.
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 112
22 APRIL 2018
A defnite diagnosis of cardiomyopathy by a consultant cardiologist. There must be clinical impairment FEB 1996
CARDIOMYOPATHY
– OF SPECIFIED SEVERITY OR of heart function resulting in at least one of the following:
JUN 1996
RESULTING IN SPECIFIED • permanent and irreversible ejection fraction of 39% or less;
TREATMENT • permanent loss of ability to perform physical activities to at least Class 3 of the New York Heart JUL 1997
Association classifcations of functional capacity*; or
• implantable cardioverter-defbrillator (ICD). JUN 1999
For the above defnition, the following are not covered:
• cardiomyopathy secondary to alcohol or drug intake; OCT 2002
• all other forms of heart disease, heart enlargement and myocarditis.
JAN 2004
*NYHA Class 3. Heart disease resulting in marked limitation of physical activities where less than
ordinary activity causes fatigue, palpitation, breathlessness or chest pain.
JUL 2004
COMA A state of unconsciousness with no reaction to external stimuli or internal needs which: MAR 2007
– WITH ASSOCIATED PERMANENT • requires the use of life support systems; and
SYMPTOMS MAY 2010
• has associated permanent neurological defcit with persisting clinical symptoms.
For the above defnition, the following are not covered: JAN 2011
• medically induced coma;
• coma secondary to alcohol or drug intake. NOV 2011
AUG 2012
CORONARY ARTERY BYPASS The undergoing of surgery to divide the breastbone (median sternotomy) or thoracotomy on the
GRAFTS advice of a consultant cardiologist to correct narrowing or blockage of one or more coronary arteries APR 2013
– WITH SURGERY TO DIVIDE THE with bypass grafts.
BREASTBONE OR THORACTOMY For the above defnition, the following is not covered: SEP 2014
• any other surgical procedure or treatment.
DEC 2015
FEB 2018
DEAFNESS No change
APR 2018
NOV 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 113
22 APRIL 2018
A defnite diagnosis of dementia by a consultant neurologist, psychiatrist or geriatrician. The diagnosis FEB 1996
DEMENTIA INCLUDING
ALZHERIMER’S DISEASE must be supported by evidence of progressive loss of ability to do all of the following:
JUN 1996
– RESULTING IN PERMANENT • remember;
SYMPTOMS • reason; and JUL 1997
• to perceive, understand, express and give effect to ideas.
For the above defnition, the following are not covered: JUN 1999
• dementia secondary to alcohol or drug intake.
OCT 2002
JUL 2004
HEART ATTACK No change
MAR 2007
22 APRIL 2018
KENNEDY’S DISEASE A defnite diagnosis of Kennedy’s disease by a consultant neurologist. There must be permanent FEB 1996
– RESULTING IN PERMANENT clinical impairment of motor function caused by Kennedy's disease.
SYMPTOMS JUN 1996
MAR 2007
LOSS OF HANDS OF FEET No change
MAY 2010
LOSS OF SPEECH No change
JAN 2011
LOW GRADE PROSTATE CANCER No change
NOV 2011
MAJOR ORGAN TRANSPLANT No change
AUG 2012
MAR 2016
OPEN HEART SURGERY The undergoing of surgery to divide the breastbone (median sternotomy) or thoracotomy on the
– WITH SURGERY TO DIVIDE THE advice of a consultant cardiologist to correct any structural abnormality of the heart.
FEB 2018
BREASTBONE OR THORACOTOMY For the above defnition, the following are not covered:
• any other surgical procedure or treatment. APR 2018
JUL 2019
CONTINUE OVER
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 115
22 APRIL 2018
PARKINSON’S DISEASE A defnite diagnosis of Parkinson’s disease by a consultant neurologist. FEB 1996
– RESULTING IN PERMANENT There must be permanent clinical impairment of motor function with associated tremor or muscle rigidity.
SYMPTOMS JUN 1996
For the above defnition, the following are not covered:
• other Parkinsonian syndromes; JUL 1997
• Parkinsonism.
JUN 1999
PRIMARY PULMONARY No change
HYPERTENSION OCT 2002
JAN 2004
PROGRESSIVE SUPRANUCLEAR Defnition now part of Critical Illness Extra offering.
PALSY JUL 2004
REMOVAL OF AN EYEBALL Defnition now part of Critical Illness Extra offering. MAR 2007
MAY 2010
RESPIRATORY FAILURE No change
JAN 2011
AUG 2012
STROKE No change
APR 2013
SYSTEMIC LUPUS No change
ERYTHEMATOSUS SEP 2014
DEC 2015
THIRD DEGREE BURNS No change
MAR 2016
TOTAL AND PERMANENT No change
DISABILITY FEB 2018
APR 2018
TRAUMATIC BRAIN INJURY No change
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 116
NOVEMBER 2018
Summary – Amendments made to a number of illnesses including Dementia and Heart Attack. FEB 1996
JUN 1996
JUL 1997
ALZHEIMER’S DISEASE No change
JUN 1999
JAN 2004
MAR 2007
APLASTIC ANAEMIA No change
– CATEGORISED AS VERY SEVERE MAY 2010
JAN 2011
BACTERIAL MENINGITIS No change
NOV 2011
FEB 2018
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 117
NOVEMBER 2018
JUL 1997
CARCINOMA IN SITU OF THE No change
BREAST JUN 1999
JUL 2004
CARDIOMYOPATHY No change
– OF SPECIFIED SEVERITY OR MAR 2007
RESULTING IN SPECIFIED
TREATMENT MAY 2010
AUG 2012
CORONARY ARTERY BYPASS No change
GRAFTS APR 2013
– WITH SURGERY TO DIVIDE THE
BREASTBONE OR THORACTOMY SEP 2014
MAR 2016
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 118
NOVEMBER 2018
DEMENTIA INCLUDING A defnite diagnosis of dementia by a consultant neurologist, psychiatrist or geriatrician. FEB 1996
ALZHERIMER’S DISEASE The diagnosis must be supported by evidence of progressive loss of ability to do all of the following:
– RESULTING IN PERMANENT • remember; JUN 1996
SYMPTOMS • reason; and
JUL 1997
• to perceive, understand, express and give effect to ideas.
JUN 1999
ENCEPHALITIS No change
OCT 2002
JAN 2004
HEART ATTACK Death of heart muscle, due to inadequate blood supply, that has resulted in all
of the following evidence of acute myocardial infarction: JUL 2004
• new characteristic electrocardiographic changes or other positive fndings on diagnostic
imaging tests; MAR 2007
• the characteristic rise of biochemical cardiac specifc markers such as troponins or enzymes.
MAY 2010
The evidence must show a defnite acute myocardial infarction. For the above defnition, the following
are not covered: JAN 2011
• other acute coronary syndromes;
• angina without myocardial infarction. NOV 2011
AUG 2012
HEART VALVE REPLACEMENT No change
OR REPAIR APR 2013
DEC 2015
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 119
NOVEMBER 2018
JUN 1996
LIVER FAILURE No change JUL 1997
– OF ADVANCED STAGE
JUN 1999
LOSS OF HANDS OF FEET No change
OCT 2002
JAN 2004
LOSS OF SPEECH No change
JUL 2004
MAY 2010
MAJOR ORGAN TRANSPLANT No change
JAN 2011
NOV 2011
MOTOR NEURONE DISEASE No change
AUG 2012
SEP 2014
MULTIPLE SYSTEM ATROPHY No change
DEC 2015
MAR 2016
OPEN HEART SURGERY No change
– WITH SURGERY TO DIVIDE THE FEB 2018
BREASTONE OR THORACOTOMY
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 120
NOVEMBER 2018
JUN 1996
PRIMARY PULMONARY No change
JUL 1997
HYPERTENSION
JUN 1999
PROGRESSIVE SUPRANUCLEAR No change
PALSY OCT 2002
JUL 2004
RESPIRATORY FAILURE No change
MAR 2007
MAY 2010
SPINAL STROKE No change
JAN 2011
AUG 2012
SYSTEMIC LUPUS No change
ERYTHEMATOSUS APR 2013
FEB 2018
APR 2018
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 121
JULY 2019
Summary – Broadened the offering, by adding new conditions and improving existing conditions. FEB 1996
JUN 1996
JUL 1997
AORTA GRAFT SURGERY No change
– REQUIRING SURGICAL JUN 1999
REPLACEMENT
OCT 2002
APLASTIC ANAEMIA No change
JAN 2004
– CATEGORISED AS VERY SEVERE
JUL 2004
BACTERIAL MENINGITIS A defnite diagnosis of bacterial meningitis by a hospital consultant resulting in permanent
– RESULTING IN PERMANENT neurological defcit with persisting clinical symptoms. MAR 2007
SYMPTOMS
MAY 2010
FEB 2018
APR 2018
NOV 2018
JUL 2019
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JULY 2019
JUL 1997
CARCINOMA IN SITU OF THE No change
BREAST JUN 1999
CARDIAC ARREST Sudden loss of heart function with interruption of blood circulation around the body resulting in OCT 2002
– WITH INSERTION OF unconsciousness, requiring resuscitation and resulting in either of the following devices being
A DEFRIBRILLATOR surgically implanted: JAN 2004
• implantable cardioverter-defbrillator (ICD); or
JUL 2004
• cardiac resynchronisation therapy with defbrillator (CRT-D).
For the above defnition, the following are not covered: MAR 2007
• insertion of a pacemaker;
• insertion of a defbrillator without cardiac arrest. MAY 2010
JAN 2011
CARDIOMYOPATHY No change
– OF SPECIFIED SEVERITY OR NOV 2011
RESULTING IN SPECIFIED
TREATMENT AUG 2012
COMA A state of unconsciousness with no reaction to external stimuli or internal needs which requires the APR 2013
– OF SPECIFIED SEVERITY use of life support systems for a period of 96 hours.
For the above defnition, the following are not covered: SEP 2014
• medically induced coma; or
DEC 2015
• coma secondary to alcohol or drug intake.
MAR 2016
CREUTZFELDT-JAKOB DISEASE A defnite diagnosis of Creutzfeldt-Jakob disease by a consultant neurologist.
FEB 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 123
JULY 2019
JAN 2004
HEART ATTACK No change
– OF SPECIFIED SEVERITY JUL 2004
JAN 2011
KIDNEY FAILURE No change
– REQUIRING PERMANENT DIALYSIS NOV 2011
AUG 2012
LIVER FAILURE Liver failure due to cirrhosis and resulting in all of the following:
– OF ADVANCED STAGE • permanent jaundice; APR 2013
• ascites; and
• encephalopathy. SEP 2014
DEC 2015
LOSS OF USE OF HAND OF FOOT Permanent loss of the use of a hand or foot due to physical severance above the wrist or ankle joint
or total and irreversible loss of muscle function. MAR 2016
FEB 2018
LOSS OF SPEECH No change
– TOTAL PERMANENT AND
APR 2018
IRREVERSIBLE
NOV 2018
JUL 2019
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 124
JULY 2019
JUN 1996
MAJOR ORGAN TRANSPLANT The undergoing as a recipient of a transplant from either a human donor, animal, insertion of an
artifcial device, or inclusion on an offcial UK, Channel Islands or Isle of Man waiting list for any of the JUL 1997
following:
• transplant of a bone marrow; JUN 1999
• transplant of a complete heart, kidney, lung, pancreas, liver; or
OCT 2002
• transplant of a lobe of liver or lung; or
• haematopoietic stem cells preceded by total bone marrow ablation. JAN 2004
For the above defnition, the following are not covered:
• transplant of any other organs, parts of organs, tissues or cells. JUL 2004
MAR 2007
MOTOR NEURONE DISEASE A defnite diagnosis of one of the following motor neurone diseases by a consultant neurologist:
– RESULTING IN PERMANENT • amyotrophic lateral sclerosis (ALS); MAY 2010
SYMPTOMS • primary lateral sclerosis (PLS);
• progressive bulbar palsy (PBP); JAN 2011
• progressive muscular atrophy (PMA); or
NOV 2011
• Kennedy’s disease, also known as spinal and bulbar muscular atrophy (SBMA); or
• spinal muscular atrophy (SMA). AUG 2012
There must be permanent clinical impairment of motor function.
APR 2013
MULTIPLE SCLEROSIS No change
SEP 2014
– WHERE THERE HAVE BEEN
SYMPTOMS
DEC 2015
APR 2018
NOV 2018
JUL 2019
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JULY 2019
PULMONARY HYPERTENSION A defnite diagnosis of pulmonary hypertension. There must be clinical impairment of heart function FEB 1996
– OF SPECIFIED SEVERITY resulting in the permanent loss of ability to perform physical activities to at least Class 3 of the New York
Heart Association classifcations of functional capacity*. JUN 1996
*NYHA Class 3. Heart disease resulting in marked limitation of physical activities where less than
ordinary activity causes fatigue, palpitation, breathlessness or chest pain. JUL 1997
JUN 1999
RESPIRATORY FAILURE No change
– OF ADVANCED STAGE OCT 2002
JAN 2004
SPECIFIED HEART SURGERY Heart surgery to divide the breastbone (median sternotomy) or thoracotomy on the advice of a
consultant cardiologist to either: JUL 2004
• correct narrowing or blockage of one or more coronary arteries with by-pass grafts; or
• correct any structural abnormality of the heart. MAR 2007
MAY 2010
SPINAL STROKE No change
– RESULTING IN SYMPTOMS LASTING JAN 2011
AT LEAST 24 HOURS
NOV 2011
SEP 2014
SYSTEMIC LUPUS ERYTHEMATOSUS No change
– WITH SEVERE COMPLICATIONS DEC 2015
MAR 2016
THIRD DEGREE BURNS No change
– COVERING 20% OF THE SURFACE FEB 2018
AREA OF THE BODY OR 20% OF THE
FACE OR HEAD APR 2018
FEBRUARY 2018
Summary – Children’s Critical Illness Extra – available for an additional cost*. FEB 2018
APR 2018
BENIGN SPINAL CORD TUMOUR A non-malignant tumour originating from the spinal cord, spinal nerves or meninges within the
– RESULTING IN EITHER SPECIFIED spinal canal, resulting in either: NOV 2018
TREATMENT OR PERMANENT • surgical removal;
SYMPTOMS JUL 2019
• radiotherapy;
• chemotherapy; or
• permanent neurological defcit with persisting clinical symptoms.
For the above defnition, the following are not covered:
• angiomas;
• cysts;
• granulomas;
• haematomas; or
• osteophytes.
BRAIN INJURY DUE TO ANOXIA Death of brain tissue due to inadequate oxygen supply resulting in permanent neurological defcit
OR HYPOXIA with persisting clinical symptoms.
– RESULTING IN PERMANENT
SYMPTOMS
CEREBRAL PALSY A defnite diagnosis of cerebral palsy by a hospital consultant resulting in permanent neurological
defcit with persisting clinical symptoms.
CHILD’S DIABETES MELLITUS A defnite diagnosis of type 1 insulin dependent diabetes mellitus by a hospital consultant, with the
TYPE 1 use of permanent insulin injections. For the above defnition, the following are not covered:
– WITH SPECIFIED TREATMENT • gestational diabetes;
• type 2 diabetes (including type 2 diabetes treated with insulin).
FEBRUARY 2018
CHILD’S INTENSIVE CARE BENEFIT Sickness or injury resulting in continuous mechanical ventilation by means of tracheal intubation for FEB 2018
– REQUIRING MECHANICAL seven consecutive days (24 hours per day) or more in an intensive care unit in a UK hospital.
VENTILATION FOR SEVEN DAYS APR 2018
• for the above defnition, the following is not covered: Sickness or injury resulting in mechanical
ventilation secondary to alcohol or drug intake; NOV 2018
• premature birth (before 37 weeks).
JUL 2019
CYSTIC FIBROSIS A defnite diagnosis of cystic fbrosis by a hospital consultant.
SEVERE CROHN’S DISEASE A defnite diagnosis of Crohn’s disease by a consultant gastroenterologist resulting in either:
– TREATED WITH TWO SURGICAL • surgical intestinal resection to remove part of the small intestine or bowel on at least two separate
INTESTINAL RESECTIONS OR
occasions; or
REMOVAL OF ENTIRE
LARGE BOWEL • removal of entire large bowel (total colectomy).
For the above defnition, the following is not covered:
• surgical treatment for abscesses, fstuals or strictures.
SPINA BIFIDA MENINGOCELE A defnite diagnosis of spina bifda meningocele or myelomeningocele by a hospital consultant.
AND MYELOMENINGOCELE For the above defnition, the following are not covered:
• spina bifda occulta.
ULCERATIVE COLITIS A defnite diagnosis of ulcerative colitis confrmed by a consultant gastroenterologist, resulting in
– RESULTING IN THE REMOVAL OF removal of the entire large bowel (total colectomy).
THE ENTIRE LARGE BOWEL
LEGAL & GENERAL CRITICAL ILLNESS COVER AND CRITICAL ILLNESS EXTRA – CONDITIONS HISTORY 129
APRIL 2018
JUL 2019
BRAIN INJURY DUE TO ANOXIA No change
OR HYPOXIA
– RESULTING IN PERMANENT
SYMPTOMS
HYDROCEPHALUS No change
– TREATED WITH INVASIVE SURGERY
TO THE BRAIN TISSUE
APRIL 2018
JULY 2019
SPINA BIFIDA MENINGOCELE No change
AND MYELOMENINGOCELE
NOVEMBER 2018
Additional illness added for Children’s Critical Illness Extra – Craniosynostosis. FEB 2018
APR 2018
BENIGN SPINAL CORD TUMOUR No change
– RESULTING IN EITHER SPECIFIED NOV 2018
TREATMENT OR PERMANENT
SYMPTOMS JULY 2019
CRANIOSYNOSTOSIS The undergoing of surgery on the advice of a hospital consultant to treat craniosynostosis.
– TREATED BY SURGERY
NOVEMBER 2018
NOV 2018
MUSCULAR DYSTROPHY No change
JULY 2019
JULY 2019
Conditions listed under Critical Illness Extra are now included, with the exception of Terminal Illness Cover and Total and FEB 2018
Permanent Disability. APR 2018
NOV 2018
BENIGN SPINAL CORD TUMOUR Included with Critical Illness Extra
– RESULTING IN EITHER SPECIFIED
JULY 2019
TREATMENT OR PERMANENT
SYMPTOMS
CHILD’S DIABETES MELLITUS Included with additional cover for Critical Illness Extra
TYPE 1
– WITH SPECIFIED TREATMENT
CRANIOSYNOSTOSIS No change
– TREATED BY SURGERY
JULY 2019
NOV 2018
MUSCULAR DYSTROPHY No change
JULY 2019
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