| |
Explanation |
Evidence Requiried |
Conditions not covered |
| Cancer means |
The presence of one or more malignant tumours |
This requires the malignant tumour to be characterised by the uncontrolled growth and spread of malignant cells and the invasion and destruction of normal tissue.
*Carcinoma in situ of the breast is covered if it results directly in the removal of the entire breast. The procedure must be performed specifically to arrest the spread of malignancy, and be considered the appropriate and necessary treatment.
|
The following tumours are excluded:
- Tumours showing the malignant changes of carcinoma in situ (including cervical dysplasia CIN-1, CIN-2 and CIN-3) or which are histologically described as premalignant*;
- All skin cancers, unless there is evidence of metastases;
- Melanoma of the skin at Stage 1A (tumour thickness of less than or equal to 1.00mm, Clark level II or III, without ulceration);
- Prostatic cancers which are histologically described as TNM Classification T1 or are of another equivalent or lesser classification, unless resulting in the surgical removal of the prostate;
- Papillary Micro-Carcinoma of the Thyroid or Bladder; and
- Chronic Lymphocytic Leukaemia less than Rai Stage 1
|
| Heart Attack means |
The occurrence of an acute myocardial infarction, which means the death of a portion of heart muscle due to inadequate blood supply. |
This requires clear evidence of:
- New electrocardiograph (ECG) changes associated with myocardial infarction, and
- The elevation of biochemical markers (such as troponin or cardiac enzymes) of myocardial necrosis.
If the above tests are inconclusive, consideration will be given to any other medical evidence in support of a diagnosis.
|
The following are excluded:
- Non-cardiac chest pain, and
- Angina, which is a more common but temporary heart condition with no death of the heart muscle.
|
| Stroke means |
A cerebrovascular event producing neurological deficit, which means the malfunction of the brain due to bleeding or a blood clot on the brain. |
This requires clear evidence on a CT, MRI or other appropriate scanning device of an:
- infarction of brain tissue caused by intracranial and/or subarachnoid haemorrhage, or
- embolisation from an extracranial source.
|
The following are excluded:
- Transient ischaemic attacks,
- Reversible neurological deficit,
- Cerebral symptoms due to migraine,
- Cerebral injury resulting from trauma or hypoxia, and
- Vascular disease affecting the eye, optic nerve or vestibular functions.
|
| Coronary Artery Bypass Surgery means |
Bypass grafting surgery performed to correct or treat coronary artery disease. |
As per explanation |
|
| Paralysis means |
The total and permanent loss of function of 2 or more limbs. |
This requires permanent damage to the nervous system due to sickness
or injury. This includes, but is not limited to, quadriplegia, paraplegia, diplegia and hemiplegia. |
|
| Permanent Incapacity means |
The loss of ability to look after yourself. |
This requires the total and irrecoverable loss of ability to perform at least 2 of the following activities without the physical assistance of another person.
- Bathing - the ability to shower and bathe;
- Dressing - the ability to put on and take off clothing;
- Toileting - the ability to get on and off, and use, the toilet;
- Mobility - the ability to get in and out of bed and a chair;
- Feeding - the ability to get food from a plate into the mouth.
|
|
How to Make a Claim on your Policy
At InsuranceLine we understand that at a time of suffering a major illness, covered under the plan, you don’t want to be further burdened by the additional stress of money worries.
Our claims process has been set up so that we can get your claims application processed and approved to get the money to you as soon as possible – usually within 48 hours of us receiving all the completed claims requirements, with as little stress as possible at this difficult time.
To make a claim just follow these steps:
1. Give us a call on 13 77 87 or email us to let us know that you’ll be making a claim. We can then help you by stopping the collection of premiums for the policy until the claim has been processed.
2. Complete a
Major Illness Claim Form.
Click here for a copy.
3. Once you have these items, if possible, fax a copy of them to us so we can get the claims process underway. Then, as soon as possible put the originals in the mail to us: Claims, Reply Paid 62, Carlton South VIC 3053. We will need to have the originals before a payment can be made to you.
4. Once your claim has been processed, if there are any other people insured on the policy, or the Optional Life Insurance Upgrade is held, we’ll make sure the necessary amendments are made, and send a new set of policy documents.
Where you can get support – Useful links
Adjusting after someone suffers a Major Illness is never easy, but there is a lot of help available.
A CentreLink Financial Information Service Officer may also be able to help you. CentreLink customers may be eligible for financial assistance. For more information, contact CentreLink on 13 28 50, or at
www.centrelink.gov.au
If you have private medical insurance, be sure to contact them as you may be eligible for financial assistance.
Below are some other websites, which you may find useful:
The Cancer Council of Australia
www.cancer.org.au
National Heart Foundation of Australia
www.heartfoundation.com.au or tel 1300 36 27 87
Stroke Foundation
www.strokefoundation.com.au
Health Insite
www.healthinsite.gov.au/topics/Paralysis