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Child Insurance Critical Illness Cover

Compensation is paidunderline under the child insurance critical illness cover if a child is diagnosed with one of the nine diseases included in the coverage.

The insurance covers the following illnesses

Cancer
  • Malignant tumor characterized by uncontrolled growth, proliferation of malignant cells and invasive tissue growth. The diagnosis must be confirmed by an oncologist and supported by a specific histologic diagnosis. This definition also includes leukaemia, malignant lymphoma and myelodysplastic syndrome, unless otherwise stated.
  • Microinvasive carcinoma of the breast, histologically defined as T1mic, if the condition requires mastectomy, chemotherapy or radiotherapy.
  • Microinvasive carcinoma of the cervix uteri histologically defined as IA1 if the condition requires hysterectomy, chemotherapy or radiotherapy.
  • Lymphoma of the skin if the condition requires chemotherapy or radiotherapy.
  • Prostate cancer if it is histologically defined with a Gleason score higher than 6 or has developed into a TNM score of T2N0M0.
Chronic Kidney Disease
  • Chronic and irreversible renal failure of both kidneys, which results in the need for either regular kidney or peritoneal dialysis or kidney transplantation. The dialysis must be medically necessary and confirmed by a renal specialist.
Transplantation
  • Transplantation where the insured has received lungs, liver, pancreas, or small intestine.
  • Composite tissue allograft transplantation where the insured has received partial or whole face, hands, arms and legs.
Multiple Sclerose
  • Unequivocal diagnosis of multiple sclerosis (MS) confirmed by a neurologist supported by all of the following criteria:
  • Persistent clinical impairment of the motor or sensory organs, which must have been present continuously for at least 6 months.
  • MRI scan showing at least two demyelinating plaques in the brain or spinal cord that are characteristic of MS.
Third-degree burns
  • Third-degree skin burn that is a full-thickness burn and extends into the underlying tissue. The third-degree burn must cover at least 10% of the body surface area according to the "Lund and Browder Chart" and have been incurred involuntarily by the insured. The diagnosis must be confirmed by a specialist with extensive experience in the treatment of burns.
Juvenile Rheumatoid
  • Juvenile rheumatoid arthritis that is diagnosed before the age of 16 and is present in at least two joints, of which two are large, i.e. nape of the neck, knee, hip, elbow, wrist, ankle or shoulder. The symptoms must have been present for more than 6 weeks and be diagnosed by a rheumatologist.
Diabetes mellitus, type 1
  • Diabetes diagnosed by a specialist in paediatrics or internal medicine. Fasting blood sugar levels in repeated samples must have been higher than 8 mmol/l and the insured must have been treated with insulin for more than three months.
HIV/AIDS
  • Infection of human immunodeficiency virus (HIV) or confirmed diagnosis of acquired immunodeficiency syndrome (AIDS) which can be attributed to transfusion of blood or blood components and meets all of the following criteria:
  • The infection occurred following a transfusion of blood or blood components that was medically necessary and performed after the insurance took effect.
  • The institution or blood bank that supplied and transfused the blood or blood components is officially recognized as such by the health authorities.
  • The healthcare institution where the blood or blood transfusion was performed acknowledges its responsibility.
  • The HIV virus must be detectable in the blood 12 months after the transfusion of blood or blood components.
  • HIV infection/AIDS due to accidental needle stick injury sustained by the insured due to a syringe that has been discarded in playgrounds, parks or other public areas.
  • All incidents that could potentially lead to a claim for compensation according to clause 2.8.1.5 shall be notified to the company at the earliest opportunity together with a notification to the appropriate authorities.
Bacterial Meningitis
  • Unequivocal diagnosis of bacterial infection of the membrane surrounding the brain or spinal cord leading to permanent nerve damage that is confirmed for at least 3 months following diagnosis. The diagnosis must be confirmed by a neurologist and supported by the growth of pathogenic bacteria in cultures of the cerebrospinal fluid.

The insurance does not cover the following illnesses

Cancer
  • All tumors that are histologically defined as pre-malignant, non-invasive or carcinoma in situ, including ductal and lobular carcinoma in situ of the breast and cervical dysplasia CIN-1, CIN-2 and CIN- 3.
  • Chronic lymphocytic leukaemia (CLL) unless it has progressed to at least Binet stage B.
  • Basal cell carcinoma, squamous cell carcinoma and malignant melanoma stage IA (T1aN0M0) unless there are indications of metastasis.
  • Thyroid cancer less than 1 cm in diameter and histologically defined as T1N0M0.
  • Polycythemia rubra vera and essential thrombocythemia.
  • Monoclonal gammopathy of undetermined significance (MGUS).
  • Gastric MALT Lymphoma if the disease can be treated by eradication of Helicobacter.
  • Gastrointestinal Stroke (GIST) staging I and II according to the AJCC Cancer Staging Manual, Seventh Edition -2010.
Chronic Kidney Disease
  • Acute reversible renal failure requiring short-term kidney dialysis.
Transplantation
  • A condition leading to transplantation or graft must be judged completely incurable and confirmed as such by a medical specialist.
Multiple Sclerose
  • Unconfirmed multiple sclerosis (MS) and neurologically or radiologically isolated symptoms suggestive of multiple sclerosis but not diagnostic for the disease.
  • Optic neuritis and neuromyelitis optica.
Juvenile Rheumatoid
  • Symptoms resulting from arthritis associated with infection, infectious joint disease, orthopedic disease, injuries, abnormal tissue regeneration, immunodeficiency and vasculitis.

Please note that the above list is not exhaustive. Further information can be found in the insurance terms for child insurance.
In case of discrepancy between this list and the insurance terms, the insurance terms applies.