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Critical Illness – Blindness, Deafness, Loss of Limbs, Loss of Speech, Coma, Paralysis, Severe Burns

Blind-Deaf
This is part V of VII in our series of covered conditions on Critical Illness Insurance in Canada. In this article we will cover specific physical conditions.

Blindness

Blindness is defined as a definite diagnosis of the total and irreversible loss of vision in both eyes, evidenced by:

  • the corrected visual acuity being 20/200 or less in both eyes; or,
  • the field of vision being less than 20 degrees in both eyes.

The diagnosis of Blindness must be made by a Specialist.

Note that while this condition would appear to be straightforward, the condition must be total and irreversible. If the condition is repairable or reversible, a benefit would not be paid.

Deafness

Deafness is defined as “a definite diagnosis of the total and irreversible loss of hearing in both ears, with an auditory threshold of 90 decibels or greater within the speech threshold of 500 to 3,000 hertz. The diagnosis of Deafness must be made by a Specialist.

Similiar to blindness, the loss of hearing must be complete and it must be irreversible. Hearing loss that is repairable is not a covered condition.

Loss of Limbs

A definite diagnosis of the complete severance of two or more limbs at or above the wrist or ankle joint as the result of an accident or medically required amputation. The diagnosis must be made by a specialist.

Of note with this covered condition is that you must lose TWO or more limbs. Loss of a single limb is not a covered condition.

The next two covered conditions are offered without commentary, if you’ve read this far you’re now aware that the contractual coverage of each condition requires careful reading and that simply contracting the condition is insufficient.

Paralysis

A definite diagnosis of the total loss of muscle function of two or more limbs as a result of injury or disease to the nerve supply of those limbs, for a period of at least 90 days following the precipitating event. The diagnosis of paralysis must be made by a specialist.

Coma

Coma is defined as “a definite diagnosis of a state of unconsciousness with no reaction to external stimuli or response to internal needs for a continuous period of at least 96 hours, and for which period the Glasgow coma score must be 4 or less. The diagnosis of Coma must be made by a Specialist.

Exclusion: No benefit will be payable under this condition for:

  • a medically induced coma; or,
  • a coma which results directly from alcohol or drug use; or,
  • a diagnosis of brain death.
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