Glossary of terms | Living Insurance

Term	Meaning
Accident	An event which solely and directly causes injury as a result of violent, external and visible means.
Activities of daily living	Are defined as: bathing and showering dressing and undressing eating and drinking maintaining continence with a reasonable level of personal hygiene getting in and out of bed, a chair or wheelchair, or moving from place to place by walking, wheelchair or walking aids.
Alzheimer's disease	The unequivocal diagnosis of Alzheimer's disease confirmed as permanent irreversible failure of brain function and resulting in a permanent deterioration or loss of intellectual capacity that requires you to be under continual care and supervision by someone else.
Blindness	The complete and irrecoverable loss of the sight of both eyes (whether aided or unaided) as a result of sickness or injury. Loss of sight is defined as: visual acuity less than 6/60 in both eyes after correction a field of vision constricted to 20 degrees or less of arc, or a combination of visual defects resulting in the same degree of visual impairment as that occurring in either of the above.
Brain damage	As a result of an accident, sickness or injury, the insured child suffers brain damage causing neurological and/or cognitive deficit, which results in the insured child either: * As defined in the American Medical Association publication 'Guides to the Evaluation of Permanent Impairment', 5th Edition. suffering at least 25% permanent impairment of whole person function*, or being permanently unable to perform at least one of the numbered activities of daily living without the physical assistance of someone else.
Cancer	The presence of one or more malignant tumours including malignant lymphoma, Hodgkin's disease, leukaemia, multiple myeloma, malignant bone marrow disorders and melanomas greater than or equal to Clark Level 3 or greater than or equal to 1.5mm depth of invasion or where melanoma is showing signs of ulceration as determined by histological examination. The tumour must be characterised by: the uncontrolled growth and spread of malignant cells, and the invasion and destruction of normal tissue. The tumour must also: require treatment by surgery, radiotherapy, chemotherapy, biological response modifiers, or any other major treatment, or be totally incurable. The following tumours are excluded: Tumours which are histologically described as pre-malignant or show the malignant changes of 'carcinoma in situ'; carcinoma in situ of the breast is not excluded if the entire breast is removed specifically to arrest the spread of malignancy, and this procedure is the appropriate and necessary treatment as recommended by a registered doctor. Melanomas which : have no evidence of ulceration are less than Clark Level 3, and are less than 1.5mm depth of invasion, as determined by histological examination. All other types of skin cancers unless they have metastasised. Prostatecancers which are both histologically described as TNM Classification T1 or lesser (or any other equivalent or lesser classification) and have a Gleason score of 5 or less.
Carcinoma in situ of female organs	Carcinoma in situ of the following female body parts: breast cervix uteri corpus uteri fallopian tube ovary vagina, or vulva.
Carcinoma in situ of the breast	A focal autonomous new growth of carcinomatous cells within the breast which has not yet resulted in the invasion of normal tissues. 'Invasion' means an infiltration and/or active destruction of normal tissue beyond the basement membrane. The tumour must be classified as Tis according to the TNM staging method or FIGO* Stage 0. *FIGO refers to the staging method of the International Federation of Gynecology and Obstetrics.
Carcinoma in situ of the cervix uteri	A focal autonomous new growth of carcinomatous cells within the cervix uteri which has not yet resulted in the invasion of normal tissues. 'Invasion' means an infiltration and/or active destruction of normal tissue beyond the basement membrane. The tumour must be classified as Tis according to the TNM staging method or FIGO* Stage 0 (excluded are Cervical Intraepithelial Neoplasia (CIN) classifications including CIN 1 and CIN 2). *FIGO refers to the staging method of the International Federation of Gynecology and Obstetrics.
Carcinoma in situ of the corpus uteri	A focal autonomous new growth of carcinomatous cells within the corpus uteri which has not yet resulted in the invasion of normal tissues. 'Invasion' means an infiltration and/or active destruction of normal tissue beyond the basement membrane. The tumour must be classified as Tis according to the TNM staging method or FIGO* Stage 0. *FIGO refers to the staging method of the International Federation of Gynecology and Obstetrics.
Carcinoma in situ of the fallopian tube	A focal autonomous new growth of carcinomatous cells within the fallopian tube which has not yet resulted in the invasion of normal tissues. 'Invasion' means an infiltration and/or active destruction of normal tissue beyond the basement membrane. The tumour must be limited to the tubal mucosa and classified as Tis according to the TNM staging method or FIGO* Stage 0. *FIGO refers to the staging method of the International Federation of Gynecology and Obstetrics.
Carcinoma in situ of the ovary	A focal autonomous new growth of carcinomatous cells within the ovary which has not yet resulted in the invasion of normal tissues. 'Invasion' means an infiltration and/or active destruction of normal tissue beyond the basement membrane. The tumour must be classified as Tis according to the TNM staging method or FIGO* Stage 0. *FIGO refers to the staging method of the International Federation of Gynecology and Obstetrics.
Carcinoma in situ of the vagina	A focal autonomous new growth of carcinomatous cells within the vagina which has not yet resulted in the invasion of normal tissues. 'Invasion' means an infiltration and/or active destruction of normal tissue beyond the basement membrane. The tumour must be classified as Tis according to the TNM staging method or FIGO* Stage 0. *FIGO refers to the staging method of the International Federation of Gynecology and Obstetrics.
Carcinoma in situ of the vulva	A focal autonomous new growth of carcinomatous cells within the vulva which has not yet resulted in the invasion of normal tissues. 'Invasion' means an infiltration and/or active destruction of normal tissue beyond the basement membrane. The tumour must be classified as Tis according to the TNM staging method or FIGO* Stage 0. *FIGO refers to the staging method of the International Federation of Gynecology and Obstetrics.
Cardiomyopathy	The impaired ventricular function of variable aetiology, resulting in permanent and irreversible physical impairment to the degree of at least Class 3 of the New York Heart Association classification of cardiac impairment.
Chronic kidney failure	End stage renal failure presenting as chronic irreversible failure of the function of both kidneys, as a result of which regular renal dialysis is put in place.
Congenital condition	A congenital condition is one which develops during pregnancy or is diagnosed shortly after birth.
Coronary artery disease	Coronary artery disease that requires coronary artery surgery for treatment. Coronary artery disease does not include angioplasty, intraarterial procedures or other non-surgical techniques.
Cover end date	The date your cover ends as stated on your Policy Schedule.
Cover start date	The date we accept your application to increase, vary or add to your original cover or application for reinstatement (as applicable) as shown on your Policy Schedule.
Deafness	The total and permanent loss of hearing, both natural and assisted, from both ears as a result of sickness or injury. Assisted hearing is not excluded if the loss of hearing is treated by cochlear implant.
Dislocation	Damage to a joint where one or more bones are completely out of place. It excludes partial dislocations, for example where the bone ends are out of place but still touching.
Early stage prostate cancer	A prostate tumour that is histologically described as having: a TNM classification T1 (or any equivalent classification) a Gleason score of 5 or less, or a TNM Classification Tis (or any equivalent classification)
Encephalitis	The unequivocal diagnosis of encephalitis where the condition is characterised by severe inflammation of the brain, that results in the insured child either: suffering at least 25% permanent impairment of whole person function, or being permanently unable to perform at least one of the numbered activities of daily living without the physical assistance of someone else. As defined in the American Medical Association publication 'Guides to the Evaluation of Permanent Impairment', 5th Edition.
Fracture	The disruption in the continuity of the bone, with or without displacement, confirmed by radiographic or scanning technique. Stress fractures are excluded.
Heart attack	The death of a portion of the heart muscle as a result of inadequate blood supply to the relevant area. The basis for the diagnosis of a heart attack will include either of the following: confirmation of new electrocardiogram (ECG) changes or a left ventricular ejection fraction of less than 50%, and elevation (other than as a result of cardiac or coronary intervention) of; cardiac enzymes CK-MB above standard laboratory levels of normal, or levels of Troponin I greater than 2.0 ug/l or Troponin T greater than 0.6 ug/l, or their equivalent. If a diagnosis cannot be made on the basis of that criteria, we'll pay a claim based on satisfactory evidence that you have unequivocally been diagnosed as having suffered a heart attack resulting in: a reduction in the left ventricular ejection fraction to less than 50%, measured 3 months or more after the event, or new pathological Q waves.
Immediate family members	Your partner, parents, siblings or children.
Indexation factor	The percentage change in the consumer price index (CPI) which is the weighted average of the 8 Australian capital cities combined as published by the Australian Bureau of Statistics or any body which succeeds it and in respect of the 12 month period finishing on 30 September. The indexation factor will be applied from 1 March the following year. If the CPI is not published by this date, the indexation factor will be calculated upon a retail price index which we consider most nearly replaces it.
Injury	Physical damage to your body which occurs while cover for the applicable benefit was in force under this policy.
Insured child	The child who has been accepted by us and is listed on your Policy Schedule as the insured child under Kids Cover.
Insured person	The person who has been accepted by us and is listed on your Policy Schedule as the insured person under the policy.
Intracranial brain tumour with impairment	The diagnosis of a non-cancerous tumour either in the brain tissue or between the brain tissue and the cranium giving rise to symptoms of increased intracranial pressure such as papilloedoma, mental symptoms, seizures, sensory impairment and motor impairment; and results in the insured child either: suffering at least 25% permanent impairment of whole person function, or being permanently unable to perform at least one of the numbered activities of daily living without the physical assistance of someone else. As defined in the American Medical Association publication 'Guides to the Evaluation of Permanent Impairment', 5th Edition.
Legal personal representative	The executor or administrator of your estate, or any other person(s) who is authorised by law to administer and distribute your estate.
Level of cover	The amount you apply for under the Day-to-Day Living Expenses, Serious Sickness or Life Covers and we accept as varied (for example if you apply for a decrease or through increases under automatic indexation) by agreement.
Living Insurance	Million Dollar Woman Living Insurance.
Living Insurance Policy Document	A document issued by us which, together with your Policy Schedule, constitutes the full terms of your Living Insurance policy with us.
Loss of limbs or sight	The total and permanent loss of use of: both feet both hands the sight in both eyes (to the extent of 6/60 or less), or any combination of at least two of: a hand, a foot, or sight in an eye (to the extent of 6/60 or less).
Loss of speech	The total loss of speech both natural and assisted for at least six months and the subsequent diagnosis that loss of speech both natural and assisted will be total and permanent. Loss of speech related to any psychological cause is excluded.
Lump sum payment	The amount payable, relating to the listed injury under the Accidental Injury Cover or listed event under Kids Cover included in your policy and we accept as varied (for example through increases under automatic indexation) by agreement.
Major head trauma	An injury to the head which results in the insured child either: suffering at least 25% permanent impairment of whole person function, or being permanently unable to perform at least one of the numbered activities of daily living without the physical assistance of someone else. As defined in the American Medical Association publication 'Guides to the Evaluation of Permanent Impairment', 5th Edition.
Major organ failure	You or the insured child suffer major organ failure resulting in either an organ transplant, or upon specialist medical advice you or the insured child are placed on an official Australian acute care hospital waiting list to undergo organ transplant, from a human donor of one or more of the following: kidney heart liver lung pancreas, or bone marrow. The transplantation of all other organs or parts of any organ or of any other tissue is excluded.
Meningitis	The unequivocal diagnosis of meningitis where the condition is characterised by severe inflammation of the meninges of the brain, that results in the insured child either: suffering at least 25% permanent impairment of whole person function, or being permanently unable to perform at least one of the numbered activities of daily living without the physical assistance of someone else. As defined in the American Medical Association publication 'Guides to the Evaluation of Permanent Impairment', 5th Edition.
Meningococcal disease	Meningococcal septicaemia which results in the insured child either: suffering at least 25% permanent impairment of whole person function, or being permanently unable to perform at least one of the numbered activities of daily living without physical assistance of someone else. As defined in the American Medical Association publication 'Guides to the Evaluation of Permanent Impairment', 5th Edition.
Motor neurone disease	The unequivocal diagnosis of motor neurone disease.
Multiple sclerosis	A disease characterised by demyelination in the brain and spinal cord. Multiple sclerosis must be unequivocally diagnosed. There must be more than one episode of well defined neurological deficit with persisting neurological abnormalities. Neurological investigations such as lumbar puncture, MRI (magnetic resonance imaging) evidence of lesions in the central nervous system, evoked visual responses and evoked auditory responses are required to confirm diagnosis.
Nominated beneficiary or nominated beneficiaries	The person you nominate using a nomination of beneficiaries form to receive, if applicable, the Life Cover and Funeral Cover under your policy.
Paralysis	The total and permanent loss of use of one or more limbs resulting from spinal cord injury or disease, or from brain injury or disease. Included in this definition are paraplegia, quadriplegia, tetraplegia, diplegia and hemiplegia.
Parkinson's disease	The unequivocal diagnosis of degenerative idiopathic Parkinson's disease as characterised by the clinical manifestation of one or more of the following: rigidity tremor, or akinesia resulting in the degeneration of the nigrostriatal system. All other types of Parkinsonism are excluded (e.g. secondary to medication).
Partner	A partner is a spouse or a person living with the relevant person as their spouse on a domestic basis in good faith. He or she can be the same sex as the relevant person.
Policy	Your Living Insurance, which consists of the Policy Document, Policy Schedule and information provided in your application.
Policy anniversary	The anniversary of your policy start date.
Policy end date	The date when all covers under your policy end as stated on your Policy Schedule.
Policy owner	The person listed on the Policy Schedule as the owner of this policy.
Policy Schedule	A document issued by us which shows important information about your policy, including your policy number, premiums, special conditions (if applicable), your cover start date and your policy start date.
Policy start date	The date as shown on your Policy Schedule.
Premium	The amount you pay us for the insurance.
Primary nominated beneficiary	The person you list first on a nomination of beneficiaries form.
Registered doctor	A doctor who is legally qualified and properly registered in Australia. The doctor cannot be you or a member of your family. If practising outside Australia, the doctor must have qualifications equivalent to Australian standards. A registered doctor could be your general practitioner or treating medical specialist.
Serious accidental injury	Injury which has resulted in the insured child being confined to an acute care hospital for a period of 30 consecutive days (24 hours per day) under the full-time care of a registered doctor.
Severe burns	Accidental burns that involve damage or destruction of the skin to its full depth through to the underlying tissue.
Sickness	An illness or disease you suffer while cover for the applicable benefit was in force under this policy.
Single loss of limb or eye	The total and permanent loss of use of: one foot one hand, or sight in one eye (to the extent of 6/60 or less).
Stroke	Any cerebrovascular accident or incident producing neurological sequelae lasting more than 24 hours. This includes infarction of brain tissue, intracranial or subarachnoid haemorrhage, embolisation from an extracranial source, but excludes transient ischaemic attacks and cerebral events and symptoms due to reversible neurological deficits and migraine.
Terminal illness	A sickness which you have been diagnosed with, that in our opinion, having considered any evidence we may require, means that your life expectancy is not greater than 12 months, regardless of any available treatment.
Waiting period	The period of time during which a payment will not be paid. The waiting period will start on the date you consult a registered doctor for the sickness or injury giving rise to your Day-to-Day Living Expenses Cover claim.
We, us and our	Suncorp Life & Superannuation Limited ABN 87 073 979 530 AFSL 229880.
You and your	The policy owner who is also the insured person who has been accepted by us and is shown on the Policy Schedule.

Accident

An event which solely and directly causes injury as a result of violent, external and visible means.

Activities of daily living

Are defined as:

bathing and showering
dressing and undressing
eating and drinking
maintaining continence with a reasonable level of personal hygiene
getting in and out of bed, a chair or wheelchair, or moving from place to place by walking, wheelchair or walking aids.

Alzheimer's disease

The unequivocal diagnosis of Alzheimer's disease confirmed as permanent irreversible failure of brain function and resulting in a permanent deterioration or loss of intellectual capacity that requires you to be under continual care and supervision by someone else.

Blindness

The complete and irrecoverable loss of the sight of both eyes (whether aided or unaided) as a result of sickness or injury. Loss of sight is defined as:

visual acuity less than 6/60 in both eyes after correction
a field of vision constricted to 20 degrees or less of arc, or
a combination of visual defects resulting in the same degree of visual impairment as that occurring in either of the above.

Brain damage

As a result of an accident, sickness or injury, the insured child suffers brain damage causing neurological and/or cognitive deficit, which results in the insured child either:

* As defined in the American Medical Association publication 'Guides to the Evaluation of Permanent Impairment', 5th Edition.

suffering at least 25% permanent impairment of whole person function*, or
being permanently unable to perform at least one of the numbered activities of daily living without the physical assistance of someone else.

Cancer

The presence of one or more malignant tumours including malignant lymphoma, Hodgkin's disease, leukaemia, multiple myeloma, malignant bone marrow disorders and melanomas greater than or equal to Clark Level 3 or greater than or equal to 1.5mm depth of invasion or where melanoma is showing signs of ulceration as determined by histological examination.

The tumour must be characterised by:

the uncontrolled growth and spread of malignant cells, and
the invasion and destruction of normal tissue.

The tumour must also:

require treatment by surgery, radiotherapy, chemotherapy, biological response modifiers, or any other major treatment, or
be totally incurable.

The following tumours are excluded:

Tumours which are histologically described as pre-malignant or show the malignant changes of 'carcinoma in situ'; carcinoma in situ of the breast is not excluded if the entire breast is removed specifically to arrest the spread of malignancy, and this procedure is the appropriate and necessary treatment as recommended by a registered doctor.

Melanomas which :

have no evidence of ulceration
are less than Clark Level 3, and
are less than 1.5mm depth of invasion, as determined by histological examination.

All other types of skin cancers unless they have metastasised.

Prostatecancers which are both histologically described as TNM Classification T1 or lesser (or any other equivalent or lesser classification) and have a Gleason score of 5 or less.

Carcinoma in situ of female organs

Carcinoma in situ of the following female body parts:

breast
cervix uteri
corpus uteri
fallopian tube
ovary
vagina, or vulva.

Carcinoma in situ of the breast

A focal autonomous new growth of carcinomatous cells within the breast which has not yet resulted in the invasion of normal tissues.

'Invasion' means an infiltration and/or active destruction of normal tissue beyond the basement membrane. The tumour must be classified as Tis according to the TNM staging method or FIGO* Stage 0.