What illnesses are covered by critical illness insurance, and what illnesses are covered by critical

Critical illness insurance includes severe and critical illness insurance, including severe and life-threatening, unguaranteed quality of life, inability to take care of oneself, poor disease prognosis, and serious shortening of life.

At present, there are about 20 kinds of diseases included in the critical illness insurance in China, including malignant tumors such as leukemia, pheochromocytoma, small cell liver cancer, and acute myocardial infarction, which refers to irreversible infarction of the heart caused by myocardial ischemia.

Hello! There are many critical illness insurance policies on the market, and the coverage may vary depending on the product.

However, no matter what the product is and how the protection changes, as long as it is critical illness insurance, it must include 28 types of critical illnesses that must be insured, which is a mandatory regulation of the CBIRC.

Things like malignant tumors, acute myocardial infarction, sequelae of stroke, benign brain tumors, etc. are included.

The 28 types of critical illness are as follows:

In the process of choosing critical illness insurance, we usually have a misunderstanding, that is, we think that the more critical illnesses covered by critical illness insurance, the better.

These critical illnesses have covered more than 95% of critical illness claims.

So we don't have to worry too much about how many critical illnesses are covered by critical illness insurance, and we can focus on other aspects of protection.

In addition to providing 28 types of critical illness protection, critical illness insurance also covers other aspects.

Generally, it also includes moderate illness protection and mild illness protection, of course, some critical illness insurance plans list these two benefits as optional liabilities, and consumers can choose flexibly.

Some critical illness insurance plans also provide a wealth of optional liabilities, such as multiple benefits for critical illnesses, multiple benefits for specific cardiovascular and cerebrovascular diseases, multiple benefits for cancer, and so on.

In addition to the benefits mentioned above, critical illness insurance may also include premium waiver for the insured person, death benefit, etc., depending on the product.

Therefore, through the above analysis, we know that the coverage of critical illness can be divided into a certain part and an uncertain part.

The definite part is the 28 types of critical illnesses that must be covered by the CBIRC's critical illness insurance, and no matter what critical illness insurance, these protections are available.

Then the uncertain part is the moderate illness benefit, mild illness benefit, death benefit, policyholder, insured waiver and other optional liabilities.

Different products, protection may also be different, when we apply for insurance, we should combine our own protection needs with the protection of the product to find a product that suits us.

Hope daddy's is helpful to you!

The diseases covered by critical illness insurance must include 6 core critical illnesses, such as: malignant tumor - severe; more severe acute myocardial infarction; sequelae of severe stroke, etc. There are also 22 types of critical illness insurance companies that can choose from.

If the product also contains the liability for mild symptoms, it must contain 3 core minor symptoms. These 28 critical illnesses and 3 minor illnesses are all defined by the Insurance Association of China and the Chinese Medical Doctor Association.

The 6 core critical illnesses that must be covered by critical illness insurance are:

malignancy - severe; more severe acute myocardial infarction; sequelae of severe stroke; Major organ transplantation or hematopoietic stem cell transplantation; coronary artery bypass grafting (also known as coronary artery bypass grafting); Severe chronic renal failure.

The other 22 critical illnesses are:

1）.multiple limb missing; 2)) acute severe hepatitis or subacute severe hepatitis; 3) Severe non-malignant intracranial tumors; 4) severe chronic liver failure; 5) sequelae of severe encephalitis or severe meningitis sequelae; 6) deep coma; 7) deafness in both ears; 8) Blindness in both eyes; 9) paralysis; 10) Heart valve surgery; 11) Severe Alzheimer's disease; 12) severe brain injury; 13) severe primary Parkinson's disease; 14) Severe burns; 15) Severe idiopathic pulmonary hypertension; 16) Severe motor neuron disease; 17) loss of language ability; 18) severe aplastic anemia; 19) Aortic surgery; 20) severe chronic respiratory failure; 21) severe Crohn's disease; 22) Severe ulcerative colitis.

The 3 core mild symptoms are:

Malignancy - mild; mild acute myocardial infarction; Mild sequelae of stroke.

At present, the mainstream critical illness insurance in the market contains these 28 kinds of critical illnesses and 3 kinds of minor diseases, as for the diseases outside of this, each insurance company has joined it itself, and there are dozens or even more than 100 kinds of critical illness insurance products that we have seen, and there are dozens of types of minor illnesses, and some insurance companies' critical illness insurance products have added insurance liability for moderate diseases in addition to critical illness and mild illness. Most of the claims for mild illnesses are 30% of the sum insured for critical illnesses, and 50-60% of the sum insured for moderate illnesses.

Summary: There are two main characteristics of critical illness defined in critical illness insurance: one is that the condition is serious, which takes a long time and can even lead to permanent consequences; The second is that the medical expenses incurred are huge, which will cause a greater financial burden to individuals and families.

In particular, it should be noted that there is a big difference between the definition of disease in critical illness insurance and the definition of medically diagnosed disease, and the definition of disease in critical illness insurance mainly defines the symptoms and extent of compensation for a certain disease; The purpose of disease definition in medicine is to explain what a certain disease is, what are the clinical manifestations, etc. Therefore, not all critical illness insurance can pay the sum insured after being diagnosed by the hospital.

2.Cardiogenic disease: common in severe coronary heart disease, acute myocardial infarction, dilated cardiomyopathy, hypertrophic obstructive cardiomyopathy, acute and chronic heart failure, myocarditis.

3.Brain and neurological diseases: such as cerebral infarction, cerebral hemorrhage, brain trauma, encephalitis, meningitis, intracranial tumors; Guillain-Barré syndrome, motor neuron disease, Alzheimer's disease and other neurological diseases.

The scope of diseases covered by this product shall include malignant tumors, acute myocardial infarction, sequelae of stroke, coronary artery bypass grafting (or coronary artery bypass grafting), major organ transplantation or hematopoietic stem cell transplantation, and end-stage renal disease (or chronic renal failure uremia stage); In addition to these six diseases, insurance companies can choose to use other diseases within the scope of this standard; At the same time, the above-mentioned diseases shall use the disease names and disease definitions of this specification.

Malignant tumors refer to the uncontrolled progressive growth and spread of malignant cells, infiltrating and destroying surrounding normal tissues, and can be menstruated with blood. Diseases in which lymphatic vessels and body cavities spread to other parts of the body. The diagnosis is confirmed by pathological examination.

The clinical diagnosis falls under the category of malignancies in the International Statistical Classification of Diseases and Related Health Problems (ICD-10) of the World Health Organization. The following illnesses are not covered:

1) carcinoma in situ;

2) chronic lymphocytic leukemia equivalent to the stage A level of BINET staging regimen;

3) Hodgkin's disease equivalent to the stage I of the ANNARBOR staging scheme;

4) ** cancer (excluding malignant melanoma and ** cancer that has metastasized);

5) Prostate cancer with TNM stage of T1N0M0 or less;

6) Infection with HIV virus or malignant tumor during AIDS treatment.

Acute myocardial infarction refers to partial myocardial necrosis caused by insufficient blood supply to the corresponding area due to coronary artery occlusion. At least three of the following conditions must be met:

1) Typical clinical manifestations, such as acute chest pain, etc.

2) Recent ECG changes suggest acute myocardial infarction.

3) Diagnostic elevation of cardiac enzymes or troponin, or dynamic changes consistent with acute myocardial infarction.

4) 90 days after the onset of the disease, the left ventricular function was confirmed to be reduced, such as the left ventricular ejection fraction was less than 50%.

Sequelae of stroke refer to cerebral vascular hemorrhage, embolism or infarction caused by sudden lesions of cerebral blood vessels, and lead to permanent dysfunction of the nervous system. Permanent dysfunction of the nervous system, defined as one or more of the following disorders remaining 180 days after the diagnosis of the disease:

1) Complete loss of function of one or more limbs (see;

2) complete loss of speech or chewing and swallowing ability (see;

3) Complete loss of the ability to live independently, unable to perform six basic activities of daily living independently (see three or more of these).

The newly defined critical illness insurance must cover 28 critical illnesses, which are divided into three categories according to the claim standard (the critical illness insurance launched by different insurance companies will add other critical illness insurance on top of the 28 critical illnesses):

1.After diagnosis, you can claim: malignant tumors (excluding some early-stage malignant tumors). Severe burns of the 3rd degree (burns that cover more than 20% of the total body area) and loss of multiple limbs (complete rupture of two or more limbs).

2.Agreed surgeries can be claimed: benign brain tumors (requiring craniotomy or radiation**), major organ transplantation or hematopoietic stem cell transplantation, coronary artery bypass grafting (coronary artery bypass grafting), heart valve surgery, aortic surgery.

3.Claims can be made after reaching the agreed state: acute myocardial infarction, sequelae of stroke (permanent dysfunction), end-stage renal disease (reaching the uremia stage), deafness in both ears (irreversible for life), blindness in both eyes (irreversible for life), acute or subacute severe hepatitis, compensated chronic liver failure, deep coma (except for alcohol or drug abuse), severe Alzheimer's disease (complete loss of independent living), severe brain injury (permanent dysfunction), severe Parkinson's disease (complete loss of independent living), Paralysis (permanent), severe primary pulmonary hypertension, severe motor neuron disease (complete loss of the ability to live independently), loss of speech (complete loss, positive** for at least 12 months), severe aplastic anemia, sequelae of encephalitis or sequelae of meningitis, severe chronic respiratory dysfunction, severe Crohn's disease, severe ulcerative colitis.

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Critical illness insurance generally includes: malignant tumors, severe cardiovascular and cerebrovascular diseases, major organ transplant surgery, injuries and illnesses that may cause lifelong disability, advanced chronic diseases, deep coma, permanent paralysis, severe brain injury, severe Parkinson's disease and severe mental illness. The law stipulates that:

According to the "Specifications for the Use of Disease Definitions and Uses of Critical Illness Insurance", if the insurance company names the product as critical illness insurance, and the insurance period is mainly for adults (over 18 years old), the scope of diseases covered by the product shall include malignant tumors, acute myocardial infarction, sequelae of stroke, coronary artery bypass grafting (or coronary artery bypass grafting), major organ transplantation or hematopoietic stem cell transplantation, end-stage renal disease (or chronic renal failure uremia stage);