Standard nomenclature and procedures for critical illnesses – Cancer

By Policybachat . Posted on November 5, 2014

Few decades back, cancer was one of the most dreadful disease in India, and it was a common belief that, anyone who develops cancer is not going to survive it.

However, this fact and concept both changed, as we see privatization of health care sector and technological advancement in medical procedures.  Though, we have every such details which says cancer is curable and sundry, yet in 2012, it took 7 lakhs life in India, and every year 10 lakhs new patient evolve with one or other form of cancer developments.

IRDA have issued standard nomenclature and procedures for some critical illnesses, which must be complied with by insured, insurer, TPA and network hospitals.  But, there is a specified degree of severity in case of cancer, which qualifies it for coverage under critical illness plan.

Specified severity of cancer that comes under critical illness plan, 

Any vindictive tumour that has hysterical growth and spread the infectious cells which infect and destroy normal tissues is covered in critical illness plan.  The diagnosis for cancer must be supported by histological tests confirming traces of malignant cells in patients’ body and that is confirmed by a registered pathologist.  Common terms that include cancer are leukemia, lymphoma and sarcoma.

When we now know, that which form of cancer is included in critical illness, we shall see, what versions or infections of cancer is not part of critical illness health insurance plans,

  • Tumours found with malignant changes on skin or organ lining in situ and tumours that are proved as premalignant or non-invasive histologically, however does include but not limited to – Carcinoma in situ of breast and cervical dysplasia.
  • Skin cancer except invasive malignant melanoma.
  • All tumours in prostate and histologically classified to have Gleason score of greater than 6 or having progressed at a specified least clinical classification.
  • Papillary micro – Thyroid carcinoma measuring less than 1 cm in diameter.
  • Chronic lymphocyctic leukemia within stage 3.
  • Micro-carcinoma of gall bladder.
  • Tumours in presence with traces of HIV infection in patient.

These are the conditions that qualify and disqualify any cancer condition to be in critical illness plan or not.  If you want to know your critical illness plan better, can call PolicyBachat and talk to insurance experts.

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