Benign brain tumour means a definite diagnosis of a non malignant tumour located in the cranial vault and limited to the brain, meninges, cranial nerves or pituitary gland. The tumour must require surgical or radiation treatment or cause irreversible new objective neurological deficit(s).
These deficits must be corroborated by diagnostic imaging showing changes that are consistent in character, location and timing with the neurological deficits.
The diagnosis of benign brain tumour must be made by a specialist.
New neurological deficits must be detectable by a physician and may include, but are not restricted to:
- measurable loss of hearing
- objective loss of sensation
- localized weakness
- dysarthria (difficulty with pronunciation)
- dysphasia (difficulty with speech)
- dysphagia (difficulty in swallowing)
- measurable visual impairment
- impaired gait (difficulty walking)
- difficulty with balance
- lack of coordination
- new onset seizures undergoing treatment or
- measurable changes in neuro-cognitive function
Headache or fatigue will not be considered a neurological deficit.
No benefit will be payable under this condition for pituitary adenomas less than 10 mm.
90 day exclusion period for benign brain tumour
No benefit will be payable for benign brain tumour if, within the first 90 days following the later of:
- the date the application for this policy was signed
- the underwriting decision date, but only if shown under the heading, Amendments to this policy
- the policy date, shown on the Policy summary, or
- the most recent date this policy was put back into effect (reinstatement),
the insured person has any of the following:
- signs, symptoms or investigations that lead to a diagnosis of benign brain tumour (covered or excluded under the policy), regardless of when the diagnosis is made, or
- a diagnosis of benign brain tumour (covered or excluded under the policy).
Your responsibility to notify us about benign brain tumour
You have a responsibility to notify us about benign brain tumour, regardless of when a diagnosis is made:
- If we are notified within 6 months of the date of the diagnosis and the coverage for benign brain tumour is excluded based on the 90 day exclusion, coverage for all other covered critical illnesses will continue.
- If information is not provided within 6 months of the date of diagnosis, we have the right to deny a claim for benign brain tumour or any critical illness caused by any benign brain tumour or its treatment.