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中国太平洋财产保险股份有限公司个人重大疾病保险(H2022A 互联网)
第15 页共 40 页
(1)经药物治疗和胸腺切除治疗一年以上仍无法控制病情;
(2)自主生活能力完全丧失,无法独立完成六项基本日常生活活动中的
三项或三项以上。
指脑皮质广泛性坏死而导致对自身及周边的认知能力完全丧失,但脑干功
能依然存在。必须由神经专科医生明确诊断,并有头颅断层扫描(CT),
核磁共振检查(MRI)或正电子发射断层扫描(PET)等影像学检查证实。
上述情况必须有至少一个月的病历记录加以证实。
由于酗酒或滥用药物所致的植物人状态不在保障范围内。
指因阿尔茨海默病以外的脑的器质性疾病造成脑功能衰竭导致永久不可
逆性的严重痴呆,临床表现为明显的认知能力障碍、行为异常和社交能力
减退。被保险人自主生活能力完全丧失,无法独立完成六项基本日常生活
活动中的三项或三项以上,日常生活必须持续受到他人监护。导致痴呆的
疾病必须明确诊断,并且由完整的临床、实验室和影像学检查结果证实。
神经官能症、精神疾病及酒精中毒所致脑损害不在本合同保障范围内。
进行性核上性麻痹(PSP)又称 Steele-Rchardson-Olszewski 综合征,是
一种少见的神经系统变性疾病,以假性球麻痹、垂直性核上性眼肌麻痹、
锥体外系肌僵直、步态共济失调和轻度痴呆为主要临床特征。PSP 必须由
三级公立医院的神经内科专科医生确诊,并且被保险人自主生活能力完全
丧失,无法独立完成六项基本日常生活活动中的三项或三项以上。
指因外伤、颅内肿瘤或脑动脉瘤破裂,被保险人实际接受了在全麻下进行
的颅骨切开手术,以清除脑内血肿、切除肿瘤或夹闭破裂动脉瘤的手术治
疗。
颅骨打孔手术、硬膜下血肿清除术、未破裂动脉瘤预防性手术、动脉瘤栓
塞手术、血管内手术、颅骨切开或切除减压术、脑积水脑脊液分流手术、
经蝶骨肿瘤切除术及其他原因的开颅手术不在本合同保障范围内。
因严重头部创伤或疾病造成被保险人智力低常(智力低于常态)或智力残
疾。根据智商(IQ)智力低常分为轻度(IQ50-70);中度(IQ35-50);
重度(IQ20-35)和极重度(IQ<20)。根据被保险人年龄采用对应的智力
量表如韦克斯勒智力量表(儿童智力量表或成人智力量表)检测证实,智
商的检测必须由本公司认可的医院的儿童或成人精神卫生科、心理科或神
经科专科医生进行。并须满足下列全部条件:
(1)造成被保险人智力低常(智力低于常态)的严重头部创伤或疾病(以
入院日期为准)发生在被保险人 6 周岁以后;
(2)本公司认可的医院的专科医师确诊被保险人由于严重头部创伤或疾
病造成智力低常;
(3)本公司认可的医院的儿童或成人精神卫生科、心理科或神经科专科
医生证实被保险人智力低常 IQ<50)(中度、重度或极重度)。
由结核杆菌引起的脑膜和脊膜的非化脓性炎症性疾病。需满足以下全部条
件:
(1)出现颅内压明显增高,表现头痛、呕吐和视乳头水肿;
(2)出现部分性、全身性癫痫发作或癫痫持续状态;