Medical Definition of Specific Critical Illnesses and the Foundations of Life Insurance: From End-Stage Disease Criteria to Life Table Stability Analysis

(XI) Definition of Terminal Illness Insurance: This refers to an insured person diagnosed with a serious terminal illness by a hospital recognized by the company, and whose illness is deemed incurable by current medical technology and whose average survival period is less than 6 months according to medical and clinical tests. (XII) Definition of Spinal Cord Disease by New China Life Insurance: This includes benign spinal cord tumors, syringomyelia, cerebral palsy, and spinal hemangioma. (XIII) Definition of Chronic Liver Disease by Taikang Life Insurance: This refers to end-stage liver failure, and its symptoms must include the following: (1) persistent jaundice; (2) esophageal varices; (3) ascites (edema); (4) hepatic encephalopathy. Any liver disease caused by alcoholism or drug abuse is excluded. (XIV) Definition of Acute Leukemia by Pacific Insurance: This refers to a blood system disease caused by malignant proliferation of leukemia cells in the bone marrow, mainly manifested as infection and fever, anemia, bleeding, and enlargement of the liver, spleen, lymph nodes, and bone and joint pain caused by cell infiltration. Bone marrow examination and blood count must meet the manifestations of acute leukemia. (XV) Definition of Aplastic Anemia under Pacific Insurance: Anemia caused by chronic bone marrow hematopoietic dysfunction, including granulocytopenia, thrombocytopenia, and moderate to severe anemia requiring at least one of the following treatments: whole blood or component blood transfusion, bone marrow transplantation, or immunosuppressive drugs. (XVI) Definition of Viral Encephalitis under Pacific Insurance: A condition caused by viral infection with inflammation of the brain parenchyma as the main lesion. (XVII) Definition of Purulent Meningitis under Pacific Insurance: A condition caused by infection with various purulent bacteria with inflammation of the meninges or spinal cord as the main lesion. (XVIII) Definition of AIDS Insurance under China Life Insurance: Refers to acquired immunodeficiency syndrome. This definition should be based on the definition established by the World Health Organization, such as the presence of the Acquired Immunodeficiency Syndrome virus or its antibodies in a blood sample. (XIX) Definition of Endemic Diseases under China Life Insurance: A disease that occurs continuously only in a certain region or population, with new cases originating locally, closely related to the geology, topography, soil, water, climate, and other factors of a specific region, and spreading and becoming prevalent in areas with similar conditions. The determination of endemic diseases in various regions shall be based on the announcement by the local endemic disease prevention and control agency. (20) Definition of Specific Infectious Diseases by China Life: Refers to outbreaks or epidemics of the following legally notifiable infectious diseases. Class A: Plague, cholera and paracholerae, smallpox; Class B: Diphtheria, epidemic cerebrospinal meningitis, dysentery (bacillary dysentery and amoebic dysentery), typhoid and paratyphoid fever, viral hepatitis, malaria, typhus, relapsing fever, leishmaniasis, tick-borne encephalitis, scrub typhus, hemorrhagic fever, leptospirosis, brucellosis.

II. Other relevant definitions Some insurance companies have also made clear provisions for the following concepts. (I) Definition of Hospital Safety Insurance: refers to public hospitals at or above the county level, but does not include medical institutions that are mainly used as clinics, rehabilitation, nursing, recuperation, alcohol or drug rehabilitation, etc. or similar. The hospital must have medical equipment that meets the standards set up in accordance with the relevant national hospital management rules, and qualified doctors and nurses must be stationed at the hospital 24 hours a day to provide medical and nursing services. (II) Hospitalization (1) Definition of China Life Insurance: refers to the process by which the insured, due to illness or accidental injury, is diagnosed by a doctor and needs to be hospitalized for treatment due to clinical needs, and formally completes the hospitalization procedures and is actually treated in the hospital. (2) Definition of Pacific Insurance: refers to the treatment received by the insured due to illness or accidental injury in a county-level or above or secondary-level hospital designated by the insurer or approved by the national health administration department. But it does not include treatment in observation rooms, home beds, joint wards, rehabilitation hospitals (wards), community hospitals, sanatoriums, township (town) health centers, etc. (3) Definition of Ping An Insurance: It refers to the insured being admitted to a formal ward of a hospital for treatment due to illness or accidental injury, and formally completing the admission and discharge procedures, excluding admission to outpatient observation rooms, other informal wards, or being hospitalized while still in bed.

Chapter 11 Sub-health Concept and Life Insurance Section 1 The Concept of Life Insurance I. Life Insurance and Its Characteristics Life insurance, also known as life insurance, is a form of personal insurance that uses the life of the insured as the insured object, the survival or death of the insured as the insured event, and pays a certain amount of insurance according to the insurance contract when the insured event occurs during the insurance period. Life insurance is the most basic and important component of personal insurance. The death of the insured during the insurance period or survival at the end of the insurance period can be considered an insured event. Life insurance adopts a level premium, which means that the insurer re-allocates the cost of death throughout the insurance period according to the actuarial principles of life insurance. The same premium is paid in each period and does not change with age. The level premium is higher than the premium in the early period and lower than the premium in the later period. (I) Special Risks, Stable Operation The personal risks faced by life insurance are the survival or death of a person. When death will occur and how long life can last are highly uncertain. Through long-term insurance practice and the use of scientific mathematical and statistical methods, we have found that the risks undertaken by life insurance are closely related to the age of the insured. Life insurance has a relatively stable probability of death at each age, and this probability changes systematically with age. In practice, insurers use life tables as the basis for risk prediction and calculating and determining net premiums. The data in life tables comes from the survival and death records of countless insured individuals accumulated over many years of life insurance practice. Due to the wide range of data sources, large sample size, and long observation period, random factors are largely eliminated, meeting the requirements of the law of large numbers in statistics and possessing scientific rigor and stability. Compared to other types of insurance, life insurance is more accurate in risk management, especially in predicting the probability of insured events. Theoretically, as long as the insurer uses an appropriate life table and a predetermined guaranteed interest rate, business losses will not occur. The probability of death increases year by year with age (except for early childhood), a very clear trend.