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Supplementary material Supplementary material 1. Market share of the top six commercial insurance companiesYear2007200820092010201120122013201420152016Market Share (%)82.781.178.076.075.874.473.066.759.852.6Supplementary material 2. Critical Illnesses Covered by guideline issued by the Insurance Association of China and the Chinese Medical Doctor Association* The complete list of 25 named critical illnesses recommended by the Insurance Association of China and the Chinese Medical Doctor Association and has been adopted by most critical illnesses policies in Chinese insurance market. 1. Cancer 2. Acute Myocardial Infarction 3. Sequelae of Stroke 4. Major Organ / Hematopoietic Stem Cells Transplant 5. Coronary Artery Bypass Graft 6. End Stage Renal Disease (Chronic Kidney Failure) 7. Loss of Limbs 8. Acute or Subacute Severe Hepatitis 9. Benign Brain Tumor 10. Chronic Liver Failure (End Stage) 11. Encephalitis Sequelae or Meningitis Sequelae 12. Deep Coma 13. Deafness in Both Ears 14. Blindness in Both Eyes 15. Paralysis 16. Heart Valve Surgery 17. Severe Alzheimer's Disease 18. Major Head Trauma 19. Severe Parkinson's Disease 20. Major Third Degree Burn 21. Severe Primary Pulmonary Hypertension 22. Severe Motor Neuron Disease 23. Loss of Speech 24. Severe Aplastic Anemia25. Aorta Surgery*Definition of disease in critical illness insurance, Available from: . Accessed January 9, 2020.Supplementary material 3. Differences of definitions for concerned diseases compared to the guideline for the use of disease definitions for critical illness insuranceCompanyProduct CodeSelling TimeCancerCHDSequelae of Stroke ESKDChina LifeS42/S431999-2009Not excluded :(1) TNM stage is T1N0M0 stage or lighter stage prostate cancer; Not included: 90 days after the onset of the disease, left ventricular function was reduced, such as left ventricular ejection fraction below 50%.The last obstacle was: all six basic activities of daily life can’t be completed independently.No restriction to 90 days after diagnosis.PingAn738/7361999-2004Not excluded :(1) Chronic lymphocytic leukemia, which is equivalent to Binet stage A; (2) equivalent to Ann Arbor stage plan I stage of Hodgkin's disease; (3) TNM stage is T1N0M0 stage or lighter stage prostate cancer;Not included: 90 days after the onset of the disease, left ventricular function was reduced, such as left ventricular ejection fraction below 50%.The last obstacle was: all six basic activities of daily life can’t be completed independently.Regular dialysis treatment is defined as twice a week for more than ten weeks. TaiBaoEL02AA1999-2010Not excluded :TNM stage is T1N0M0 stage or lighter stage prostate cancer; Not included: 90 days after the onset of the disease, left ventricular function was reduced, such as left ventricular ejection fraction below 51%.The last obstacle was: all six basic activities of daily life can’t be completed independently.No restriction to 90 days after diagnosisTaiBaoAL65AA2005-2010Not covered : (1)Melanoma with a thickness less than 1.5mm; (2)The papillary carcinoma of the thyroid or bladder is less than 1cm in diameter. As same as the definition in the guideline.As same as the definition in the guideline.Regular dialysis treatment was done for more than 10 weeksTaiKangCI_RD92004-2010As same as the definition in the guideline.As same as the definition in the guideline.As same as the definition in the guideline.As same as the definition in the guideline.Supplementary material 4. The definitions and criteria for insurance for the four major NCDs concerned in our study *NCDsDefinitionNot coveredCancerUncontrolled progressive growth and diffusion of malignant cells, infiltration and destruction of normal tissues around the body, which can spread to other parts of the body through the diffusion of blood vessels, lymphatic vessels and body cavity. The incident case of cancer should have pathological examination confirmation and the diagnosis of cancer should be included in the malignant tumor category of the 10th revision the International Statistical Classification of Diseases and Related Health Problems (ICD-10).(1) Carcinoma in situ; (2) Chronic lymphocytic leukemia, which is equivalent to Binet stage A; (3) equivalent to Ann Arbor stage plan I stage of Hodgkin's disease; (4) skin cancer (excluding malignant melanoma and metastatic skin cancer); (5) TNM stage is T1N0M0 stage or lighter stage prostate cancer; (6) malignant tumor infected with HIV or AIDS.Coronary heart diseaseAcute myocardial infarction: Partial myocardial necrosis is caused by insufficient blood supply in the corresponding area due to coronary artery occlusion. At least three conditions must be met: (1) typical clinical manifestations, such as acute chest pain, etc; (2) recent ECG changes suggest acute myocardial infarction; (3) myocardial enzyme or troponin has a diagnostically significant increase, or is consistent with a dynamic change in acute myocardial infarction; (4) 90 days after the onset of the disease, left ventricular function was reduced, such as left ventricular ejection fraction below 50%.Coronary Artery Bypass Graft: in order to treat serious coronary heart disease, the operation of coronary artery bypass grafting was carried out. Coronary stent implantation, cardiac balloon dilatation, laser radiofrequency and other non-thoracotomy interventional procedures.Sequelae of strokeCerebral vascular hemorrhage, embolism or infarction caused by sudden cerebrovascular disease, and leads to permanent dysfunction of the nervous system. Permanent dysfunction of the nervous system means that 180 or more days after the disease is diagnosed, one or more of the following obstacles remain: (1) Complete loss of function of at least one limb; (2) Complete loss of language ability or chewing and swallowing; (3) The ability to live independently is completely lost, and three or more of six basic activities of daily life can’t be completed independently.ESKDIrreversible kidney failure and receiving regular dialysis for at least 90 days after diagnosis or renal transplantation.*Definition of disease in critical illness insurance, Available from: . Accessed January 9, 2020. ................
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