GENERAL POLICY EXCLUSIONS
Unless specifically provided for elsewhere under the Policy, the Policy does not cover loss caused by or resulting from, nor is any premium charged for, any of the following:
- Preventative medicines, routine physical examinations, or any other examination where there are no objective indication of impairment in normal health.
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Services and supplies not Medically Necessary for the diagnosis or treatment of a Sickness or Injury.
- Surgery for the correction of refractive error and services and prescriptions for eye examinations, eye glasses or contact lenses or hearing aids, except when Medically Necessary for the Treatment of an Injury.
- Plastic or cosmetic surgery, unless they result directly from an Injury which necessitated medical treatment within 24 hours of the Accident.
- For diagnostic investigation or medical treatment for infertility, fertility, or birth control.
- Expenses incurred in excess of Reasonable Expenses.
- Expenses incurred for Injury resulting from the Covered Person’s being legally intoxicated or under the influence of alcohol as defined by the jurisdiction in which the Accident occurs. This exclusion does not apply to the Medical Evacuation benefit, to the Repatriation of Remains Benefit and to the Bedside Visit Benefit.
- Voluntarily using any drug, narcotic or controlled substance, unless as prescribed by a Physician. This exclusion does not apply to the Medical Evacuation Benefit, to the Repatriation of Remains Benefit and to the Bedside Visit Benefit.
- Organ or tissue transplant.
- Participating in an illegal occupation or committing or attempting to commit a felony.
- For treatment, services, supplies, or Confinement in a Hospital owned or operated by a national government or its agencies. (This does not apply to charges the law requires the Covered Person to pay.)
- While traveling against the advice of a Physician, while on a waiting list for a specific treatment, or when traveling for the purpose of obtaining medical treatment.
- The diagnosis or treatment of Congenital Conditions, except for a newborn child insured under the Policy.
- Treatment to the teeth, gums, jaw or structures directly supporting the teeth, including surgical extraction’s of teeth, TMJ dysfunction or skeletal irregularities of one or both jaws including orthognathia and mandibular retrognathia.
- Expenses incurred in connection with weak, strained or flat feet, corns or calluses.
- Diagnosis and treatment of acne and sebaceous cyst.
- Deviated nasal septum, including submucous resection and/or surgical correction, unless treatment is due to or arises from an Injury.
- Self inflicted Injuries while sane or insane; suicide or any attempt thereat while sane or insane. This exclusion does not apply to the Medical Evacuation Benefit, to the Repatriation of Remains Benefit and to the Bedside Visit Benefit.
- Loss due to war, declared or undeclared; service in the armed forces of any country or international authority; riot; civil commotion; or acts of terrorism.
- Riding in any aircraft, except as a passenger on a regularly scheduled airline or charter flight.
- Loss arising from participation in professional sports, scuba diving, hang gliding, parachuting or bungee jumping.
- Medical Treatment Benefits provision for loss due to or arising from a motor vehicle Accident if the Covered Person operated the vehicle without a proper license in the jurisdiction where the Accident occurred.
- Under the Accidental Death and Dismemberment provision, for loss of life or dismemberment for or arising from an Accident in the Covered Person’s Home Country.
- Expenses incurred for treatment of sports related accidents resulting from professional sports.
- Expenses incurred as a result of pregnancy that is not covered.
