Unless specified in the Schedule of Benefits, in any written endorsement, or agreed by the Company in writing, no claim can be made for compensation or payment for damage or expenses caused by or as a result of the following:
- 1. Pre-Existing Conditions as defined.
- 2. Costs related to medical examination, treatment and surgical intervention which are not administered in a licensed healthcare institution.
- 3. Costs related to medical examination where no Sickness has been diagnosed or Accident has been ascertained; for non-specified pain; or preventative or routine exams, except as specifically provided for in this policy.
- 4. Any visit to a medical provider that does not result in a covered Diagnosis code after medical review or testing.
- 5. Any treatment by a family member/family associate or any type of direct relationship.
- 6. In respect of accidental damage to Natural Teeth, no benefit is payable for Injury caused by eating or drinking (even if it contains a foreign body), normal wear and tear, tooth brushing or any other oral hygiene procedure or any means other than extra-oral impact, any form of restorative or remedial work, the use of precious metals, orthodontic treatment of any kind or dental treatment performed in a hospital unless dental surgery is the only treatment available.
- 7. Suicide or attempted suicide, intentional self-injury, the effect of intoxicating liquors or drugs.
- 8. Treatment of hernia; Osgood-Schlatters Disease; osteochondritis; osteomyelitis; congenital weakness whether or not caused by a Covered Accident.
- 9. Evacuation costs where the Insured Person is not being admitted to a Hospital for Treatment or where costs have not been approved by Company prior to travel commencing.
- 10. Any costs arising after expiry of the current Policy Period unless this plan has been extended for a subsequent 12 months or the Insured Person was being treated during the Policy Period as a result of an accident.
- 11. Any form of treatment or surgery which in the opinion of the Doctors(s) in attendance and the Assistance Provider that can be delayed until your return to your home country.
- 12. Medical Expenses incurred after you have returned to your home country which exceed the number of days or in excess of a limit stated in the Schedule of Benefits.
- 13. Medical Expenses in excess of a limit stated in the Schedule of Benefits.
- 14. The amount of the Policy Excess, Deductible or Co-Payment, as stated in the Schedule of Benefits.
- 15. Any cost resulting in a Sickness, Injury or death from the misuse of drugs or being under the influence or effect of alcohol (other than a legally prescribed medication by a licensed medical professional).
- 16. Needless self-exposure to peril except in an attempt to save human life.
- 17. Intentional or fraudulent acts on the Insured Person's part or their consequences.
- 18. Trips specifically made for the purpose of obtaining medical treatment.
- 19. Cosmetic surgery or remedial surgery, removal of fat or other surplus body tissue and any consequences of such treatment, weight loss or weight problems/eating disorders, whether or not for psychological purposes, unless required as a direct result of an Accident which occurs during the Policy Period.
- 20. Treatment for alcoholism, narcotics, drug and substance abuse/dependency or any addictive condition of any kind and any Injury or Sickness arising from the Insured Person being under the influence of alcohol, drugs or any other intoxicating substance.
- 21. Pregnancy, childbirth whether normal or complicated, including the transfer of a pregnant woman to hospital to give routine childbirth or air travel when the Insured Person is more than 20 weeks pregnant and was NOT a result of an accident or onset of complications relating from an accident.
- 22. Any sexually transmitted or venereal disease; and/or any testing for the following: HIV, Vaccine induced seropositivity to the AIDS virus, AIDS related Illnesses, ARC Syndrome, AIDS.
- 23. Treatment for transitional life Events, homesickness, fatigue, jetlag or work related stress.
- 24. Any loss as the result of the use of any type of firearm(s) (Defined as any device that discharges a projectile of any type).
- 25. Any expenses relating to search and rescue operations to find an Insured Person in mountains, at sea, in the desert, in the jungle and similar remote locations, including air/sea rescue charges for evacuation to shore from a vessel or from the sea.
- 26. Charges or fees incurred for the completion of Medical Claim Forms.
- 27. Any expenses as the result of or related to participating in any sports or sport related activity. Inclusive of conditions that arise out of sport activity including but not limited to Cardiac, Respiratory, Orthopedic conditions etc.
- 28. Any loss as the result of the use of a Motorcycle or two or three wheeled device of any kind.
- 29. The radioactive, toxic, explosive or other hazardous or contaminating properties of any nuclear installation, reactor or other nuclear assembly or nuclear component thereof.
- 30. War Insurrection and Terrorism related to the following: Nuclear, and Weapons of mass destruction: means the use of any explosive nuclear weapon or device or the emission, discharge, dispersal, release or escape of fissile material emitting a level of radioactivity capable of causing incapacitating disablement or death amongst people or animals. Chemical Weapons: mass destruction means the emission, discharge, dispersal, release or escape of any solid, liquid or gaseous chemical compound which, when suitably distributed, is capable of causing incapacitating disablement or death amongst people or animals. Utilization of Biological weapons of mass destruction means the emission, discharge, dispersal, release or escape of any pathogenic (disease producing) micro-organism(s) and/or biologically produced toxin(s) (including genetically modified organisms and chemically synthesized toxins) which are capable of causing incapacitating disablement or death amongst people or animals. Terrorism: Terrorist activity means an act, or acts, of any person, or group(s) of persons, committed for political, religious, ideological or similar purposes with the intention to influence any government and/or to put the public, or any section of the public, in fear. Terrorist activity can include, but not be limited to, the actual use of force or violence and/or the threat of such use. Furthermore, the perpetrators of terrorist activity can either be acting alone, or on behalf of, or in connection with any organization(s) or governments(s).
- 31. Any infection of the urinary tract (including, without limitation, infection of the kidney, ureter, bladder, prostate or urethra) and any complication, medical condition or other Illness directly or indirectly arising therefrom, that occurs within ninety (90) days of the Effective Date of this Insurance and that requires Treatment of the Insured Person in a Hospital as an inpatient.
- 32. Payment for any medical services related to an illness when an Insured Person leaves a medical facility against medical advice.
- 33. This policy does not cover any type of sports Injury or Sickness.
- 34. The Covered Person did not exercise reasonable care to prevent accident, Injury, loss or damage and at all times, act as if uninsured
