INSURANCE EXCLUSIONSCharges for the following conditions, services or treatments are excluded:
- Any injury or illness which is not incurred by an insured
Person during the Period of Coverage.
- Charges for treatment which is not incurred by an insured
person during the Period of Coverage or Benefit Period.
- Charges for injury or illness incurred during to Period of
coverage which are not presented to the Company for payment within 3 months from the date
of services rendered.
- Charges for treatment which is not administered by a
physician.
- Charges for treatment which is not medically necessary.
- Treatment provided at no cost to the Insured Person.
- Charges exceeding usual, reasonable and customary.
- Treatment or surgeries which are investigational, experimental
or for research purposes.
- Charges for treatment or surgeries which are Incurred by the
Insured who was HIV+ at time of enrollment into this insurance.
- Routine Dental Treatment and the provision of false teeth or
dentures: normal eye tests and the provision of visual aids; normal ear tests and the
provision of hearing aids.
- Elective cosmetic surgery & associated treatment.
- Any Surgery or Treatment in respect of an injury or illness
diagnosed at the time of inception of coverage.
- Pregnancy and childbirth costs.
- Injury sustained while taking part in mountaineering where
ropes or guides are normally used, amateur or professional athletics, aviation (except
when traveling as a passenger in a commercial aircraft), hang gliding and parachuting,
snow skiing, racing by horse, motor or motorcycle, spelunking and subaqua pursuits
involving underwater breathing apparatus.
- Injury sustained while under the influence of or disablement
due wholly or partly to the effects intoxicating liquor or drugs other than drugs taken in
accordance with treatment prescribed and directed by a Physician but not for the treatment
of Substance Abuse or drug addiction.
- Willfully self-inflicted injury or illness.
- Venereal Disease.
- All costs arising from Medical Expenses incurred when the
Insured Person was traveling against the advice of a Physician or medical professional.
- Testing for the following: HIV, seropositivity to the AIDS
virus, AIDS related Illnesses, ARC Syndrome, AIDS.
- AIDS virus, AIDS related illness, ARC Syndrome, AIDS, and/or
any illness arising as complications from these conditions.
- Illness or injury where the trip to the host country is
undertaken for treatment or advice for such Illness or injury.
- Immunizations and routine physical examinations and associated
laboratory tests and diagnostic procedures.
- Treatment in the United States.
- Treatment for mental and nervous disorders.
- Treatment by a chiropractor, unless ordered by a physician.
- Charges resulting from or occurring during the commission of a
violation of law by the insured, including without limitation, the engaging in an illegal
occupation or act, but excluding minor traffic violations.
- Treatment for substance abuse or drug addiction.
- Telephone consultations or failure to keep a scheduled
appointment.
- Treatment while confined primarily to receive custodial care,
educational or rehabilitative care, or nursing services.
- Any drug , treatment or procedure the either promotes or
prevents conception, or prevents child birth, including but not limited to: artificial
insemination, treatment for infertility or impotency, sterilization or reversal thereof,
or abortion.
- Treatment of Temporomandibular Joint.
- Vocational, recreational or music therapy.
- Organ or tissue transplants or related services.
- Any services or supplies performed or provided by a relative
of the insured.
- For Speech Therapy.
- Charges resulting from Emergency Evacuations or Repatriations
of bodily remains that were not coordinated by the Company or its designee.
- Charges for Emergency Reunion expenses that were not
coordinated by the Company or its designee.
- Treatment required as a result of complications from a
treatment or condition not covered hereunder.
- Treatment incurred as a result of exposure to nuclear
radiation, and/or radioactive material(s).
- Treatment incurred as a result of a Pre-existing Condition in
excess of U.S. $5000.00.
- War; political insurrection, protest; or any act thereof.
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