Exclusions

For the Medical Expense, Emergency Medical Evacuation, Repatriation of Remains, Emergency Reunion and Home Country benefits, no benefit shall be payable with respect to expenses incurred:

1.  For pre-existing conditions defined as an Sickness, disease or other condition of the covered person, that in the 36 month period before the covered person’s coverage became effective under the Policy: 1) first manifested itself, worsened, became acute or exhibited symptoms that would have caused a person to seek diagnosis, care or treatment; or 2) required taking prescribed drugs or medicines, unless the condition for which the prescribed drug or medicine is taken remains controlled without any change in the required prescription; or 3) was treated by a doctor or treatment had been recommended by a doctor.  (This pre-existing condition exclusion does not apply to the Emergency Medical Evacuation, Emergency Reunion, or Repatriation of Remains Benefits.);

2.   Injury or sickness where the covered person’s trip to the host country is undertaken for treatment or advice for such injury or sickness.

3.   For services, supplies, or treatment including any period of hospital confinement which were not recommended, approved and certified as necessary and reasonable by a doctor; or expenses which are non-medical in nature.
 
4.   For suicide or attempted suicide, while sane or insane.
 
5.   For loss incurred as a result of war or any act of war, whether declared or not.
 
6.   a) For injury sustained while participating in an amateur, club, intramural, interscholastic or intercollegiate sport; b) For injury sustained while participating in a  professional or semi professional sport.

7.   For loss incurred as a result of pregnancy, childbirth, or miscarriage, or any complications thereof.
 
8.    For routine physicals, preventive medicines, serums, vaccines.

9.   For cosmetic surgery, except for reconstructive surgery needed as the result of an Injury or Sickness.
 
10. For elective surgery.
 
11. For any mental and nervous disorders except for what is provided by the policy.

12. Dental care, except as the result of Injury to natural teeth cause by Accident or for emergency pain relief treatment to sound, natural teeth.  Routine dental care and treatment, damage to dentures and bridges, unless noted in the policy; treatment of temporomandibular joint dysfunction and associated myofacial pain.

13.  For eye refractions or eye examinations for the purpose of prescribing corrective lenses for eyeglasses or for the fitting thereof, unless caused by accidental bodily injury incurred while insured hereunder.

14. Injury or Sickness that occurs while the Covered Person while under the influence of any drug unless administered under the advice and consent of a Doctor.

15.  For expenses as a result of, or in connection with, intentionally self-inflicted injury.
 
16.  For expenses as a result of, or in connection with, the commission or attempt to commit an assault or a felony.
 
17.  For treatment furnished under any other individual or group policy, or other service or medical pre-payment plan to the extent so furnished; or under any mandatory government program or facility set up for treatment without cost to any individual.
 
18.   Cosmetic or plastic surgery, including but not limited to, breast implants and breast reduction surgery.

19.   Hernia of any kind.

20.   Routine nursery care.

21.   Eye refractions or eye examinations for the purpose of prescribing corrective lenses for the fitting thereof; eyeglasses, contact lenses, and hearing aids.

22.   Braces, appliances, wheelchairs, examinations or prescriptions for them or repair or replacement of artificial limbs, orthopedic braces or orthotic devices.

23.   Services, supplies or treatment including any period of Hospital confinement which were not recommended, approved and certified as necessary and reasonable by a Doctor; or expenses which are non-medical in nature.

24.   Treatment or service provided by a private duty nurse.

25.   Treatment by any Immediate Family member or member of the Insured’s household.

26.   Services provided by any government hospital or agency; any expense covered by another employer or government sponsored plan for which, and to the extent that the Insured is eligible for reimbursement.

27.   Expenses incurred as the result of loss or injuries arising out of employment which would be covered by Workers' Compensation or a similar program.

28.   Expenses incurred for services related to the diagnostic treatment of infertility or other problems related to the inability to conceive a child, including but not limited to, fertility testing and in-vitro fertilization.

29.   Custodial care or rest cures.

30.   Services incurred in home country, unless provided in the policy.

31.   Elective treatment, exam or surgery including those (a) deemed to be experimental and (b) are not recognized and generally accepted medical practices in the United States.

32.   Injury caused by or resulting from travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle, or while riding without a helmet in or on, entering into or alighting from, or being struck by a 2 or 3-wheeled motor vehicle or a motor vehicle not designed primarily for use on public streets and highways.

33.   Expenses payable by any automobile insurance policy without regard to fault.

34.   Birth defects and congenital anomalies; or complications which arise from such conditions
.
35.   Injury resulting from off-road motorcycling, scuba diving, jet, snow or water skiing, mountain climbing (where ropes or guides are used), sky diving, amateur racing, racing or speed contests, bungee jumping, spelunking, white water rafting, surfing and parasailing.

36.   Organ or tissue transplant.

37.   Elective termination of pregnancy; Sexually transmitted diseases or immune deficiency disorders and related conditions.  This exclusion does not apply to the care or treatments of Acquired Immune Deficiency Syndrome (AIDS), AIDS Related Complex (ARC) or Human Immunodeficiency Virus (HIV) infection, or any illness or disease arising from these medical conditions.
 
38.   Injury or Sickness that occurs while the Covered Person is under the influence of any drug unless administered under the advice and consent of a Doctor.

39.  Any treatment, services or supplies received by the covered person with respect to an Injury or Sickness which are incurred or received by the covered person while he or she is in his or her Home Country, except as provided by the Home Country Benefits provided or if selected by the covered person.

For Accidental Death and Dismemberment Indemnity the Plan does not cover any loss caused by or resulting from:
 
1.  Intentionally self inflicted injury;

2.  Suicide or attempted suicide;

3.  War or any act of war, declared or undeclared;

4.  Service in the military, naval, or air service of any country;

5.  Sickness, disease, or infection of any kind, except bacterial infections due to an accidental cut or wound, botulism or ptomaine poisoning.

6.  Piloting or acting as a crewmember or riding in any aircraft; except as a fare paying passenger on a scheduled airline. 

This insurance does not apply to the extent that trade or economic sanctions or regulations prohibit Us from providing insurance, including, but not limited to, the payment of claims.