Exclusions

For the Medical Expense, Emergency Medical Evacuation, Emergency Reunion Benefit, and Repatriation of Remains Benefits, no benefit shall be payable with respect to expenses incurred:
1 For pre-existing conditions defined as a Sickness, disease or other condition of the covered person, that in the 12-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.  However, this limitation will not apply if the Covered Person was previously covered for such pre-existing condition under Creditable Coverage and such Creditable Coverage was continuous to a date less than 63 days prior to the effective date of coverage under the Policy.  “Creditable Coverage” means: 1) a self-funded employer group health plan under ERISA; 2) a group or individual health Insurance coverage; 3) Part A or Part B of Medicare; 4) Medicaid; 5) CHAMPUS; 6) the Indian Health Service of a tribal organization; 7) a state health benefits risk pool; 8) a health plan offered under the federal employees health benefits program (FEHBP); 9) a public health plan; or 10) a health benefit plan. (This pre-existing condition exclusion does not apply to the Emergency Medical Evacuation, Emergency Reunion, or Repatriation of Remains Benefits.)
2. 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;
3. For loss incurred as a result of war or any act of war, whether declared or not;
4. For injury sustained while participating in professional, club, interscholastic, or intercollegiate sports;
5. For routine physicals;
6. For cosmetic surgery, except for reconstructive surgery needed as the result of an Injury;
7. For elective surgery;
8. For dental care, except as the result of Injury to natural teeth caused by an accident;
9. For eye refraction 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;
10. For expenses as a result of, or in connection with, intentionally self-inflicted injury;
11. For suicide or attempted suicide, while sane or insane; 
12. For expenses as a result of, or in connection with, the commission or attempt to commit an assault or a felony;
12. For scuba diving, jet and water skiing, mountain climbing (where ropes or guides are normally used), sky diving, and professional or amateur racing;
13. For treatment furnished under any mandatory government program or facility set up for treatment without cost to any individual;
14. For treatment by an immediate family member;
15. Piloting or acting as a crew member or riding in any aircraft, except as a fare-paying passenger on a scheduled airline.

For the Accidental Death and Dismemberment Benefit, this plan does not cover any loss, fatal or non-fatal, caused by or resulting from: 

1. Intentionally self-inflicted injury;
2. Suicide or attempted suicide; while sane or insane;
2. War or any act of war, whether declared or not;
3. Service in the military naval or air service of any country;
4. Sickness, disease. or infection of any kind, except bacterial infections due to an accidental cut or wound, botulism or ptomaine poisoning;
 5. Piloting or acting as a crew member 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.