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What is Not Covered?


The Policy does not cover any event which either in origin or extent, directly or indirectly, proximately or remotely, is to be attributed to or is a consequence of:

  1. war, invasion, act of foreign enemy, hostilities or warlike operations (whether war is declared or not), civil war, rebellion, revolution, insurrection or military or usurped power; (This exclusion does not apply to acts of terrorism in Oklahoma.)
  1. atomic nuclear reaction;
  1. mental or nervous illness or anxiety;
  1. the Covered Person's intoxication (alcohol or drugs);
  1. suicide or attempted suicide and self inflicted injuries (while sane or insane) (in Colorado and Missouri while sane);
  1. involvement in willful exposure to needless peril;
  1. venereal diseases, sexually transmitted conditions, Acquired Immune Deficiency Syndrome (AIDS or AIDS related syndromes);
  1. pregnancy or childbirth, if the Period of Insurance exceeds three months.  In the event that the Period of Insurance does not exceed three months, then coverage will apply to Injury or Sickness arising from or affecting the pregnancy, providing that the Covered Person is not expected to give birth before or within eight weeks after the expiration of the Period of Insurance;
  1. abortion;
  1. commission or attempting to commit a felony or engagement in an illegal occupation;
  1. aviation other than travel as a fare-paying passenger on a scheduled, commercial or scheduled charter flight; or
  1. taking part in any of the following activities:
    1. Hazardous Sports unless the additional Hazardous Sports Option has been chosen and the additional premium has been paid;
    2. Dangerous Sports;
    3. hunting, with the use of a fire arm;
    4. engaging in professional, club, interscholastic, intercollegiate or competitive sporting event; or
    5. the driving or any two-or three-wheeled motorized vehicle, or any motorized vehicle used primarily for recreational use and not for general transportation.

     

  1. any pre-existing physical defect, infirmity, Sickness or disease in the case that this was known to the Covered Person at the time of effecting the Coverage;
  1. a medical condition in relation to which the Covered Person has received treatment in the 12 months prior to effecting the Certificate.
Also, no benefits are payable:
  1. if a claim results from circumstances which reasonably could have been anticipated by the Covered Person or any other person at the date of issue of the Certificate.
  1. for Sickness or Accident of a person over 65 years of age.
  1. if there is any insurance or other financial vehicle designed for reimbursement covering the same loss, damage or any part thereof.  In such case this insurance will not be liable for the risks paid or covered by such other insurance or other financial vehicle designed for reimbursement.

 

Pre-existing Conditions

Medical expenses and/or air ambulance, transportation costs, extra traveling expenses, and loss of deposits and cancellation charges, as a result of any pre-existing physical defect, infirmity, Sickness, disease or affliction, are not covered when:

  1. it was to be expected at the time of effecting the insurance that the medical expenses must be incurred during the Period of Insurance;
  1. the Covered Person was already under medical treatment at the time effecting the insurance and that it is necessary to continue with the treatment during the Period of Insurance;
  1. The Covered Person travels against the advice of a Physician;
  1. the Covered Person travels to obtain medical treatment;
  1. the Covered Person is undergoing, or is on a waiting list for a course of medical treatment;
  1. the Covered Person has received a terminal prognosis;
  1. medical expenses incurred within the United States or any of its territories.

 

Medical Expenses

This Benefit does not cover:

  1. vaccinations, acupuncture, routine medical treatment and any routine check-ups for pregnancy, cosmetic or plastic surgery (except as the result of an Accident), and elective surgery;
  1. physiotherapy, unless prescribed by a Physician;
  1. treatment in a private Hospital if it is possible to receive treatment in a ward of a public Hospital; or optical prescriptions, eye refraction or eye examinations for the purpose of prescribing corrective lenses for eye glasses as for the fitting thereon, unless caused by Accidental bodily Injury incurred during the Period of Insurance.

 

Accidental Death and Permanent Disablement

This Benefit does not cover:

  1. Accidents as a consequence of a risky undertaking in which the Covered Person has recklessly endangered his life or body, unless this risky undertaking was reasonably necessary for legitimate self defense or attempts to save ones self, others, animals or goods.
  1. Accidents which arise as a consequence of a sickly condition or as a consequence of bodily or physical abnormalities of a Covered Person, unless these circumstances are a result of an Accident for which the Company was obliged to pay indemnification under this insurance.
  1. Psychic affections, as a result of any cause, unless medically determinable as a direct result of brain damage caused by the Accident.
  1. Hernia inguinalis (rupture), lumbago, ruptured intervertebral disk (hernia nuclei pulposi), tendovaginitis crepitans, muscle spraining, periarthritis humeroscapularis, tennis-elbow (epicondylitis lateralis), or golfer's arm (epicondylitis medialis).
  1. The consequences of medical treatment, which the Covered Person has undergone, without there being any link with an Accident covered under the Certificate making this treatment necessary.
  1. Accidents as a result of partaking in a Hazardous Sport which excludes the Death and Permanent Disablement Cover.
This is a brief description of the coverage.  For actual benefits, limitations, exclusions and other provisions, please refer to the policy or certificate.

 

ISIS Health Insurance
www.isis-travelinsurance.com
Correspondence: P.O. Box 20069, Alexandria, VA  22320  (202) 347-7324/ (800) 247-5575/ (202) 296-0007 fax
email: info@isis-travelinsurance.com