- 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.)
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- atomic
nuclear reaction;
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- mental or
nervous illness or anxiety;
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- the
Covered Person's intoxication (alcohol or drugs);
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- suicide
or attempted suicide and self inflicted injuries
(while sane or insane) (in Colorado and Missouri
while sane);
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- involvement
in willful exposure to needless peril;
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- venereal
diseases, sexually transmitted conditions,
Acquired Immune Deficiency Syndrome (AIDS or AIDS
related syndromes);
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- 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;
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- abortion;
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- commission
or attempting to commit a felony or engagement in an
illegal occupation;
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- aviation
other than travel as a fare-paying passenger on a
scheduled, commercial or scheduled charter flight;
or
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- taking
part in any of the following activities:
- Hazardous
Sports unless the additional Hazardous
Sports Option has been chosen and the
additional premium has been paid;
- Dangerous
Sports;
- hunting,
with the use of a fire arm;
- engaging
in professional, club, interscholastic,
intercollegiate or competitive sporting
event; or
- the
driving or any two-or three-wheeled
motorized vehicle, or any motorized vehicle
used primarily for recreational use and not
for general transportation.
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- 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;
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- a
medical condition in relation to which the Covered
Person has received treatment in the 12 months prior
to effecting the Certificate.
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Also,
no benefits are payable:
- 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.
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- for
Sickness or Accident of a person over 65 years of
age.
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- 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.
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| 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:
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- it was
to be expected at the time of effecting the
insurance that the medical expenses must be incurred
during the Period of Insurance;
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- 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;
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- The
Covered Person travels against the advice of a
Physician;
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- the
Covered Person travels to obtain medical treatment;
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- the
Covered Person is undergoing, or is on a waiting
list for a course of medical treatment;
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- the
Covered Person has received a terminal prognosis;
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- medical
expenses incurred within the United States or any of
its territories.
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| Medical
Expenses
This Benefit does not cover:
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- 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;
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- physiotherapy,
unless prescribed by a Physician;
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- 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.
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| Accidental
Death and Permanent Disablement
This Benefit does not cover:
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- 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.
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- 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.
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- Psychic
affections, as a result of any cause, unless
medically determinable as a direct result of brain
damage caused by the Accident.
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- 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).
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- 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.
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- Accidents
as a result of partaking in a Hazardous Sport which
excludes the Death and Permanent Disablement Cover.
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| This
is a brief description of the coverage. For actual
benefits, limitations, exclusions and other provisions,
please refer to the policy or certificate. |
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