| EXCLUSIONS |
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This policy shall not cover:-
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| 1. |
Pre-existing illness.
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| 2. |
Specified Illnesses occurring
during the first 120 days of continuous cover.
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| 3. |
Any medical or physical conditions
arising within the first 30 days of the Insured Person's
cover or date reinstatement whichever is latest except
for accidental injuries.
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| 4. |
Plastic/Cosmetic surgery, circumcision,
eye examination, glasses and refraction or surgical
correction of nearsightedness (Radial Keratotomy
or Lasik) and the use or acquisition of external
prosthetic appliances or devices such as artificial
limbs, hearing aids, implanted pacemakers and prescriptions
thereof.
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| 5. |
Dental conditions including
dental treatment or oral surgery except as necessitated
by Accidental Injuries to sound natural teeth occurring
wholly during the Period of Insurance.
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| 6. |
Private nursing, rest cures
or sanitaria care, illegal drugs, intoxication, sterilization,
venereal disease and its sequelae, AIDS (Acquired
Immune Deficiency Syndrome) or ARC (AIDS Related
Complex) and HIV related diseases, and any communicable
diseases required quarantine by law.
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| 7. |
Any treatment or surgical operation
for congenital abnormalities or deformities including
hereditary conditions.
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| 8. |
Pregnancy, child birth (including
surgical delivery), miscarriage, abortion and prenatal
or postnatal care and surgical, mechanical or chemical
contraceptive methods of birth control or treatment
pertaining to infertility. Erectile dysfunction and
tests or treatment related to impotence or sterilization.
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| 9. |
Hospitalization primarily for
investigatory purposes, diagnosis, x-ray examination,
general physical or medical examinations, not incidental
to treatment or diagnosis of a covered Disability
or any treatment which is not Medically Necessary
and any preventive treatments, preventive medicines
or examinations carried out by a Physician, and treatments
specifically for weight reduction or gain.
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| 10. |
Suicide, attempted suicide or
intentionally self-inflicted injury while sane or
insane.
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| 11. |
War or any act of war, declared
or undeclared, criminal or terrorist activities,
active duty in any armed forces, direct participation
in strikes, riots and civil commotion or insurrection.
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| 12. |
Ionizing radiation or contamination
by radioactivity from any nuclear fuel or nuclear
waste from process of nuclear fission or from any
nuclear weapons material.
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| 13. |
Expenses incurred for donation
of any body organ by an Insured Person and costs
of acquisition of the organ including all costs incurred
by the donor during organ transplant and its complications.
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| 14. |
Investigation and treatment
of sleep and snoring disorders, hormone replacement
therapy and alternative therapy such as treatment,
medical service or supplies, including but not limited
to chiropractic services, acupuncture, acupressure,
reflexology, bonesetting, herbalist treatment, massage
or aroma therapy or other alternative treatment.
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| 15. |
Care or treatment for which
payment is not required or to the extent which is
payable by any other insurance or indemnity covering
the Insured Person and Disabilities arising out of
duties of employment or profession that is covered
under a Workman's Compensation Insurance Contract.
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| 16. |
Psychotic, mental or nervous
disorders, (including any neuroses and their physiological
or psychosomatic manifestations).
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| 17. |
Costs/expenses of services of
a non-medical nature, such as television, telephones,
telex services, radios or similar facilities, admission
kit/pack and other ineligible non-medical items.
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| 18. |
Sickness or Injury arising from
racing of any kind (except foot racing), hazardous
sports such as but not limited to skydiving, water
skiing, underwater activities requiring breathing
apparatus, winter sports, professional sports and
illegal activities.
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| 19. |
Private flying other than as
a fare-paying passenger in any commercial scheduled
airlines licensed to carry passengers over established
routes.
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| 20. |
Expenses incurred for sex changes. |
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| "Pre-Existing Illness" shall mean: |
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Disabilities that the Insured
Person has reasonable knowledge of. An Insured Person may
be considered to have reasonable knowledge of a pre-existing
condition where the condition is one for which:
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| (a) |
the Insured Person had received or is receiving treatment; |
| (b) |
medical advice, diagnosis, care
or treatment has been recommended;
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| (c) |
clear and distinct symptoms are
or were evident; or
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| (d) |
its existence would have been
apparent to a reasonable person in the circumstances.
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| "Specified Illnesses" shall mean: |
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The following disabilities
and its related complications, occurring within the first
120 days of Insurance of the Insured Person:
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| (a) |
Hypertension, diabetes mellitus
and cardiovascular disease
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| (b) |
All tumours, cancers, cysts, nodules,
polyps, stones of the urinary system and biliary system
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| (c) |
All ear, nose (including sinuses)
and throat conditions
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| (d) |
Hernias, haemorrhoids, fistulae,
hydrocele, varicocele
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| (e) |
Endometriosis including disease
of the reproduction system
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| (f) |
Vertebro-spinal disorders (including
disc) and knee conditions
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