1. No claim will be paid where the Insured Person:
- is traveling against the advice of a Physician; or
- is receiving or on a waiting list for specified medical treatment declared in the Physician’s report or certificate; or
- is traveling for the purpose of obtaining treatment; or
- has received a terminal prognosis for a medical condition.
2. No claim will be paid arising from suicide attempted suicide or willfully self inflicted injury or illness, mental disorder, anxiety, stress or depression, venereal diseases, alcoholism, drunkenness or the abuse of the drugs, or any loss arising directly or indirectly from any injury, illness, death, loss expenses or other liability attributable to HIV (Human Immunodeficiency Virus) and/or any HIV related illness including AIDS (Acquired Immune Deficiency Syndrome) and/or any mutant derivative or variation thereof however caused.
3. No claim will be paid arising from the insured person taking part in Naval, Military or Airforce operations.
4. No claim will be paid arising from War, invasion, acts of foreign enemy, hostilities (Whether war be declared or not), civil war, rebellion, revolution, insurrection, military or usurped power or confiscation or nationalization or requisition of or destruction of or damage to property by or under the order of any government or local authority.
5. This insurance does not cover any claim arising from the loss or destruction or damage to any property whatsoever or any loss or expenses whatsoever resulting or arising therefrom or any consequential loss directly or indirectly caused by or contributed to by or arising from
- ionizing radiation or contamination by radioactivity from any nuclear waste from the combustion of nuclear fuel; or
- the radioactive, toxic, explosive or other hazardous properties of any explosive nuclear assembly or nuclear component thereof.
6. No claim will be paid arising from the participation of the Insured person engaging in Air Travel unless he or she flies as a passenger on an aircraft properly licensed to carry passengers. For the purpose of this exclusion, Air Travel means being in or on, or boarding an aircraft for the purpose of flying therein or alighting therefrom following a flight.
7. No claim will be paid arising from the participation of the Insured person in winter sports, mountaineering (where ropes or guides are customarily used), riding or driving in races or rallies, caving or potholing, hunting or equestrian, skew diving or other underwater activity, rafting or canoeing involving white water rapids, yachting or boating outside coastal waters (2 miles). Further no claim will be paid in case Insured Person participates in professional sports or any other hazardous sports. The claim is neither payable if arises from participation in potentially dangerous sports for which the Insured Person is either untrained or physically unfit or using improper equipment.
8. No claim will be paid for losses arising from accidents on two wheeled motorized vehicles unless at the time of the accident the driver is duly qualified, is in possession of a current full International driving license and the injured person is wearing a safety crash helmet, or losses arising from accidents on two wheeled motorized vehicles over 50cc.
9. No claims will be paid for losses arising directly or indirectly from manual work or hazardous occupation, self exposure to needless peril (except in an attempt to save human life) or if engaging in any criminal or illegal act.
atment or surgery of any kind unless requiring hospitalization.
7. Convalescence, general debility, run-down condition or rest cure, congenital external disease or defects or anomalies, Sterility, Infertility, Venereal disease, intentional self injury and use of intoxication drugs/alcohol, AIDS.
8. Charges incurred at Hospital or Nursing Home primarily for diagnosis purpose only.
9. Expenses on vitamins and tonics unless forming part of treatment for injury or diseases as certified by the attending physician.
10. Expenses in excess of 5% of the Sum Insured as mentioned in the schedule due to treatment due to treatment arising from or traceable to pregnancy (including voluntary termination of pregnancy) and child birth (including Caesarean Section) and allied maternity benefits. No expenses will be payable for any treatment arising from or traceable to Voluntary Termination of Pregnancy.
11. Naturopathy Treatment.
12. The benefits like Cumulative Bonus and Cost of Health Check up, enjoyed under the previous Policy/Policies, issued by any other Insurance Company shall not be available under this Policy.
(N.B. Company's Liability in respect of all claims admitted during the period of Insurance shall not exceed the Floater Sum Insured per family as mentioned in the schedule). |