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1. All diseases/injuries, which are pre-existing when the cover incepts for the first time.This exclusion will be deleted after three consecutive continuous claims free policy years in respect of all diseases provided, there was no hospitalisation for pre-existing ailment during such three years of insurance.For this purpose policy/policies issued by other insurance companies for last three continuous consecutive years will be considered,provided there was no hospitalisation for pre-existing ailment during such three years of insurance.
2. Any hospitalization expenses incurred in the first 30 days from the commencement date of Insurance cover except in case of Injury arising out of accident.
3. During the 1st year of operation of insurance cover the expenses on treatment of diseases such as Cataract, Benign, Prostatic Hypertrophy, and Hysterectomy for Hemorrhagic, or Fibromyoma, Hernia, Hydrocele, congenital internal disease, Fistula in anus, Piles, Sinusitis and related disorders are not payable. If these diseases are pre existing it will be covered after three consecutive continuous claims free policy years.
4. Circumcision, vaccination or inoculation or change of life or cosmetic or aesthetic treatment of any description, plastic surgery other than as may be necessitated due to an accident or as apart of any illness.
5. Cost of spectacles and contact lenses, hearing aids.
6. Dental treatment 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.
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 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. |
