4.5 Injury or disease directly or indirectly caused by or arising from or attributable to War, Invasion, Act of Foreign Enemy, War like operations (whether war be declared or not) or by nuclear weapons / materials.
4.6 Circumcision (unless necessary for treatment of a disease included hereunder or as may be necessitated due to any accident), vaccination, inoculation or change of life or cosmetic or of aesthetic treatment of any description, hair transplant, plastic surgery other than as may be necessitated due to an accident or as a part of any illness / disease.
4.7 Surgery for correction of eye sight, cost of spectacles, contact lenses, hearing aids etc.
4.8 Convalescence, general debility. “run down” condition or rest cure, congenital external diseases or defects or anomalies, sterility, any fertility, sub- fertility or assisted conception procedure, venereal diseases, intentional self- injury/ suicide, all psychiatric conception procedure, venereal diseases, intentional self- injury/ suicide, all psychiatric and psychosomatic disorders and diseases / accident due to and or use, misuse or abuse of drugs / alcohol or use of intoxicating substances or such abuse or addiction etc.
4.9 All expenses arising out of any condition directly or indirectly caused by, or associated with Human T-cell Lymphotropic Virus Type III (HTLD- III) or Lymohadinopathy Associated Virus (LAV) or the Mutants Derivative or Variations Deficiency Syndrome or any Syndrome or condition of similar kind commonly referred to as AIDS, HIV and its complications including sexually transmitted diseases.
4.10 Expenses incurred at Hospital or Nursing Home primarily for evalution / diagnostic purposes which is not followed by active treatment for the ailment during the hospitalised period.
4.11 Expenses on vitamins, tonics, mineral water and allied items unless forming part of treatment for injury or disease as certified by the attending physician.
4.12 Naturopathy treatment, unproven procedure or treatment, experimental or alternative medicine and related treatment including acupressure, acupuncture, magnetic and such other therapies etc.
4.13 Expenses incurred for investigation or treatment irrelevant to the diseases diagnosed during hospitalisation or primary reasons for admission. Private nursing charges, Referral fee to family doctors, Out station consultants / Surgeons fees etc.
4.14 External and / or durable Medical / Non medical equipment like Ambulatory devices i.e. Walker, Crutches, Belts, Collars, Caps, Splints, Slings, Braces, Stocking etc of any kind, CPAP, CAPD, Infusion pump, Diabetic foot wear, Glucometer/ Thermometer, nebuliser and similar related items etc and also any medical equipment which is subsequently used at home etc.
4.15 All non medical expenses including Personal comfort and convenience items or services such as telephone, television, Aya / barber or beauty services, diet charges, baby food, cosmetics, napkins, toiletry items etc., guest services and similar incidental expenses or services etc.
4.16 Change of treatment from one system of medicine to another unless necessitated and agreed / allowed by the TPA / Company.
4.17 Treatment of obesity or condition arising therefrom (including morbid obesity) and any other weight control programme, services or supplies etc.
4.18 Any treatment required arising from Insured’s participation in any hazardous activity such as scuba diving, motor racing, parachuting, hang gliding, rock or mountain climbing, other allied similar activities etc.
4.19 Any treatment received in convalescent home, convalescent hospital, health hydro, nature care clinic or similar establishments.
4.20 Any stay in the hospital for any domestic reason or where no active regular medical treatment is given by the specialist / physician.
4.21 Out Patient Diagnostic, Medical or Surgical procedures or treatments, non-prescribed drugs and medical supplies.
4.22 Massages, Steam bathing, Shirodhara and like treatment under Ayurvedic treatment.
4.23 Any kind of Service charges, Surcharges, Admission fees / Registration charges, File Charges etc levied by the hospital.
4.24 Doctor’s home visit charges, Attendant / Nursing charges during pre and post hospitalisation period.
4.25 Treatment which is continued before hospitalization and continued even after discharge for an ailment / disease / injury other than the one for which hospitalisation claim is made / admissible. |
