Collegiate Care Plus

Plan Detail

Plan Administrator: Trawick International | AM Best Rating: A "Excellent" | Underwriter: United States Fire Insurance Company

Exclusions


Exclusions

We will not pay benefits for any Accidental Death and Dismemberment or Paralysis loss or Injury that is caused by, or results from:
  • intentionally self-inflicted Injury;
  • suicide or attempted suicide;
  • war or any act of war, whether declared or not;
  • service in the military, naval or air service of any country;
  • disease or bacterial infection except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
  • Sickness resulting from pregnancy, childbirth, miscarriage (except as provided by the Policy);
  • piloting or serving as a crewmember or riding in any aircraft except as a passenger on a regularly scheduled or charter airline;
  • commission of, or attempt to commit, a felony;
  • Injury or Sickness that occurs while the Covered Person has been determined to be legally intoxicated as determined according to the laws of the jurisdiction in which the Injury or Sickness occurred, or under the influence of any narcotic, barbiturate, or hallucinatory drug, unless administered by a Doctor and taken in accordance with the prescribed dosage;
  • flying in any aircraft being used for or in connection with acrobatic or stunt flying, racing or endurance tests; flying in any rocket propelled aircraft; flying in any aircraft being used for or in connection with crop dusting, or seeding or spraying, firefighting, exploration, pipe or power line inspection, any form of hunting bird or fowl herding, aerial photography, banner towing or any test or experimental purpose; flying any aircraft which is engaged in flight which requires a special permit or waiver from the authority having jurisdiction over civil aviation, even if granted;
  • specific named hazards: Abseiling, Aviation (except when traveling as a passenger in a commercial aircraft), BASE Jumping, Bobsleigh, BMX, Bungee Jumping, Canopying, Canyoning, Caving, Extreme sports, High Diving, Hang Gliding, Heli-skiing, Hot Air Ballooning, Inline Skating, Jet Skiing, Kayaking, Luge, Motocross, Motorcycling, Moto-X, Mountaineering, Mountain Biking, Mountain Climbing, Paragliding, Parasailing, Parascending, Piloting any Aircraft, Racing of any kind, Rock Climbing, Rodeo Activities, Rappelling, Scuba Diving, Ski Jumping, Skydiving Snow Skiing, Snowboarding, Snowmobiling, Spelunking, Surfing, Trekking, Water Skiing, Wind Surfing, White Water Rafting, Zip Lining, Zorbing;
  • All professional and semi-professional sports.
In addition to the exclusions above, We will not pay Medical Expense Benefits for any loss, treatment or services resulting from or contributed to by:
  • “Pre-existing Conditions” except if the individual is covered under the Policy for 6 consecutive months, then the Pre-existing Condition exclusion will no longer apply and any eligible expenses incurred thereafter will be considered for reimbursement;
  • services, supplies or treatment, including any period of Hospital confinement, which were not recommended, approved and certified as necessary and reasonable by a Physician;
  • suicide or any attempt thereat while sane or self-destruction or any attempt thereat while insane(except as provided by the policy);
  • declared or undeclared war or any act thereof;
  • Injury sustained while participating in a professional, semi-professional, club or amateur sport;
  • Injury sustained while participating in an intramural, interscholastic or intercollegiate sport (except as provided by the Policy);
  • Sickness resulting from pregnancy, childbirth, miscarriage (except as provided by the policy);
  • miscarriage resulting from Accident (except as provided by the Policy);
  • immunizations, routine physical or other examinations where there are no objective indications or impairment in normal health, or laboratory diagnostic or x-ray examinations except in the course of a disability established by the prior call or attendance of a Physician (except as provided by the policy);
  • cosmetic or plastic surgery, except as the result of an accident;
  • elective surgery which can be postponed until the Covered Person returns to his or her Home Country;
  • any mental or nervous disorders or rest cures (except as provided by the Policy);
  • any dental treatment (except as provided by the Policy); 14. eye refractions or eye examinations for the purpose of prescribing corrective lenses for eye glasses or for the fitting thereof, unless caused by accidental bodily Injury incurred while covered under the Policy;
  • congenital anomalies and conditions arising out of or resulting therefrom;
  • services, supplies, or treatment including any period of Hospital confinement which were not recommended, approved and certified as necessary and reasonable by a Doctor; or expenses which are nonmedical in nature;
  • the ordinary cost of a one-way airplane ticket used in the transportation back to the Covered Person’s country where an air ambulance benefit is provided;
  • expenses as a result of or in connection with intentionally self-inflicted Injury;
  • specific named hazards: Abseiling, Aviation (except when traveling as a passenger in a commercial aircraft), BASE Jumping, Bobsleigh, BMX, Bungee Jumping, Canopying, Canyoning, Caving, Extreme sports, High Diving, Hang Gliding, Heli-skiing, Hot Air Ballooning, Inline Skating, Jet Skiing, Kayaking, Luge, Motocross, Motorcycling, Moto-X, Mountaineering, Mountain Biking, Mountain Climbing, Paragliding, Parasailing, Parascending, Piloting any Aircraft, Racing of any kind, Rock Climbing, Rodeo Activities, Rappelling, Scuba Diving, , Ski Jumping, Skydiving, Snow Skiing, Snowboarding, Snowmobiling, Spelunking, Surfing, Trekking, Water Skiing, Wind Surfing, White Water Rafting, Zip Lining, Zorbing;
  • treatment paid for or furnished under any other individual or group policy, or other service or medical prepayment plan arranged through an employer to the extent so furnished or paid, or under any mandatory government program or facility set up for treatment without cost to any individual;
  • pregnancy (except as provided by the Policy) or childbirth, birth control, artificial insemination, treatment for fertility or impotency, sterilization or reversal thereof or abortion;
  • organ transplants, marrow procedures and chemotherapy;
  • sexually transmitted diseases or immune deficiency disorders and related conditions;
  • treatment, service or supply not specifically covered by the Policy;
  • treatment by any Immediate Family Member or member of the Covered Person’s household;
  • treatment of hernia, Osgood-Schlatter’s Disease, osteochondritis, osteomyelitis, cardiac disease or conditions, pathological fractures, congenital weakness whether or not caused by a Covered Accident;
  • expense incurred for treatment of Temporomandibular or craniomandibular joint dysfunction and associated myofacial pain;
  • elective treatment, surgery, health treatment, or examination including any service, treatment or supplies that: a. are deemed by Us to be experimental; and b. are not recognized and generally accepted medical practices in the United States;
  • contact lenses, hearing aids, wheelchairs, braces, appliances, examinations or prescriptions for them, or repair or replacement of existing artificial limbs, orthopedic braces, orthotic devices, artificial eyes and larynx;
  • treatment or service provided by a private duty nurse or while confined primarily to receive custodial care, educational or rehabilitative care or nursing care;
  • covered medical expenses for which the Covered Person would not be responsible for in the absence of the Policy;
  • conditions that are not caused by a Covered Accident;
  • vocational, recreational, speech or music therapy;
  • traveling against the advice of a Physician, traveling while on a waiting list for inpatient Hospital or clinic treatment, or traveling for the purpose of obtaining medical treatment abroad;
  • any potential fatal condition which was diagnosed before the date your coverage became effective or any condition for which You are traveling to seek treatment;
  • expenses incurred while in your Home Country, except as provided under the Home Country Coverage and Home Country Extension of Benefits Coverage; or which exceed 30 days or $1,000;
  • sex change operations, or for treatment of sexual dysfunction or sexual inadequacy;
  • weight reduction programs or the surgical Treatment of obesity;
  • Injury sustained as the result of the Insured Person operating a motor vehicle while not properly licensed to do so in the jurisdiction in which the motor vehicle accident takes place.

This insurance does not apply to the extent that trade or economic sanctions or other laws or regulations prohibit us from providing insurance, including, but not limited to, the payment of claims.