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Any Pre-existing Condition as defined hereunder. This exclusion does not apply to Emergency Evacuation/Repatriation.
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Injury or Illness which is not presented to Us for payment within 90 days of receiving Treatment.
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Charges for Treatment which is not Medically Necessary.
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Charges provided at no Expense to You.
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Charges for Treatment which exceeds Reasonable and Customary charges.
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Charges incurred for Surgery or Treatments which are, Experimental/Investigational, or for research purposes.
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Services, supplies or Treatment, including any period of Hospital confinement, which were not recommended, approved and certified as Medically Necessary and reasonable by a Physician.
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Suicide or any attempt thereof, while sane or self-destruction or any attempt thereof, while insane.
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This plan does not insure against loss or damage (including death or Injury) from any consequences, whether direct or indirect, invasion, act of foreign enemy, hostilities, or warlike operation (whether War be declared or not), “armed conflict” by military forces, civil war, mutiny, military or usurped power, martial law or state of siege or any events or causes which determine the proclamation or maintenance of martial law or state of siege, except as provided under the Political and Natural Disaster Evacuation and/or optional War Risk Coverage Rider.
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Injury or Illness sustained while participating in professional athletics, Intercollegiate, Interscholastic Athletics, Club Sports, and Organized Amateur Sports except as provided under the optional Athletic Sports & Hazardous Activity Rider.
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Injury or Illness sustained while participating in Athletic Sports and Hazardous Activities except as provided under the optional Athletic Sports & Hazardous Activity Rider. Including but not limited to: Arial Photograph (Use of proper restraints required); BMX (Racing or Competitive); Bobsledding; Bungee Jumping; Canopying; Diving with Sharks; Flying in any Chartered or Leased Aircraft or Helicopter; Hang Gliding; Heli-skiing; Horseback Riding; Jet, Snow, and Water Skiing; Kayaking; Martial Arts; Motorcycling & Motor Scooter; Mountain Bike; Mountain Climbing (if over 14 thousand feet, guide required); Mountain Climbing (under 14 thousand feet); MX; Paragliding; Parasailing; Piloting any Non-commercial Aircraft; Running with Bulls; Safari; Safari & Big Game Hunting (use of firearms); Scuba Diving; Security Detail (use of firearms); Skydiving; Snowboarding; Snowmobiling; Spelunking; Surfing; Trekking; Whitewater Rafting (up to and including class V rapids only); Wind Surfing; Zip Lining.
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Routine physicals, immunizations or other examinations where there are no objective indications or impairment in normal health, and laboratory diagnostic or x-ray examinations, except in the course of a Disablement established by a prior call or
attendance of a Physician.
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Treatment of the Temporomandibular joint.
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Vocational, speech, recreational or music therapy.
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Services or supplies performed or provided by a Relative of Yours, or anyone who lives with You.
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Cosmetic or plastic Surgery, except as the result of a Covered Accident; for the purposes of this Plan, Treatment of a deviated nasal septum will be considered a cosmetic condition.
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Elective Surgery which can be postponed until You return to Your Home County, where the objective of the trip is to seek medical advice, Treatment or Surgery.
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Treatment and the provision of false teeth or dentures, normal ear tests and the provision of hearing aids.
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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 hereunder.
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Treatment in connection with alcoholism and drug addiction, or use of any drug or narcotic agent.
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Injury sustained while under the influence of or Disablement due wholly or partly to the effects of intoxicating liquor or drugs
other than drugs taken in accordance with Treatment prescribed and directed by a Physician for a condition which is covered hereunder, but not for the Treatment of drug addiction.
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Any Mental and Nervous disorders or rest cures.
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Congenital abnormalities and conditions arising out of or resulting therefrom.
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Expenses which are non-medical in nature. Including but not limited to: taxes, administration fees, and service fees.
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Expenses as a result or in connection with intentionally self-inflicted Injury or Illness.
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Expenses as a result or in connection with the commission of a felony offense.
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Treatment paid for or furnished under any other individual or group policy or other service or medical pre-payment plan arranged through the employer to the extent so furnished or paid, or under any mandatory government program or facility set up for Treatment without Expense to You.
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Treatment of venereal disease.
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Dental care, except as the result of Injury to natural teeth caused by Accident, unless otherwise covered under this Plan.
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Routine Dental Treatment.
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For Pregnancy or Illness resulting from Pregnancy, childbirth, or miscarriage.
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For miscarriage resulting from Accident.
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Drug, Treatment or procedure that either promotes or prevents conception, or prevents childbirth, including but not limited to: artificial insemination, Treatment for infertility or impotency, sterilization or reversal thereof.
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Treatment for human organ tissue transplants and their related Treatment.
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Expenses incurred while in Your Home Country, except as provided under the Home Country Coverage.
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Expenses incurred during a Hospital emergency visit which is not of an emergency nature.
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Expenses incurred for which the Trip to the Host Country was undertaken to seek medical Treatment for a condition.
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Expenses incurred during a Trip after Your Physician has limited or restricted travel.
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Sex change operations, or for Treatment of sexual dysfunction or sexual inadequacy.
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Weight reduction programs or the surgical Treatment of obesity.
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Expenses resulting from Acquired Immune Deficiency Syndrome (AIDS), Aids-Related Complex (ARC) or the Human Immunodeficiency Virus (HIV).
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For any violent or unlawful act of an Immediate Family Member, another insured, or an individual that resides with the insured on a permanent basis.
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For the ordinary Expense of a one-way airplane ticket used in the transportation back to the insured's country where an air ambulance benefit is provided.
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Long or short term care outside of the Hospital. Included but not limited to: 1) Home health care; 2) Convalescent, nursing, or rest home facilities; 3) Rehabilitation Centers; and 4) Hospice Care facilities.