Global Student USA

Plan Detail

Plan Administrator: HTH Worldwide | AM Best Rating: A "Excellent" | Underwriter: Unicare

Exclusions


POLICY EXCLUSIONS*

The Insurer does not pay benefits for loss due to a Pre-Existing Condition during the first one (1) year of coverage. Pre-Existing Conditions will be covered after the Covered Person’s coverage has been in force for one (1) year. This limitation does not apply to the Medical Evacuation Benefit, the Repatriation of Remains Benefit and to the Bedside Visit Benefit.  Unless specifically provided for elsewhere under the Policy, the Policy does not cover loss caused by or resulting from, nor is any premium charged for, any of the following:

  1. Preventative medicines, routine physical examinations, or any other examination where there are no objective indications of impairment in normal health.
  2. Services and supplies not Medically Necessary for the diagnosis or treatment of Sickness or Injury.
  3. Surgery for the correction of refractive error and services and prescriptions for eye examinations, eye glasses or contact lenses or hearing aids, except when Medically Necessary for the Treatment of an Injury.
  4. Plastic or cosmetic surgery, unless they result directly from an Injury which necessitated medical treatment within 24 hours of the Accident.
  5. For diagnostic investigation or medical treatment for infertility, fertility, or birth control.
  6. Expenses incurred in excess of Reasonable Expenses.
  7. Expenses incurred for Injury resulting from the Covered Person’s being legally intoxicated or under the influence of alcohol as defined by the jurisdiction in which the Accident occurs. This exclusion does not apply to the Medical Evacuation Benefit, to the Repatriation of Remains Benefit and to the Bedside Visit Benefit.
  8. Voluntarily using any drug, narcotic or controlled substance, unless as prescribed by a Physician. This exclusion does not apply to the Medical Evacuation Benefit, to the Repatriation of Remains Benefit and to the Bedside Visit Benefit.
  9. Organ or tissue transplant.
  10. Participating in an illegal occupation or committing or attempting to commit a felony.
  11. For treatment, services, supplies, or Confinement in a Hospital owned or operated by a national government or its agencies. (This does not apply to charges the law requires the Covered Person to pay.)
  12. While traveling against the advice of a Physician, while on a waiting list for a specific treatment, or when traveling for the purpose of obtaining medical treatment.
  13. The diagnosis or treatment of Congenital Conditions, except for a newborn child insured under the Policy.
  14. Treatment to the teeth, gums, jaw or structures directly supporting the teeth, including surgical extraction’s of teeth, TMJ dysfunction or skeletal irregularities of one or both jaws including orthognathia and mandibular retrognathia.
  15. Expenses incurred in connection with weak, strained or flat feet, corns or calluses.
  16. Diagnosis and treatment of acne and sebaceous cyst.
  17. Outpatient treatment for specified therapies including, but not limited to Physiotherapy and acupuncture.
  18. Deviated nasal septum, including submucous resection and/or surgical correction, unless treatment is due to or arises from an Injury.
  19. Self inflicted Injuries while sane or insane; suicide, or any attempt thereat while sane or insane. This exclusion does not apply to the Medical Evacuation Benefit, to the Repatriation of Remains Benefit and to the Bedside Visit Benefit.
  20. Loss due to war, declared or undeclared; service in the armed forces of any country or international authority; riot; or civil commotion.
  21. Riding in any aircraft, except as a passenger on a regularly scheduled airline or charter flight.
  22. Elective termination of pregnancy.
  23. Loss arising from participation in professional sports, scuba diving, hang gliding, parachuting or bungee jumping.
  24. Medical Treatment Benefits provision for loss due to or arising from a motor vehicle Accident if the Covered Person operated the vehicle without a proper license in the jurisdiction where the Accident occurred.
  25. Expenses incurred as a result of pregnancy that is not covered.
*subject to state law
 
FRAUD NOTICE PLEASE READ CAREFULLY
 
Any person who knowingly and with intent to defraud or deceive any insurance company submits an insurance application or statement of claim containing any false, incomplete or misleading information may be subject to civil or criminal penalties, depending upon state law. 
 
For your protection, California requires the following to appear on this form: Any person who knowingly presents a false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison. 
 
In Florida, any person who knowingly and with intent to injure, defraud or deceive any insurer files a statement of claim or an insurance application containing any false, incomplete or misleading information is guilty of a felony of the third degree. 
 
In Kentucky, any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime. Any application for insurance in writing by the applicant shall be altered solely by the applicant or by his written consent except that insertions may be made by the insurer for administrative purposes only in such manner as to indicate clearly that such insertions are not to be ascribed to the applicant.
 
In New Jersey, any person who includes any false or misleading information on an application for insurance is subject to criminal and civil penalties.
 
Applicants applying for accident and health insurance in New York: Any person who knowingly and with intent to defraud or deceive any insurance company submits an insurance application or statement of claim containing any false, incomplete or misleading information may be subject to civil or criminal penalties, depending on state law.
 
In Ohio, any person who, with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud.
 
In Oklahoma, WARNING: Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony.
 
In Pennsylvania, any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.
  1. proof of ineligibility is provided or
  2. cancellation occurs within the first 10 days from the effective date or most recent renewal date or
  3. the Covered Member requests cancellation in writing.  If cancellation is after 10 days, premium will be refunded in whole months only.