Liaison International

Plan Detail

Plan Administrator: Seven Corners | AM Best Rating: A "Excellent"  | Underwriter: United States Fire Insurance Company & Lloyd's of London


Description of Exclusions

No Benefit shall be payable for Accident Medical, Sickness Medical, Hospital Indemnity, Unexpected Recurrence, Dental, Emergency Medical Evacuation/Repatriation, Return of Mortal Remains, Return of Minor Child, Emergency Medical Reunion, as the result of:

  1. Pre-existing Conditions: Any Injury or Illness which meets the following criteria (unless covered under the Unexpected Recurrence benefit): 1) a condition that would have caused a person to seek medical advice, diagnosis, care or Treatment during the 36 months prior to the Effective Date of coverage under this Policy, 2) a condition for which manifestation, medical advice, diagnosis, care or Treatment was recommended or received during the 36 months prior to the Effective Date of coverage under this Policy. For Individuals traveling outside of the United States and Canada, this period is 12 months instead of 36 months. This exclusion does not apply to Emergency Evacuation/Repatriation or Return of Mortal Remains. Note: U.S. citizens traveling outside the United States shall receive up to $20,000 (Age 70+, up to $5,000) subject to the chosen Deductible and Coinsurance, for Covered Expenses resulting from a sudden, unexpected recurrence of a Pre-existing Condition while traveling outside the United States and Canada. This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs or Treatments existent or necessary prior to the Effective Date of coverage.
  2. Injury or Illness which is not presented to the Company for payment within ninety (90) days of receiving Treatment.
  3. Charges for Treatment which is not Medically Necessary.
  4. Charges provided at no cost to You.
  5. Charges for Treatment which exceeds Reasonable and Customary charges.
  6. Charges incurred for Surgery or Treatments which are, Experimental/Investigational, or for research purposes.
  7. 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.
  8. Suicide, or any attempt thereof, while sane or self destruction or any attempt thereof, while insane, may vary by state of residence.
  9. Any consequence, whether proximately or remotely occasioned by, or traceable to, or arising in connection with: War, invasion, act of foreign enemy hostilities, warlike operations (whether war be declared or not), or civil war, mutiny, riot, strike, military or popular uprising insurrection, rebellion, revolution, military or usurped power, any act of any person acting on behalf of or in connection with any organization with activities directed towards the overthrow by force of the Government du jure or de facto, martial law or state of siege or any events or causes which determine the proclamation or maintenance of marital law or state of siege. (Lloyd’s of London has alternative exclusionary wording, see program summary)
  10. Injury sustained while participating in professional athletics.
  11. Injury sustained while participating in amateur or interscholastic athletics, this exclusion does not apply to non-competitive, recreational or intramural activities. Note: A sponsored and/or organized Amateur or Interscholastic Athletic event includes training camps, team sports, or any formal grouping of people participating in one or multiple events that may/ may not require a fee for participation.
  12. 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.
  13. Treatment of the temporomandibular joint.
  14. Vocational, speech, recreational or music therapy.
  15. Services or supplies performed or provided by a relative of Yours, or anyone who lives with You.
  16. Cosmetic or plastic Surgery, except as the result of a covered Accident, for the purposes of this Plan, Treatment of a deviated nasal septum shall be considered a cosmetic condition.
  17. Elective Surgery which can be postponed until You return to Your Home Country, where the objective of the trip is to seek medical advice, Treatment or Surgery.
  18. Treatment and the provision of false teeth or dentures, normal ear tests and the provision of hearing aids.
  19. Eye refractions or eye examinations for the purpose of prescribing corrective lenses for eyeglasses or for the fitting thereof, unless caused by Accidental bodily Injury incurred while covered hereunder.
  20. Treatment in connection with alcoholism and drug addiction, or use of any drug or narcotic agent.
  21. Injury sustained or Disablement due wholly or partly to the Insured being intoxicated or drug use, other than drugs taken in accordance with treatment prescribed and directed by a Physician.
  22. Any Mental and Nervous disorders or rest cures, may vary by state.
  23. Congenital abnormalities and conditions arising out of or resulting there from.
  24. Expenses which are non-medical in nature.
  25. Expenses as a result of or in connection with intentionally self-inflicted Injury or Illness.
  26. Expenses as a result of or in connection with the commission of a felony offense.
  27. Injury sustained while taking part in mountaineering, hang gliding, parachuting, bungee jumping, racing by horse, motor vehicle or motorcycle, snowmobiling, motorcycle/motor scooter riding (whether as a driver or passenger), scuba diving, involving underwater breathing apparatus (unless PADI or NAUI certified), snorkeling, water skiing, snow skiing, spelunking, parasailing and snowboarding. Hazardous Sport Coverage: the following are covered if the required premium has been paid: motorcycle/motor scooter riding whether as a driver or passenger), hang gliding, parachuting, bungee jumping, water skiing, snow skiing, snowmobiling, snowboarding, snorkeling and spelunking. • Mountaineering shall mean the sport, hobby or profession of walking, hiking, and climbing up mountains either: 1) utilizing harnesses, ropes, crampons or ice axes; or 2) ascending 4500 meters or above. • Parachuting shall mean an activity involving the breaking of a free fall from an airplane using a parachute.
  28. 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 plan or facility set up for Treatment without any cost to You.
  29. Dental care, except as the result of Injury to natural teeth caused by Accident, unless otherwise covered under this Plan.
  30. Routine Dental Treatment.
  31. Pregnancy or Illness resulting from Pregnancy, childbirth, or miscarriage.
  32. Miscarriage resulting from Accident.
  33. 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.
  34. Treatment for human organ tissue transplants and their related Treatment.
  35. Expenses incurred while in Your Home Country, except as provided under the Home Country Coverage.
  36. Expenses incurred during a Hospital emergency visit which is not of an emergency nature.
  37. Covered Expenses incurred for which the Trip to the Host Country was undertaken to seek medical Treatment for a condition.
  38. Covered Expenses incurred during a Trip after Your Physician has limited or restricted travel.
  39. This Policy does not insure against loss or damage (including death or injury) and any associated cost or expense resulting directly from the discharge, explosion or use of any device, weapon or material employing or involving nuclear fission, nuclear fusion or radioactive force, or chemical, biological, radiological or similar agents, whether in time of peace or war, and regardless of who commits the act.
  40. Sex change operations, or for Treatment of sexual dysfunction or sexual inadequacy.
  41. Weight reduction programs or the surgical Treatment of obesity.