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INF Plans vs. Acute Onset of Pre Existing Conditions

Acute Onset of Pre-Existing Conditions are visitor health insurance plans which claim to provide pre existing conditions coverage- when you meet a certain requirement. If you look at most "acute onset" plans- they never define what can actually be qualified as an acute onset of pre-existing condition. Most have generic definitions, which state:

"An sudden of unexpected outbreak or recurrence of a pre-existing conditions which occurs spontaneously and without advance warning (in terms of both symptoms and doctors advice), and is of short duration, rapidly progressing, and requires immediate medical attention"

Insurance companies place more restrictions on top of that- such as medical care must be obtained within 24 hours, and there is no coverage for chronic or congenital conditions. Isn't diabetes chronic? Isn't blood pressure chronic? If these insurance plans don't cover chronic conditions- then what good will they be!

Acute onset of pre-existing conditions plans will offer comprehensive 100% co-insurance, $0 deductibles, and visitors coverage up to $2,000,000. And the price for this insurance? On average, we found around $287.00 across various providers for the 60-69 age group. How is this possible? Because acute onset plans do not pay claims. These plans only provide you the peace of mind if you have no claim, but when you do have a claim- it becomes a nightmare.
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Visiting Parents with Pre-Existing Conditions suffer during their travel.

Other Visitors Insurance Providers & Acute Onset Plans

Some insurance providers will harass you and not pay any claims. And the worst part- you may have to sue the insurance company to get any recourse! Why does it go to such an extreme? Most visitors insurance companies are underwritten by Non-Admitted Carriers- meaning they are unregulated by your states insurance company. They don't care if you are mad about claims- there's no recourse for them!

Visitor medical insurance is rife with scams meant to trick people into buying something they don't understand. Most visitors insurance companies also know that since the insured is only in USA for a limited amount of time- there is no threat of litigation unless their family member takes it up. Visitors insurance which covers acute onset of pre-existing conditions will not pay claims!

Only INF offers an alternative to acute onset of pre-existing conditions coverage. INF offers the only full pre-existing visitors insurance option for parents. This means parents with pre-existing conditions have visitors insurance which will cover them for the "full scope" of medical services. INF Full Pre-Existing visitors insurance cover all pre-existing conditions. Full Pre-Existing visitors insurance covers the worsening of pre-existing conditions, have no look back period, and cover out-patient care for your visitors. This means you can visit any urgent care or specialist for any worsening pre-existing condition and it will be covered by INF's full pre-existing conditions plans.

Insurance is not something you can touch or feel. It's not something you can see. But it is something you can know. When we purchase an insurance policy, we are trying to cover our risks. We buy insurance to protect again unknown risks. In essence, we don't know what we don't know when it comes to the health of our visitors. Certain risks are avoidable, like slip and falls, cuts, and burns. But we never know when a pre-existing episode can take place. When it does- you want an insurance that works. You want INF.

Why should I go with INF vs. an Acute Onset Plan?

Why should I go with INF vs. an Acute Onset Plan?


Statistically speaking- INF claims data shows that there is a 1% chance of any true acute onset of pre-existing conditions event happening to your visitor during their stay. More than that, most visitors insurance policies are written such that they are able to exclude 99% of situations which could be considered pre-existing related.

Does your visitor feel lightheaded? You claim is denied as its related to their blood sugar level. Did your visitor contract a Urinary Tract Infection? Your claim is denied as other visitors insurance will consider that a worsening of pre-existing conditions. Moreover- when you look at the cost of American health care and compare it to the premiums of visitor insurance plans- it does not make sense what these companies are offering.

The average 65 year old pays $4300 out-of-pocket in health insurance expenses, according to a study by the Center for Retirement Research at Boston Colloege. Now compare this to your typical acute onset of pre-existing conditions visitors insurance premiums in that age group, which can start for as little as $28 per month. It should be clear that When you buy a cheap plan, you can expect cheap coverage. There's no free lunch in the USA. If you purchase a plan promising $1,000,000 coverage and it actually pays out anything close to that- you will be very lucky.

What's the difference between Acute Onset of Pre-Existing Conditions and Full Pre-Existing Visitors Insurance?


Acute Onset plans do not cover pre-existing conditions. They rarely cover emergencies in any capacity. If your visiting parents have chest pain, and you go to the emergency room- this is not covered by an Acute Onset of Pre-Existing condition plan. If your visiting parents have an asthma attack or an allergic reactions- these are also not covered under acute onset of pre-existing conditions.

Full Pre-Existing plans cover all pre-existing conditions. There is no time limit on when you can seek coverage, and there is no exclusions for any pre-existing condition. Full Pre-Existing plans cover you for any type of medical care related to a worsening pre-existing condition. This means if your mom or dad have arthritis and you need to visit a rheumatologist- this is going to be covered as per the policy.

To put your mind at ease- take a look at the exclusions in comparable plans, and compare them to INF Elite's exclusions. INF has a plain vanilla policy that does not sneak in any exclusions to prevent you from getting the coverage you want, and the peace of mind you need. Take a look for yourself at the exclusions of these other plans vs. INF: 
Atlas America -Exclusions
Excluded Conditions, Treatments (includes Diagnoses, Tests, and Examinations), Services, Supplies, Acts, Omissions, and/or Events:
  1. Pre-existing Conditions, except charges resulting directly from an Acute Onset of Pre-existing Condition, as herein defined, subject to the limits set forth in the Schedule of Benefits and Limits.
  2. Birth defects and congenital illnesses. Birth defects are deemed to include hereditary conditions.
  3. Mental health disorders.
  4. Pregnancy except as covered under Complications of Pregnancy, as herein defined, termination of pregnancy except in connection with covered Complications of Pregnancy, all charges related to pregnancy after the 26th week of pregnancy, routine prenatal care, child birth, postnatal care, and charges incurred by a child under the age of 14 days.
  5. Impotency or sexual dysfunction.
  6. All sexually transmitted diseases and conditions.
  7. HIV, AIDS, or ARC, and all diseases caused by and/or related to HIV.
  8. All forms of cancer / neoplasm.
  9. Substance abuse or addiction or conditions that may be attributed to substance abuse or addictions and direct consequences thereof.
  10. Acne, moles, skin tags, diseases of sebaceous glands, seborrhea, sebaceous cyst, hypertrophic and atrophic conditions of skin, nevus.
  11. Sleep apnea or other sleep disorders.
  12. Obesity or weight modification, including but not limited to wiring of the teeth and all forms of intestinal bypass surgery.
  13. Self-inflicted injury or illness and/or suicide or attempted suicide whether sane or insane.
  14. Injury sustained that is due wholly or partially to the effects of intoxication or drugs other than drugs taken in accordance with treatment prescribed by a physician and except drugs prescribed for the treatment of substance abuse.
  15. Injury sustained while operating any motorized vehicle, aircraft or watercraft whether registered or not while under the influence of alcohol as defined under the law of the jurisdiction where the injury occurs or with a .08 Blood Alcohol Content (BAC) whichever is lower.
  16. Routine medical examinations, including but not limited to vaccinations, immunizations, annual check- ups, the issue of medical certificates and attestations, and examinations as to the suitability of employment or travel.
  17. Dental treatment and treatment of the temporomandibular joint, except for emergency dental treatment necessary to replace sound natural teeth lost or damaged in an accident covered hereunder or for the emergency relief of acute onset of pain.
  18. Promotion or prevention of conception including but not limited to: artificial insemination, treatment for infertility, sterilization or reversal of sterilization.
  19. Organ or tissue transplants or related services.
  20. Eye surgery, such as corrective refractory surgery, when the primary purpose is to correct nearsightedness, farsightedness or astigmatism.
  21. Corrective devices and medical appliances, including eyeglasses, contact lenses, hearing aids, hearing implants, eye refraction, visual therapy, and any examination or fitting related to these devices, dentures or dental appliances, and all vision and hearing tests and examinations, except as provided for under Emergency Eye Exam.
  22. Orthoptics and visual eye training.
 
  1. Orthopedic shoes, orthopedic prescription devices to be attached to or placed in shoes, treatment of weak, strained, flat, unstable or unbalanced feet, metatarsalgia or bunions, and treatment of corns, calluses or toenails.
  2. Hair loss including wigs, hair transplants or any drug that promises hair growth, whether or not prescribed.
  3. Speech, vocational, occupational, biofeedback, acupuncture, recreational, sleep or music therapy, holistic care of any nature, massage and kinesiotherapy.
  4. Psychometric, intelligence, competency, behavioral and educational testing.
  5. Cosmetic or aesthetic reasons, except for reconstructive surgery when such surgery is directly related to and follows a surgery which was covered hereunder.
  6. Modifications of the physical body intended to improve the psychological, mental or emotional well- being, including but not limited to sex-change surgery.
  7. Exercise programs, whether or not prescribed or recommended by a physician.
  8. Incurred as a result of exposure to non-medical nuclear radiation and/or radioactive material(s).
  9. Cryo preservation and implantation or re-implantation of living cells.
  10. Genetic or predictive testing.
  11. Investigational, experimental or for research purposes.
  12. While confined primarily to receive custodial care, educational or rehabilitative care, or any medical treatment in any establishment for the care of the aged, except rehabilitative care received upon direct transfer from an acute care hospital.
  13. Not medically necessary.
  14. Not administered by or under the supervision of a physician, and products that can be purchased without a doctor's prescription.
  15. Provided by a relative, family member or any person who ordinarily resides with you.
  16. Provided at no cost to you.
  17. Telephone consultations or failure to keep a scheduled appointment.
  18. Payable under any government system, including the Australian Medicare system.
  19. Charges exceeding usual, reasonable and customary.
  20. Charges resulting from or occurring during the commission of a violation of law, including without limitation, the engaging in an illegal occupation or act, but excluding minor traffic violations.
  21. Charges resulting from a disease outbreak in a country or location for which the U.S. Centers for Disease Control and Prevention (CDC) has issued a Level 3 Travel Warning if a) the warning has been in effect within the 6 months immediately prior to your date of arrival, or b) within 10 days following the date the warning is issued you have failed to depart the country or location.
  22. War, military action or while on duty as a member of a police or military force unit.
  23. Travel or accommodations, except as provided for in the Local Ambulance, Emergency Medical Evacuation, Repatriation of Remains, Emergency Reunion, Natural Disaster, Return of Minor Children, Political Evacuation, Trip Interruption, Travel Delay, and Border Entry Protection sections of this insurance.
  24. Incurred outside your certificate period.
  25. Submitted to us for payment more than 60 days after the last day of the certificate period.
  26. When departure from the home country is to obtain treatment in the destination country/countries.
  27. Complications or consequences of a treatment or condition not covered hereunder.
  28. Not included as Eligible Expenses as described herein.

YOU ARE NOT COVERED IF:
  1. Any kidnapping or express kidnapping first occurs in Iraq, Afghanistan, Pakistan, Nigeria, Somalia, Venezuela or any country for which we are prohibited from transaction due to sanctions by the United States Department of the Treasury’s Office of Foreign Assets Control (OFAC).
  2. Any express kidnapping or kidnapping is a result of fraudulent, dishonest or criminal act(s) by you or an authorized representative (whether acting alone or in collusion with others) unless the person authorizing the ransom payment had, prior to payment, made every reasonable attempt to determine that the ransom demand or threat was genuine.
  3. Expenses arise directly or indirectly from anything in the General Exclusions.
YOU ARE NOT COVERED IF:
  1. The illness or injury giving rise to the expense is not covered under this insurance; or
  2. Medically necessary treatment, services and supplies can be provided locally; or
  3. If transportation by any other method would not result in the loss of your life or limb; or
  4. The condition giving rise to the Emergency Medical Evacuation did not occur spontaneously and without advance warning, either in the form of physician recommendation or symptoms which would have caused a prudent person to seek medical attention prior to the onset of the emergency; or
  5. Expenses are directly or indirectly from anything in the General Exclusions.
YOU ARE NOT COVERED IF:
  1. Accidents or loss caused by or contributed to by any of the following:
    1. Terrorism, war or act of war, whether declared or undeclared;
    2. Your participation in a riot, insurrection or violent disorder;
    3. Your service in the armed forces of any country;
    4. Suicide or attempted suicide or self-inflicted injury, while sane or insane;
    5. The voluntary use of any chemical compound, poison or drug, unless used according to the directions of a physician;
    6. Committing or attempting to commit a felony;
    7. Sickness, mental health disorder, or pregnancy;
    8. As the result of intoxication as defined by the laws of the jurisdiction in which the accident
occurred, whether directly or indirectly;
  1. Myocardial infarction or cerebrovascular accident (CVA / Stroke);
  2. Infection, except infection through a wound caused solely by an accident;
  3. Injury while riding, boarding, or alighting from an aircraft if you were operating the aircraft, learning to operate the aircraft, serving as a member of the aircraft crew, or if the aircraft was being used for any purpose other than passenger transportation;
  4. Medical or surgical treatment for any of the above; or m.Any non-covered sports activities.
  1. Expenses arise directly or indirectly from anything in the General Exclusions.
 
In no event will our 

YOU ARE NOT COVERED IF:
  1. The activity is organized athletics involving regular or scheduled practice and/or games; or
  2. The activity is performed in a professional capacity or for any wage, reward, or profit; or
  3. Expenses arise directly or indirectly from anything in the General Exclusions; or
  4. Any of the excluded items listed below:
 
  • All-Terrain Vehicles
  • American Football
  • Aussie Rules Football
  • Aviation (except when traveling solely as a passenger in a commercial aircraft)
  • Base Jumping
  • Big Game Hunting
  • Bobsleigh
  • Boxing
  • Cave Diving
  • Hang-Gliding
  • Heli-Skiing
  • Hot Air Ballooning as a Pilot
  • Ice Hockey
  • Jousting
  • Kite-Surfing
  • Luge
  • Martial Arts
  • Modern Pentathlon
  • Motorized Dirt Bikes
  • Mountaineering at elevations of 4,500 meters or higher
  • Outdoor Endurance Events
  • Parachuting
  • Paragliding
 
  • Parasailing
  • Powerlifting
  • Quad Biking
  • Racing by any Animal, Motorized Vehicle, or BMX, and Speed Trials and Speedway
  • Rugby
  • Running with the Bulls
  • Skeleton
  • Sky Surfing
  • Snow Skiing and Snowboarding, except recreational downhill and/or cross-country snow skiing or snowboarding (no cover provided while skiing away from prepared and marked in-bound territories and/or against the advice of the local ski school or local authoritative body)
  • Snow Mobiles
  • Spelunking
  • Sub Aqua Pursuits involving underwater breathing apparatus unless accompanied by a certified instructor at depths less than 10 meters, or PADI/NAUI certified
  • Tractors
  • Whitewater Rafting
  • Wrestling


YOU ARE NOT COVERED IF:
  1. You are traveling to the United States without a Visitor Visa B-2, or you are travelling illegally; or
  2. You are from a country named on any active executive order at the time of purchase; or
  3. You are on the United States terror watch list; or
  4. You were denied entry to the United States upon arrival or while en route to the United States because you have violated any rule, law, condition of or guideline regarding the visa upon which you are traveling; or
  5. You are visiting the United States for medical treatment, participation by amateurs in musical, sports, or similar events or contests, if compensation is received; or
  6. You are visiting the United States for studies that receive credits towards a degree; or
  7. You committed a crime en route or upon entry to the United States which caused or would have caused you to be returned to your country of origin; or
  8. The United States government or the common carrier has paid, offered to pay, or will pay for
your repatriation to your country of origin; or
  1. You have an unused return ticket or credit issued by the common carrier. If credit is not used, the amount reimbursed will be reduced by the amount of the credit.


YOU ARE NOT COVERED IF:
  1. The death occurs in your home country; or
  2. The Emergency Medical Evacuation or Repatriation of Remains benefit is used; or
  3. Expenses arise directly or indirectly from anything in the General Exclusions. 

YOU ARE NOT COVERED IF:
1. Expenses arise directly or indirectly from anything in the General Exclusions.
 
YOU ARE NOT COVERED IF:
  1. You are able to leave your host country by normal means, such as changing a commercial airline ticket; we will assist in rebooking flights or other transportation. Such expenses for non-emergency transportation are your responsibility.
  2. Expenses are directly or indirectly from anything in the General Exclusions.
 YOU ARE NOT COVERED IF:
  1. Loss, damage, cost or expense directly or indirectly caused by, resulting from or in connection with any of the following regardless of any other cause or event contributing concurrently or in any other sequence to the loss, damage, cost or expense:
    1. War, invasion, acts of foreign enemies, hostilities or warlike operations (whether war be declared or not), civil war, rebellion, revolution, insurrection, civil commotion assuming the proportions of or amounting to an uprising, military or usurped power; or
    2. The use of any biological, chemical, cyber, radioactive or nuclear agent, material, device or weapon; however, this exclusion shall not apply where you are exposed to nuclear radioactive and/or radioactive material for the purpose of medical treatment; or
    3. Aany Act of Terrorism, not specifically covered above; or
    4. Coverage for loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to (a), (b) or (c) above; or
    5. Expenses arise directly or indirectly from anything in the General Exclusions.
 


Patriot America Exclusions
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  1. Except as expressly provided for in the BENEFIT SUMMARY, all Charges, costs, expenses and/or claims incurred by the Insured Person, and any claim for death or dismemberment benefits, and directly or indirectly relating to or arising or resulting from or in connection with any of the following acts, omissions, events, conditions, Charges, consequences, claims, Treatment (including diagnoses, consultations, tests, examinations and evaluations related thereto), services and/or supplies are expressly excluded from coverage under this insurance, and the Company shall provide no benefits or reimbursements and shall have no liability or obligation for any coverage thereof or therefor:
  1. WAR; MILITARY ACTION: The Company shall not be liable for and will not provide coverage or benefits for any claim or Charges incurred with respect to any Illness, Injury, death and dismemberment, or other consequence, whether directly or indirectly, proximately or remotely occasioned by, contributed to by, or traceable to or arising or incurred in connection with or as a result of any of the following acts or occurrences:
    1. war, invasion, act of foreign enemy hostilities, warlike operations (whether war be declared or not), or civil war
    2. mutiny, riot, strike, military or popular uprising, insurrection, rebellion, revolution, military or usurped power
    3. 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 de jure or de facto or to the influencing of it by violence of any type
    4. martial law or state of siege or any events or causes which determine the proclamation or maintenance of martial law or state of siege
    5. any use of radiological, chemical, nuclear or biological weapons or any other radiological, chemical, nuclear or biological events of any type (including in connection with an act of Terrorism).
Any claim, Charges, Illness, Injury or other consequence happening or arising during the existence of abnormal conditions (whether physical or otherwise), whether or not directly or indirectly, proximately or remotely occasioned by, or contributed to by, traceable to, or arising in connection with, any of the said occurrences shall be deemed and considered to be consequences for which the Company shall not be liable under the Master Policy or this Certificate, except to the extent that the Insured Person shall prove that such claim, Charges, Illness, Injury or other consequence happened independently of the existence of such abnormal conditions and/or occurrences.
  1. TERRORISM: The Company shall not be liable for and will not provide coverage or benefits in excess of the amount shown in the BENEFIT SUMMARY for any claim or Charges, Illness, Injury or other consequence, whether directly or indirectly, proximately or remotely occasioned by, contributed to by, or traceable to or arising in connection with any act of Terrorism. Further, the Company shall not be liable for and will not provide any coverage or benefits for any claim, Charges, Illness, Injury or other consequence, whether directly or indirectly, proximately or remotely occasioned by, contributed to by, or traceable to or arising in connection with the following:
    1. the Insured Person’s active and voluntary planning or coordination of or participation in any act of Terrorism

  1. any act of Terrorism that takes place in a location, post, area, territory or country for which a Travel Warning or Emergency Travel Advisory was issued or in effect on or within six (6) months prior to the Insured Person’s date of arrival in said location, post, area, territory or country
  2. any act of Terrorism that takes place in a location, post, area, territory or country for which a Travel Warning or Emergency Travel Advisory becomes effective or is in effect on or after the Insured Person’s date of arrival in said location, post, area, territory or country, and the Insured Person unreasonably fails or refuses to heed such warning and thereafter remains in said location, post, area, territory or country.
  1. PRE-EXISTING CONDITIONS: Charges resulting directly or indirectly from or relating to any Pre-existing Condition are excluded from coverage under this insurance.
  2. MATERNITY AND NEWBORN CARE: Charges for pre-natal care, delivery, post-natal care, and care of Newborns, including complications of Pregnancy, miscarriage, complications of delivery and/or of Newborns are excluded from this insurance.
  3. MENTAL OR NERVOUS DISORDERS: Charges for Treatment of Mental or Nervous Disorders are excluded from coverage under this insurance.
  4. PREVENTATIVE CARE: Charges for Routine Physical Examinations and immunizations are excluded from coverage under this insurance.
  5. Charges for any Treatment or supplies that are:
    1. not incurred, obtained or received by an Insured Person during the Period of Coverage
    2. not presented to the Company for payment by way of a completed Proof of Claim within one hundred eighty (180) days from the date such Charges are incurred
    3. not administered or ordered by a Physician
    4. not Medically Necessary for the diagnosis, care or Treatment of the physical condition involved. This also applies when and if they are prescribed, recommended or approved by the attending Physician
    5. provided at no cost to the Insured Person or for which the Insured Person is not otherwise liable
    6. in excess of Usual, Reasonable and Customary
    7. related to Hospice Care
    8. incurred by an Insured Person who was HIV + on or before the Initial Effective Date of this insurance, whether or not the Insured Person had knowledge of his/her HIV status prior to the Effective Date, and whether or not the Charges are incurred in relation to or as a result of said status. This exclusion includes Charges for any Treatment or supplies relating to or arising or resulting directly or indirectly from HIV, AIDS virus, AIDS related Illness, ARC Syndrome, AIDS and/or any other Illness arising or resulting from any complications or consequences of any of the foregoing conditions
    9. provided by or at the direction or recommendation of a chiropractor, unless ordered in advance by a Physician
    10. performed or provided by a Relative of the Insured Person
    11. not expressly included in the ELIGIBLE MEDICAL EXPENSES provision
    12. provided by a person who resides or has resided with the Insured Person or in the Insured Person's home
    13. required or recommended as a result of complications or consequences arising from or related to any Treatment,
Illness, Injury, or supply excluded from coverage or which is otherwise not covered under this insurance
  • for Congenital Disorders and conditions arising out of or resulting therefrom
  1. Charges incurred for failure to keep a scheduled appointment
  2. Telemedicine consultations through an established Telemedicine protocol system will be considered individually based on medical necessity and appropriateness as determined by the Company under the plan
  3. Charges incurred for Surgeries, Treatment or supplies which are Investigational, Experimental and for research purposes
  4. Charges incurred related to genetic medicine, genetic testing, surveillance testing and/or wellness screening procedures for genetically predisposed conditions indicated by genetic medicine or genetic testing, including, but not limited to amniocentesis, genetic screening, risk assessment, preventive and prophylactic surgeries recommended by genetic testing, and/or any procedures used to determine genetic pre-disposition, provide genetic counseling, or administration of gene therapy
  5. Charges incurred for testing that attempts to measure aspects of an Insured Person’s mental ability, intelligence, aptitude, personality and stress management. Such testing may include but is not limited to psychometric, behavioral and educational testing
  6. Charges incurred for Custodial Care

  1. Charges incurred for Educational or Rehabilitative Care that specifically relates to training or retraining an Insured Person to function in a normal or near-normal manner. Such care may include but is not limited to job or vocational training, counseling, occupational therapy and speech therapy
  2. Charges for weight modification or any Inpatient, Outpatient, Surgical or other Treatment of obesity (including without limitation morbid obesity), including without limitation wiring of the teeth and all forms or procedures of bariatric Surgery by whatever name called, or reversal thereof, including without limitation intestinal bypass, gastric bypass, gastric banding, vertical banded gastroplasty, biliopancreatic diversion, duodenal switch, or stomach reduction or stapling
  3. Charges for modification of the physical body in order to change or improve or attempt to change or improve the physical appearance or psychological, mental or emotional well-being of the Insured Person (such as but not limited to sex-change Surgery or Surgery relating to sexual performance or enhancement thereof)
  4. Charges or Treatment for cosmetic or aesthetic reasons, except for reconstructive Surgery when such Surgery is Medically Necessary and is directly related to and follows a Surgery which was covered under this insurance
  5. elective Surgery or Treatment of any kind
  6. Charges incurred for any Treatment or supply that either promotes or prevents or attempts to promote or prevent conception, insemination (natural or otherwise) or birth, including but not limited to: artificial insemination; oral contraceptives; Treatment for infertility or impotency; vasectomy; reversal of vasectomy; sterilization; reversal of sterilization; surrogacy or abortion
  7. Charges incurred for any Treatment or supply that either promotes, enhances or corrects or attempts to promote, enhance or correct impotency or sexual dysfunction
  8. any Illness or Injury sustained while taking part in, practicing or training for: Amateur Athletics; Professional Athletics; or athletic activities that are sponsored by any Governing Body or Authority, including the National Collegiate Athletic Association, any other collegiate sanctioning or Governing Body or the International Olympic Committee
  9. any Illness or Injury sustained while taking part in activities designated as Adventure Sports, which are limited to the following: abseiling; BMX; bobsledding; bungee jumping; canyoning; caving; hot air ballooning; jungle zip lining; parachuting; paragliding; parascending; rappelling; skydiving; spelunking; wildlife safaris; and windsurfing
  10. any Illness or Injury sustained while taking part in activities designated as Extreme Sports, which include but are in no way limited to the following (and include any combination or derivative of the following): BASE jumping; cave diving; cliff diving; downhill mountain biking and racing; extreme skiing; freediving; free flying; free running; free skiing; freestyle scootering; gliding; heli-skiing; ice canoeing; ice climbing; kitesurfing; mixed martial arts; motocross; motorcycle racing; motor rally; mountaineering above elevation of 4500 meters from ground level; parkour; piloting a commercial or non-commercial aircraft; powerbocking; scuba diving or sub aqua pursuits below a depth of 50 meters; snowmobile racing; truck racing; whitewater kayaking or whitewater rafting Class VI and higher difficulty; and wingsuit flying
  11. any Illness or Injury sustained while taking part in snow skiing, snowboarding or snowmobiling where the Insured Person is in violation of applicable laws, rules or regulations of a ski resort, out of bounds or in unmarked or unpatrolled areas
  12. any Illness or Injury sustained while taking part in backcountry skiing
  13. any Illness or Injury sustained while taking part in skiing off-piste
  14. any Illness or Injury sustained while taking part in Collision Sports
  15. any Illness or Injury sustained while taking part in athletic or recreational activities where the Insured Person is not physically or medically fit or does not hold the necessary qualifications to engage in said activities
  16. any Illness or Injury sustained while participating in any sporting, recreational or adventure activity where such activity is undertaken against the advice or direction of any local authority or any qualified instructor or contrary to the rules, recommendations and procedures of a recognized Governing Body for the sport or activity
  17. any Illness or Injury sustained while participating in any activity where such activity is undertaken in disregard of or against the recommendations, Treatment programs, or medical advice of a Physician or other healthcare provider
  18. any Injury or Illness sustained as a result of being under the influence of or due wholly or partly to the effects of alcohol, liquor, intoxicating substance, narcotics or drugs other than drugs taken in accordance with Treatment prescribed and directed by a Physician but not for the Treatment of Substance Abuse
  19. any Injury or Illness sustained while operating a moving vehicle after consumption of intoxicating liquor or drugs in excess of the applicable blood/alcohol legal limit, other than drugs taken in accordance with Treatment prescribed and directed by a Physician. For purposes of this exclusion, “vehicle” shall include motorized devices regardless of whether or not a driver or operator license is required (including watercraft and aircraft) and non-motorized bicycles and scooters for which no permit or license is required
  20. any willfully Self-inflicted Injury or Illness
  21. any sexually transmitted or venereal disease
  22. any testing for the following when not Medically Necessary: HIV, seropositivity to the AIDS virus, AIDS-related Illnesses, ARC Syndrome, AIDS

  1. any Illness or Injury resulting from or occurring during the commission of a violation of law by the Insured Person, including, without limitation, the engaging in an illegal occupation or act, but excluding minor traffic violations
  2. any Substance Abuse
  3. biofeedback, acupuncture, music, occupational, recreational, sleep, speech, or vocational therapy
  4. orthoptics, visual therapy or visual eye training
  5. any non-surgical Illness or Treatment of the feet, including without limitation: orthopedic shoes; orthopedic prescription devices to be attached to or placed in shoes; Treatment of weak, strained, flat, unstable or unbalanced feet; metatarsalgia, bone spurs, hammer toes or bunions; and any Treatment or supplies for corns, calluses or toenails; except as otherwise expressly set forth
  6. hair loss, including without limitation wigs, hair transplants or any drug that promises to promote hair growth, whether or not prescribed by a Physician
  7. any sleep disorder, including without limitation sleep apnea
  8. any exercise and/or fitness program or equipment, whether or not prescribed or recommended by a Physician
  9. any exposure to any non-medical nuclear or atomic radiation, and/or radioactive material(s)
  10. any organ or tissue or other transplant or related services, Treatment or supplies
  11. any artificial or mechanical devices designed to replace human organs temporarily or permanently after termination of Inpatient status
  12. any efforts to keep a donor alive for a transplant procedure
  13. any Illness or Injury incurred in the Destination Country as a result of epidemics, pandemics, public health emergencies, Natural Disasters, or other disease outbreak conditions that may affect a person’s health when, prior to the Insured Person’s entry into the Destination Country, any of the following were issued regarding the Destination Country
    1. the World Health Organization had issued an Emergency Travel Advisory
    2. the United States Centers for Disease Control & Prevention had issued a Warning Level 3 (avoid nonessential travel)
    3. a similar governmental agency of the Insured Person’s Country of Residence had published, communicated or issued a Travel Warning or Emergency Travel Advisory restriction or official declaration informing the public about such health issues before the Insured Person traveled to the Destination Country
  14. Charges incurred for eyeglasses, contact lenses, hearing aids or hearing implants and Charges for any Treatment, supply, examination or fitting related to these devices, or for eye refraction for any reason, except as otherwise expressly provided for hereunder
  15. Charges incurred for eye Surgery, such as but not limited to radial keratotomy, when the primary purpose is to correct or attempt to correct nearsightedness, farsightedness, or astigmatism
  16. Charges incurred for Treatment or supplies for temporomandibular joint (TMJ) including but not limited to TMJ syndrome, craniomandibular syndrome, chronic TMJ pain, orthognathic Surgery, Le-Fort Surgery or splints
  17. Charges incurred in the Insured Person’s Country of Residence, except as otherwise expressly provided for in this insurance
  18. Charges incurred for any travel, meals, transportation and/or accommodations, except as otherwise expressly provided for in this insurance
  19. Charges or expenses incurred for nonprescription drugs, medicines, vitamins, food extracts, or nutritional supplements; IV vitamin or herbal therapy; drugs or medicines not approved by the United States Food and Drug Administration or which are considered “off-label” drug use; and for drugs or medicines not prescribed by a Physician
  20. any infection of the urinary tract (including, without limitation, infection of the kidney, ureter, bladder, prostate or urethra) and any complication, medical condition or other Illness directly or indirectly arising therefrom, that occurs within ninety (90) days of the Effective Date of this Insurance and that requires Treatment of the Insured Person in a Hospital as an Inpatient
  21. Charges and all costs related to or arising from or in connection with all trips to the Destination Country undertaken for the purpose of securing medical Treatment or supplies
  22. Charges incurred for Dental Treatment, except as specifically provided for hereunder
  23. Wear and tear of teeth due to cavities and chewing or biting down on hard objects, such as but not limited to pencils, ice cubes, nuts, popcorn, and hard candies
  24. Dental Injury without associated face, skull, neck and/or jaws Injury or that can be evaluated and Treated in a dental office
  25. Dental Treatment for services which provide oral care maintenance including tooth repair by fillings, root canals, tooth removal and x-rays

  1. Charges for Treatment of an Illness or Injury for which payment is made or available through a workers' compensation law or a similar law
  2. Charges incurred for massage therapy
  3. Charges incurred for Personal Liability legal fees or out-of-pocket costs associated and/or related to the determination and/or settlement of a legal liability
  4. Accidental Death or Dismemberment when the Insured Person’s death or dismemberment is caused directly or indirectly by, results from, or where there is a contribution from, any of the following:
    1. bodily or mental infirmity, Illness or disease
    2. infection, other than infection occurring simultaneously with, and as a direct result of, the accidental Injury.
Safe Travels usa - Exclusions
We will not pay for any Accidental Death, Dismemberment or Paralysis loss or Injury that is caused by, or results from:
  1. intentionally self-inflicted Injury.
  2. suicide or attempted suicide.
  3. war or any act of war, whether declared or not (except as provided by the Policy).
  4. service in the military, naval or air service of any country.
  5. disease or bacterial infection except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food.
  6. hernia of any kind.
  7. piloting or serving as a crewmember or riding in any aircraft except as a passenger on a regularly scheduled or charter airline.
  8. commission of, or attempt to commit, a felony.
  9. 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.
  10. 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.
  11. 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.
  12. All professional, semi-professional, amateur, club, intramural, interscholastic or intercollegiate 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:
  1. Pre-Existing Conditions, as defined.
  2. Acute Onset of Pre-Existing condition, as defined, where treatment is obtained after the 24 hour period from the initial Acute Onset.
  3. services, supplies or treatment, including any period of Hospital confinement, which were not recommended, approved and certified as necessary and reasonable by a Physician.
  4. suicide or any attempt thereat while sane or self-destruction or any attempt thereat while insane.
  5. Injury sustained while participating in a professional, semi-professional, amateur, club, intramural, interscholastic or intercollegiate

sport (except as provided by the Athletic Sport Rider).
  1. Sickness resulting from pregnancy (except as provided by Emergency Medical Treatment of Pregnancy).
  2. Miscarriage resulting from Accident (except as provided by Emergency Medical Treatment of Pregnancy).
  3. 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 specifically provided for in this policy.
  4. cosmetic orplastic surgery, except as the result ofan accident.
  5. elective surgery which can be postponed until the Covered Person returns to his or her Home Country.
  6. any mental or nervous disorders or rest cures (except as provided in the Schedule by Mental or Nervous Disorders Charges).
  7. any dental treatment (except as provided by the for Dental Treatment for Injury and Emergency alleviation of pain).
  8. 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.
  9. congenital anomalies and conditions arising out of or resulting therefrom.
  10. services, supplies, or treatment expenses which are non-medical in nature.
  11. 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.
  1. expenses as a result of or in connection with an intentionally self-inflicted Injury.
  2. 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.
  3. treatment paid for or furnished under any other individual or group policy, or other service or medical pre payment 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.
  4. childbirth, miscarriage, birth control, artificial insemination, treatment for fertility or impotency, sterilization or reversal thereof or abortion.
  5. organ transplants, marrow procedures and chemotherapy.
  6. any sexually transmitted or venereal disease; and/or any testing for the following: HIV, Vaccine induced seropositivity to the AIDS virus, AIDS related Illnesses, ARC Syndrome, AIDS.
  7. any treatment, service or supply not specifically covered by the Policy.
  8. treatment by any Family Member or member of the Covered Person’s household.
  9. treatment of hernia; Osgood-Schlatter’s Disease; osteochondritis; osteomyelitis; congenital weakness whether or not caused by a  Covered Accident.
  10. expense incurred for treatment of temporomandibular or cranio-mandibular joint dysfunction and associated myofascial pain.
  11. any 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.
  12. 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.
  13. treatment or service provided by a private duty nurse or while confined primarily to receive custodial care, educational or rehabilitative care or nursing care.
  14. covered medical expenses for which the Covered Person would not be responsible for in the absence of the Policy.
  15. conditions that are not caused by a Covered Accident.
  16. vocational, recreational, speech or music therapy.
  17. 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.
  18. 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.
  19. Expenses incurred in your Home Country (unless Home Country Coverage was purchased).
  20. Any infection of the urinary tract (including, without limitation, infection of the kidney, ureter, bladder, prostate or urethra) and any complication, medical condition or other Illness directly or indirectly arising therefrom, that occurs within ninety (90) days of the Effective Date of this Insurance and that requires Treatment of the Insured Person in a Hospital as an inpatient.
  21. declared or undeclared war or any act thereof.
  22. Payment for any medical services related to an illness when an Insured Person leaves a medical facility against medical advice.
 
We will not pay Political Evacuation Expense Benefits for expenses and fees:
  1. payable under any other provision of the Policy.
  2. that are recoverable through the Covered Person’s employer.
  3. arising from or attributable to an actual fraudulent, dishonest or criminal act committed or attempted by the Covered Person, acting alone or in collusion with other persons.
  4. arising from or attributable to an alleged:
    1. violation of the laws of country in which the Covered Person is traveling while covered under the Policy; or
    2. violation of the laws of the Covered Person’s Home County or country of residence.
  5. due to the Covered Person’s failure to maintain and possess duly authorized and issued required travel documents and visas.
  6. for repatriation of remains expenses.
  7. for common or endemic or epidemic diseases or global pandemic disease as defined by the World Health Organization.
  8. for medical services.
  9. for monies payable in the form of a ransom, if a Missing Person case evolves into a kidnapping.
  10. arising from or attributable, in whole or in part, to: a. a debt, insolvency, commercial failure, the repossession of any property by any title holder or lien holder or any other financial cause; b. non-compliance by the Covered Person with regard to any obligation specified in a contract or license.
  11. due to military or political issues if the Covered Person’s Security Evacuation request is made more than 30 days after the
Seven Corners Plans exclusions
Exclusions. You shall have no benefits or coverages for and the Company shall have no liability or obligation of any kind to pay or reimburse You or any third person or Relative for, any changes, fees (including attorneys’ fees), costs, expenses, damages, losses, judgments, claims or other liabilities incurred or sustained by or assessed against You or any third person or Relative, if directly or indirectly relating to, arising from or in connection with any of the following acts, omissions, events, conditions, charges, consequences, occurrences or circumstances, all of which are expressly excluded from coverage under this Insurance and all of which the Company will provide no benefits or coverages for and shall have no liability or obligation for same, and the Company will not pay or reimburse You or any third person or Relative for any claims of any kind arising directly or indirectly from, happening through or as a consequence of:
  1. Any damages, losses or claims caused in whole or in part by You during any hunt or as a result of hunting;
 
  1. Any criminal, fraudulent, deceptive, willful, reckless, malicious, or other unlawful acts or omissions committed by You or any acts or omissions committed by You in connection with the violation or breach of any laws, statutes, ordinances, legal orders, rules or regulations to which You are subject or by which You are bound;
  2. Any loss, damage, or claim arising or resulting from the use of any firearms, fireworks, explosives, welding equipment, propane tanks, or other flammables, deadly weapons, or hazardous implements;
  3. The pursuit of any trade, business, profession, or employment activity;
  4. Ownership, possession, control, or occupation of any land or building;
  5. Ownership, possession, control, or use of any automobile, motorcycle, ATV, off-road vehicle, watercraft, aircraft, parachute, parasail, glider, or any other motorized, gravity-induced, or self- propelled vehicle or craft of any kind;
  6. Resulting from any fire, flood, wind, hail, water leak, gas leak, explosion, or other catastrophe or loss occurring in or about the residence or premises of any Relative, or in or about the residence or any other premises of which You are the owner, lessee, invitee, licensee, occupant, or Resident, or in or about any residence or premises which are contiguous or adjacent to any of the foregoing residences or premises;
  7. The consequences of any breach, violation, or failure to perform any contractual undertakings or obligations of You, whether verbal or in writing;
  8. Criminal or disciplinary proceedings, charges, arrests, indictments, or arraignments of any kind;
  9. Shoplifting, vandalism, theft, conversion, misappropriation, public drunkenness, fighting or brawling, arson, or any malicious or intentional activity resulting in personal injury or destruction of property;
  10. Gross negligence, fraud, bad faith, assault and battery, domestic disputes, and all other intentional torts or actions based or sounding in tort without regard to how named or presented;
  11. Any collusion, conspiracy, deceit, or other fraudulent scheme or artifice to defraud or other fraudulent means or methods;
  12. Fines, penalties, assessments, or claims by any governmental authorities or regulatory bodies including traffic fines or traffic violations or parking tickets, and the costs, fees, or expenses incurred by You as a witness, custodian, or in any other non-party status in connection with responding to any order to appear in court, subpoena, subpoena duces tecum, notice of deposition, or any other nonparty legal or administrative proceeding or activity;
  13. All non-compensatory damages including, without limitation, damages imposed as a punishment, punitive or exemplary damages, consequential damages, lost profits, criminal damages, excessive damages, expectancy damages, incidental damages, liquidated damages, presumptive damages, prospective damages, special damages, speculative damages, statutory damages, double, treble or other multiples of damages, and/or unliquidated damages, and all claims and damages for pain and suffering, loss of consortium, physical discomfort, mental or emotional distress, trauma, disfigurement, dismemberment, loss of use, or scarring;
  14. Contractual or employer’s liability or workman’s compensation claims;
  15. Animals or pets belonging to You or any Relative, or in the care, custody, or control of You or any Relative;
  16. Intentionally committed acts caused or brought about by You;
  17. Arising or occurring while You are, to any extent, under the influence of alcohol or drugs or due to Your use of drugs, prescription medicines, narcotics, or tranquilizers not medically prescribed for You by a licensed physician;
  18. Caused by Your suicide or attempted suicide;
  19. Your participation in gambling, gaming, or betting of any kind;
  20. Your participation in any fights, brawls, criminal activity, or other unlawful activity;
  21. During the practice or participation of sports, recreational endeavors, or Athletics either as a professional, amateur or novice, unless performed solely for recreational purposes or during high school activities;
 
  1. Hazardous Activities;
  2. Occurring when You are a passenger in an aircraft other than a commercial aircraft;
  3. War, Hostilities, and War-Like Operations;
  1. Thermal, mechanic, radioactive, and other effects due to any modification of the atomic structure of matter or the artificial acceleration of atomic particles or due to radiation from radio-isotopes or the use of nuclear or chemical materials;
(aa) Judgments or damage awards that have not been ordered, declared, or entered within twelve (12) months from the date of the act, omission, occurrence, or event causing personal injury or property damage or within twelve (12) months from the date of termination of group coverage under the Certificate, whichever is earlier;
(bb) Any lawsuit, claim for benefits, enforcement action, complaint, or other civil or administrative proceeding of any kind brought by or on behalf of You or any third person or Relative against the Company, the Administrator, or the Participating Organization including, without limitation, any lawsuit or proceeding alleging breach of contract, bad faith, or any tortuous conduct of any kind, seeking equitable or declaratory relief, or otherwise seeking the recovery, enforcement or effectuation of any benefits or coverages under this Insurance;
(cc) Any loss, personal injury, property damage, or other claim arising or  resulting  from any  act, omission, failure to act, event or other occurrence committed or occurring at any time prior to or subsequent to the Period of Coverage; or
(dd) Any personal injury, medical expense, damage or other loss suffered by a  Relative except for  damage to a Relative’s personal property, which shall be limited to a maximum of $2,500 and subject to the per Injury/Illness Deductible set forth in the Schedule of Benefits.

ECTION 8. EXCLUSIONSUnless otherwise specifically provided for therein, the coverage provided by the Certificate under Sections 3.2 through 3.5, 3.8, 3.9, 4.1, 4.2, 5.1 through 5.6, 5.8, 6.2, 6.3, 6.5, and 7 excludes Expenses that are for, resulting from, related to, or incurred for the following:
  1. Pre-Existing Condition(s) except as waived under Sections 3.10 and 3.11 above.
  2. Claims not received by the Company or Administrator within ninety (90) days of the date of service:
  1. Treatment that (i) exceeds Usual, Reasonable, and Customary Expenses; (ii) is Investigational, Experimental, or for research purposes; or (iii) received in a Hospital emergency room visit that is not a Medical Emergency;
  2. Treatment, services, or supplies that are not administered by or under the supervision of a Physician or Surgeon and products that can be purchased without a Physician’s or Surgeon’s prescription;
 
  1. Routine physicals, inoculations, or other examinations or tests conducted when there is no objective indications or impairments in normal health;
  2. Chiropractic care or acupuncture;
    1. Services, supplies, medications, testing, or Treatment prescribed, performed, or provided by a Relative or Immediate Family Member;
  3. Durable medical equipment;
  1. False teeth, dentures, dental appliances, dental expenses, normal ear or hearing tests, hearing aids, hearing implants, eye refractions, eye examinations for prescribing corrective lenses or eye- glasses unless caused by Accidental Injury, eyeglasses, contact lenses, or eye surgery when the primary purpose is to correct nearsightedness, farsightedness, or astigmatism;
  2. Replacement of artificial limbs, eyes, larynx, and orthotic appliances;
  3. Custodial Care, Educational or Rehabilitative Care, or any Treatment in any establishment for the care of the aged;
  4. Vocational, occupational, sleep, speech, recreational, or music therapy;
  5. Pregnancy, Illness or complications from Pregnancy, childbirth, abortion, miscarriage including that resulting from an Accident, postnatal care, preventing conception or childbirth, artificial insemination, infertility, impotency, sexual dysfunction, or sterilization or reversal thereof;
  6. Sleep apnea or other sleep disorders;
    • Mental and Nervous Disorder, Rest Cures, learning disabilities, attitudinal disorders, or disciplinary problems;
  7. Congenital abnormalities and conditions arising out of or resulting therefrom.
  8. Temporomandibular joint;
  9. Occupational Diseases;
  10. Exposure to non-medical nuclear radiation or radioactive materials;
  11. Sexually-transmitted diseases, venereal diseases, and conditions and any consequences thereof;
    1. Acquired Immune Deficiency Syndrome (AIDS), AIDS-Related Complex (ARC), or the Human Immunodeficiency Virus (HIV);
  12. Human organ or tissue transplants.
  13. Exercise programs whether prescribed or recommended by a Physician or therapist;
    1. Weight reduction programs or the surgical Treatment of obesity including, but not limited to, wiring of the teeth and all forms of intestinal bypass Surgery;
  14. Cosmetic or plastic Surgery including deviated nasal septum; modifications of Your physical body intended to improve Your psychological, mental, or emotional well-being including, but not limited to, sex-change Surgery;
  15. Acne, moles, skin tags, disease of sebaceous glands, seborrhea, sebaceous cyst, unspecified disease of the sebaceous glands, hypertrophic and atrophic conditions of skin, nevus;
(aa)         Hazardous Activities unless You purchase optional hazardous activities coverage and then only for the activities covered under that option under Section 7;
(bb) Injuries sustain while participating in professional Athletics, amateur Athletics, or interscholastic Athletics including, but not limited to, events, games, matches, practice, training camps, sport camps, conditioning, and any other activity related thereto but excluding non-competitive, recreational, or intramural activities;
(cc)  Abuse, misuse, illegal use, overuse, dependency upon, or being under the influence of alcohol,   drugs, chemicals, or narcotic agents unless administered under the advice of a Physician and taken in accordance with the proper dosing as directed by the Physician;
(dd)         Suicide or any attempt thereof; self-destruction or any attempt thereof; or any intentionally self- inflicted Injury or Illness;
(ee)         Terrorist Activity except as provided under Section 5.10; War, Hostilities, or War-Like Operations; (ff)            Commission of a criminal offense or any other criminal or illegal activity as defined by the local
governing body;
(gg)   You unreasonably fail or refuse to depart a country or location following the date a warning to   leave that country or location is issued by the United States government or similar warnings issued by other appropriate authorities of either Your Host Country or Your Home Country;

(hh)         Service in the military, naval, coast guard, or air service of any country or while on duty as a member of a police force or unit;
(ii)           Treatment paid for or furnished under any other individual, government, or group policy or Expenses incurred at no cost to You;
(jj)           You while in Your Home Country unless covered under Section 3.8 or 3.9;
(kk)         Conditions for which travel was undertaken to seek Treatment after Your Physician has limited or restricted travel;
(ll)           Travel accommodations;
(mm)       Injury sustained while You are riding as a pilot, student pilot, operator, or crew member, in or on, boarding or alighting, from any type of aircraft;
(nn) Injury sustained while You are riding as a passenger in any aircraft (i) not having a current and valid Airworthy Certificate and (i) not piloted by a person who holds a valid and current certificate of competency for piloting such aircraft;
(oo) Flying in any aircraft being used for acrobatic or stunt flying, racing, endurance tests, rocket- propelled aircraft, crop dusting or seeding or spraying, firefighting, exploration, pipe or power line inspection, any form of hunting or herding, aerial photography, banner towing, or any experimental purpose; and
(pp)         Participating in contests of speed or riding or driving in any type of competition. (qq)        Loss of life;
(rr)          Long-term disability; or
(ss)          Financial guarantee, financial default, bankruptcy, or insolvency risks.
INF Elite Exclusions

We will not pay benefits for any 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.
  • a Covered Accident that occurs while a Covered Person is on active duty service in the military, naval or air force of any country or international organization. Upon receipt of proof of service, we will refund any premium paid for this time. Reserve or National Guard active duty training is not excluded unless it extends beyond 31 days.
  • piloting or serving as a crew member in any aircraft (unless otherwise provided in the Policy).
  • riding in any aircraft except as a fare-paying passenger on a regularly scheduled or charter airline
  • commission of, or attempt to commit, a felony.
  • sickness, disease, bodily or mental infirmity, bacterial or viral infection, or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food (Applicable to accident benefits only).
  • the Covered Person being legally intoxicated as determined according to the laws of the jurisdiction in which the Injury occurred.
  • commission of or active participation in a riot or insurrection.
  • In addition, We will not pay Medical Expense Benefits for any loss, treatment, or services resulting from:
  • routine physicals and care of any kind.
  • routine dental care and treatment.
  • routine nursery care.
  • cosmetic surgery, except for re constructive surgery needed as the result of an Injury.
  • eye refractions or eye examinations for the purpose of prescribing corrective lenses or for the fitting thereof; eyeglasses, contact lenses, and hearing aids​
  • services, supplies, or treatment including any period of Hospital confinement which is not recommended, approved, and certified as Medically Necessary and reasonable by a Doctor, or expenses which are non-medical in nature.
  • treatment or service provided by a private duty nurse.
  • treatment by any Immediate Family Member or member of the Insured’s household. “Immediate Family Member” means a Covered Person’s spouse, child, brother, sister, parent, grandparent, or in-laws.
  • Pregnancy (unless treatment is required as a result of a Medical Emergency), childbirth, miscarriage, abortion or any complications of any of these conditions.
  • expenses incurred during travel for purposes of seeking medical care or treatment, or for any other travel that is not in the course of the Policyholder’s activity (unless Personal Deviations are specifically covered).
  • medical expenses for which the Covered Person would not be responsible to pay for in the absence of the Policy. Expenses incurred for services provided by any government Hospital or agency, or government sponsored-plan for which, and to the extent that, the Covered Person is eligible for reimbursement.
  • any treatment provided under any mandatory government program or facility set up for treatment without cost to any individual.
  • services or expenses incurred in the Covered Person’s Home Country.
  • elective treatment, exams or surgery; elective termination of pregnancy.
  • expenses for services, treatment or surgery deemed to be experimental and which are not recognized and generally accepted medical practices in the United States.
  • expenses payable by any automobile insurance policy without regard to fault.
  • organ or tissue transplants and related services.
  • Preexisting Conditions, unless otherwise provided in the Policy.
  • Any expense paid or payable by any other valid and collectible group insurance plan.
  • Injury or Sickness for which benefits are paid or payable under any Workers' Compensation or Occupational Disease Law or Act, or similar legislation, whether United States federal or foreign law.
  • Injury sustained while participating in club, intramural, intercollegiate, interscholastic, professional or semi-professional sports.
  • expenses incurred for services related to the diagnostic treatment of infertility or other problems related to the inability to conceive a child, including but not limited to, fertility testing and in-vitro fertilization.
  • expenses incurred in connection with weak, strained or flat feet, corns, calluses or toenails.
  • expenses incurred for birth control including surgical procedures and devices.
  • birth defects and congenital anomalies, or complications which arise from such conditions.
  • sexually transmitted diseases or immune deficiency disorders and related conditions. This exclusion does not apply to the care or treatment of Acquired Immune Deficiency Syndrome (AIDS), AIDS Related Complex (ARC), or Human Immunodeficiency Virus (HIV) infection, or any illness or disease arising from these medical conditions​

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