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Exclusions

 

    1. Intentionally self-inflicted Injury.
    2. Suicide or attempted suicide while sane.
    3. War or any act of war, whether declared or not.
    4. Service in the military, naval or air service of any country.
    5. Piloting or serving as a crewmember or riding in any aircraft(for Accident Death and Dismemberment benefit only);
    6. Commission of, or attempt to commit, a felony, an assault or other illegal activity.
    7. Commission of or active participation in a riot, or insurrection.
    8. Bungi-cord jumping, parachuting, skydiving, parasailing, hang-gliding;(for Accident Death and Dismemberment benefit only);
    9. Flight in, boarding or alighting from an Aircraft. except as a fare-paying passenger on a regularly scheduled commercial airline (for Accident Death and Dismemberment only).
    10. Travel in or on any on-road and off-road motorized vehicle not requiring licensing as a motor vehicle (for Accident Death and Dismemberment benefit only);
    11. An accident if the Covered Person is the operator of a motor vehicle and does not possess a valid motor vehicle operator's license, except while participating in Driver's Education Program.
    12. Medical or surgical treatment, diagnostic procedure, administration of anesthesia related to medical mishap or negligence, including malpractice.
    13. Travel or activity outside the United States, Canada, or Mexico
    14. Travel in any Aircraft owned, leased or controlled by the Participating Organization, or any of its subsidiaries or affiliates. An Aircraft will be deemed to be “controlled” by the Participating Organization if the Aircraft may be used as the Participating Organization wishes for more than 10 straight days, or more than 15 days in any year. (for Accident Death and Dismemberment benefit only);
    15. Alcoholism, drug addiction or the use of any drug or narcotic except as prescribed by Doctor unless specifically provided herein.
    16. Repair or replacement of existing dentures, partial dentures, braces, fixed or removable bridges, or other artificial dental restoration;
    17. Repair, replacement, examinations for prescriptions or the fitting of eyeglasses or contact lenses.
    18. While the Covered Person is legally intoxicated (as determined by that state's laws) or while under the influence of any drug unless administered under the advice and consent of a Physician.
    19. Medical expenses and disability for which the Covered Person is entitled to benefits under any Worker's Compensation Act.
    20. Medical expenses paid or payable under any mandatory no fault automobile insurance contract or mandatory basic reparations benefit of no fault.
    21. Injury to a Covered Person resulting from that Covered Person’s willful violation of the Participating Organization’s rules or regulations. Willful violation includes, but is not limited to: a) competing without protective clothing, helmets, gloves, etc. required by the Participating Organization’s rules or regulations; or b) competing in a racing vehicle that is in violation of the Participating Organization’s rules or regulations.
    22. Pregnancy or childbirth unless conception occurred while coverage was in force under the Policy.
    23. Elective Abortion. Elective Abortion means an abortion for any reason other than to preserve the life of the female upon whom the abortion is performed.
    24. Mental and nervous disorders (except as provided in the Policy).
    25. Covered medical expenses for which the Covered Person would not be responsible for in the absence of this Policy.
    26. Sickness, disease, or any bacterial infection, except one that results from an accidental bodily injury or pyogenic infections that result from accidental ingestion of contaminated substances.

 

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