Inbound Immigrant Travel Insurance Exclusions

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Rates:  $50,000 Max | $100,000 Max | $50,000 Max - 70+ Years

EXCLUSIONS

No benefits will be paid for loss or expense caused by, contributed to, or resulting from:

1. Pre-existing Conditions;
2. Any loss that occurs while traveling solely for the purpose of obtaining medical treatment while on a waiting list for a specific treatment, or while traveling against the advice of a physician;
3. Expense incurred within the Insured Person's Home Country or country of regular domicile;
4. Routine physical or other examinations where there are no objective indications of impairment of normal health, or well baby care;
5. Eye examinations; prescriptions or fitting of eyeglasses and contact lenses; or other treatment for visual defects and problems. "Visual defects: means any physical defect of the eye which does or can impair normal vision;
6. Hearing examinations or hearing aids; or other treatment for hearing defects and problems. "Hearing defects: means any physical defect of the ear which does or can impair normal hearing:
7. Dental treatment, except as the result of injury to sound, natural teeth as stated in the Schedule of Benefits:
8. Professional services rendered by a Member of the Insured Person's immediate family, or anyone who lives with the Insured Person;
9. Services or supplies not necessary for the medical care of the patient's injury or sickness;
10. Weak, strained or flat feet, corns, calluses, or toenails;
11. Cosmetic surgery, or treatment for congenital anomalies (except as specifically provided), except reconstructive surgery as the result of a covered Injury or Sickness. Correction of a deviated nasal septum is considered cosmetic surgery unless it results from a covered Injury or covered Sickness;
12. Elective Surgery and Elective Treatment;
13. Diagnostic or surgical procedures in connection with infertility unless infertility is a result of a covered Injury or covered Sickness;
14. Birth control, including surgical procedures and devices;
15. Routine new-born baby care, well-baby nursery and related Physician charges;
16. Participation in professional or intercollegiate athletics;
17. Injury or Sickness for which benefits are paid or payable under any Worker's Compensation or Occupational Disease Law or Act, or similar legislation;
18. Organ transplants;
19. War or any act of war, declared or undeclared; or while in the armed forces of any country (a pro-rata premium will be refunded upon request for such period not covered);
20. Participation in a riot or civil disorder, commission of or attempt to commit a felony in the country in which it was attempted or committed;
21. Suicide or attempted suicide (including drug overdose), while sane or insane (while sane in Missouri), or intentionally self-inflected Injury;
22. Charges of an institution, health service, or infirmary for whose service payment is not required in the absence of insurance;
23. Treatment of nervous or mental disorders, except as stated in the Schedule of Benefits, or treatment of alcoholism or drug abuse, except as provided for treatment of mental or nervous disorders, according to the Schedule of Benefits;
24. Loss incurred from riding in any aircraft, other than as a passenger in an aircraft licensed for the transportation of passengers;
25. Treatment services, supplies or facilities in a hospital owned or operated by: a) The Veteran's Administration; or b) A national government or any of its agencies. (This exclusion does not apply to treatment when a charge is made which the Insured is required by law to pay);
26. Duplicate services actually provided by both a certified nurse-midwife and Physician;
27. Expenses payable under any prior policy which was in force for the person making the claim;
28. Expenses incurred during a hospital emergency room visit which is not of an emergency nature;
29. Expenses incurred for outpatient treatment in connection with the detection or correction by manual or mechanical means of structural imbalance, distortion or sublimation in the human body for purposes of removing nerve interference and the effects thereof, where such interference is the result of or related to distortion, misalignment or subluxation of or in the vertebral column;
30. Injury sustained as the result of the Insured operating a motor vehicle while not properly licensed to do so in the jurisdiction the motor vehicle accident occurs;
31. Voluntary or elective abortion;
32. Expense covered by any other valid and collectible medical, health or accident insurance;
33. Expense incurred after the date insurance terminates for an Insured Person except as may be specifically provided;
34. Expenses incurred for injuries resulting from the use of alcohol or intoxicants, or any drugs unless prescribed by a Physician;
35. Sexually transmitted diseases, including AIDS.
    

DEFINITIONS

"Injury" means: bodily injury: (1) directly and independently caused by specific accident which is unrelated to any pathological, functional, or structural disorder of injury, (2) treated by a Physician within 30 days after the date of accident; and (3) which causes loss during the term of the policy.

"Sickness" means: sickness or disease of the insured Person which causes loss and originates while the Insured Person is covered under the policy. All related conditions and recurrent symptoms of the same or a similar condition will be considered one sickness.

"Pre-Existing Condition" means: (1) the existence of symptoms within the 6 months (or 12 months for persons 70 and older) immediately prior to the Insured's Effective Date under the policy, or, (2) any condition which originates, is diagnosed, treated or recommended for treatment within the 6 months (or 12 months for persons 70 and older) immediately prior to the Insured's Effective Date under the policy; or (3) congenital conditions.

"Usual and Customary Charges" means: a reasonable charge which is: (1) usual and customary when compared with the charges made for similar services and supplies; and (2) made to persons having similar medical conditions in the locality of the Policyholder. No payment will be made under the policy for any expenses incurred which in the judgment of the Company are in excess of Usual and Customary Charges.