The following Treatments, events, conditions, activities and their related or consequential expenses are excluded from the Policy, unless specifically agreed upon in writing by the Company:

• Any expenses or claim directly or indirectly related to Pre-existing Medical conditions.


• Any charges in respect of the donor for organ transplant Claims.


• Services or Treatment in any spa, hydro clinic, sanatorium, nursing home or long term-care facility that is not a Hospital.


• Routine medical examinations or check-ups including charges arising out of any Hospital confinement or admission primarily for diagnostic purposes unless specifically authorised by the Company, routine eye or ear examinations, vaccinations (except WHO recommended EPI vaccinations for Children), medical certificates, examination for employment or travel, spectacles, contact lenses, hearing aids. Cost of correction of refractive errors of the eye and procedures such as Radial Keratotomy and Excimer Laser.


• All dental Treatment apart from Emergency Accidental Dental Treatment.


• Any Out-Patient Treatment, except Emergency Accidental Out-Patient Treatment within forty eight hours of the Accident.


• Cosmetic or plastic surgery, unless it is re-constructive surgery necessitated by an Injury that occurred during the period whilst the Insured Member was covered under this Policy and subject to the limits and sub-limits stated in the Benefits Table.


• Pregnancy and complications thereof, childbirth (including surgical delivery), miscarriage, abortion and/or any related prenatal or postnatal care unless covered by a separate rider under this Policy.


• Tests or Treatment relating to fertility, infertility, contraception or sterilisation.


• Birth defects or congenital Illness.


• Prostheses, corrective devices and medical appliances which are not surgically required.


• Psychotic, mental or nervous disorders (including any neuroses and their physiological or psychosomatic manifestations) or sexual reassignment (whether or not for psychological reasons).


• Experimental Treatment and Treatment not approved by FDA – USA.


• In Cataract Surgeries, the cost of IOL exceeding Rs.25,000/- is not covered under the Policy.
• Assistant Surgeon/Physician Charges are not covered under the policy.
• Self-inflicted Injury, attempted suicide, abuse of alcohol or drug addiction.


• Participation in or training for any dangerous or hazardous sport, pastime or competition or riding or driving in any form of race or competition or any professional sport.


• Aviation other than as a fare-paying passenger of a recognized airline or charter service.


• Treatment received in a location other than the Insured Member’s Geographical Area of Coverage.


• Injury or Treatment resulting from war, riots, invasion, act of foreign enemies, hostilities or warlike operations (whether war be declared or not), civil war, mutiny, civil commotion assuming the proportions of or amounting to a popular uprising, military uprising, insurrection, rebellion, military or usurped power or any act of any person acting on or on behalf of or in connection with any organization actively directed towards the overthrow or to the influencing of any government or ruling body by force, terrorism or violence.


• Injuries as a result of an illegal act other than a minor misdemeanour or minor delinquency by the Insured Member.


• Ionising radiation or contamination by radioactivity from any nuclear fuel or nuclear waste, from the process of nuclear fission or from any nuclear weapons material.


• Any increase in the expenses incurred for Treatment on account of the Insured Member being admitted to a more expensive room than allowed by his Daily Room and Board Limit.


• The cost of non-medically necessary goods or services including such items as telephone, television, newspapers or accommodation for the insured person’s family members.


• Weight management services and treatment related to weight reduction programs including treatment of obesity.


• Natural catastrophes, epidemic, including, but not limited to, flood, earthquake, avalanche and cyclone.


• Any Disability directly or indirectly related to or resulting from HIV, AIDS or any other sexually transmitted disease.


• Air ambulance or evacuation or repatriation expenses.