Exclusions and Limitations
Charges for certain services, treatments and/or conditions, among others, are excluded from coverage under the plan. Exclusions include but are not limited to:
- A Pre-existing Condition which is any injury, illness, sickness, disease, or other physical, medical, mental or nervous condition, disorder or ailment that, with reasonable medical certainty, existed at the time of application or at any time during the three years prior to the effective date of the insurance, including any subsequent, chronic or recurring complications or consequences related thereto or arising therefrom, whether or not previously manifested or known, diagnosed, treated, or disclosed.
- Treatment or surgeries which are elective, investigational, experimental or for research purposes.
- War, military action, terrorism, political insurrection, protest, or any act thereof. We will not pay for a Political Evacuation if there is a travel advisory in effect on or within six (6) months prior to the insured person’s date of arrival in the host country.
- Immunisations and routine physical exams.
- Treatment of Temporomandibular Joint or dental treatment, except as expressly provided for in the plan.
- Venereal disease, AIDS virus, AIDS related illness, ARC Syndrome, or AIDS, and the cost of testing for these conditions, and charges for treatment or surgeries which are incurred by any Insured who was HIV+ at time of enrolment into this insurance.
- Pregnancy, childbirth, birth control, artificial insemination, treatment for infertility or impotency, sterilisation or reversal thereof, or abortion.
- Any illness or injury sustained while taking part in: Amateur
Athletics, Professional Athletics, or other athletic activity that
is sponsored or sanctioned by any collegiate sanctioning or governing body, or the International Olympic Committee. The following
Adventure Sports are excluded unless the Adventure Sports
Option is purchased: abseiling, BMX, bobsledding, bungee
jumping, canyoning, caving, hang gliding, heli-skiing, high
diving, hot air ballooning, inline skating (with proper use
of helmet and pads), jet skiing, jungle zip lining, kayaking,
mountain biking, parachuting, paragliding, parascending,
piloting a non-commercial aircraft, rappelling, rock climbing
or mountaineering (ropes and guides to 4500m above ground level), scuba diving (to 50m), skydiving, snowboarding,
snowmobiling, spelunking, surfing, trekking,
whitewater rafting (to Class V), wildlife safaris, and windsurfing. All such activities must be carried out in strict accordance
with the rules, regulations and guidelines of the applicable
Governing Body or Authority of each such activity.
Injury sustained while participating in contact sports of any kind, racing of any kind, any rodeo activity, BASE jumping, kiteboarding, mountaineering or climbing or trekking above elevation 4500 meters above ground level or without proper ropes or guides; luge, motocross, Moto-X, ski jumping, sub-aquatic activities below 50 meters, whitewater rafting exceeding Class V difficulty; and/or adventure sports activity not expressly covered hereunder are excluded regardless of which plan or option is selected. - Vision or ear tests and the provision of visual or hearing aids.
- Vocational, recreational, speech or music therapy.
- Treatment while confined primarily to receive custodial care, educational or rehabilitative care, or nursing services.
- Charges, injuries and/or illnesses resulting or arising from or occurring during the commission of a violation of law by the insured person, including, without limitation, the engaging in an illegal or malicious occupation or act, but excluding minor traffic violations.
- Treatment for, and injuries and/or illnesses resulting or arising from, substance abuse or drug addiction.
- Injury and/or illness resulting or arising from being under the influence of alcohol or drugs; and injury or illness resulting from operating any type of vehicle after consuming any alcohol or drugs.
- Willful self-inflicted injury or illness.
- Treatment required as a result of or arising from complications from a treatment or condition not covered under the certificate.
- Any services or supplies performed or provided by a relative of the Insured or provided at no cost to Insured.
- Treatment for mental and nervous disorders.
- Organ or tissue transplants or related services.
- Illness or injury where the trip to the host country is undertaken for treatment or advice for such illness or injury, except as expressly provided for in the Policy Wording.
- Treatment incurred as a result of or arising from exposure to nuclear radiation, and/or radioactive material(s).
- Travelling against the advice of a medical practitioner.
- Any infection of the urinary tract (or illness arising therefrom), that occurs within ninety (90) days of the effective date of coverage and that requires treatment of the insured person in a hospital; provided that any such illness will be deemed by us to be a Pre-existing Condition.
* This Web page contains only a consolidated and summary description of all current benefits, conditions, limitations and exclusions. A certificate containing the complete Certificate Wording with all terms, conditions and exclusions will be included in the fulfillment kit. IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this Web page, application, and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request.
Important Notice regarding USA Patient Protection and Affordable Care Act (PPACA). With regards to USA citizens and/or coverage in the USA: This insurance is not subject to, and does not provide benefits required by PPACA. On 1st January 2014, PPACA requires USA citizens and certain USA residents to obtain PPACA compliant insurance coverage, unless they are exempt from PPACA. Penalties may be imposed on USA citizens and USA residents who are required to maintain PPACA complaint coverage within the USA but do not do so. Please note it is solely your responsibility to determine if PPACA is applicable to you.