The company shall not be liable to make any payment under this policy in respect of any expenses whatsoever incurred by any Insured Person in connection with or in respect of.
All diseases/injuries which are pre–existing when the cover incepts for the first time.
Any diseases other than stated clause 4.3 contracted by the Insured Person during the first 30 days from the commencement date of the policy.
The exclusion shall not however, apply if in the opinion of Panel of Medical Practitioners constituted by the company for the purpose, the insured Person could not have known of the existence of the Disease or any symptoms or complaints thereof at the time of making then proposal for insurance to the Company This condition 4.2 shall not however apply in case of the insured person having been covered under this scheme or group insurance scheme with any of the Indian Insurance Companies for a continuous period of 12 months without any break.
During the first year of the operation of insurance cover, the expenses on treatment of diseases such Cataract, Benign Prostates Hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Congenital Internal Diseases, Fistula–in–ano, Piles, Sinusitis and related disorders are not payable. Injury or disease directly or indirectly caused by or arising from or attributable to War, Invasion, Act of Foreign Enemy, Warlike operations (whether war be declared or not). Circumcision unless necessary for treatment of a disease not excluded hereunder or as may be necessitated due to an accident, vaccination or inoculation or changes of life or cosmetic or aesthetic treatment for any description, plastic surgery other than as may be necessitated due to an accident or as a part of any illness.
- Cost of spectacles and contact lenses, hearing aids.
- Dental treatment or surgery of any kind of unless requiring hospitalization.
- Convalescence, general debility, “Run–down” condition or rest cure, congenital external disease or defects or anomalies, sterility, venereal disease, intentional self–injury and use of intoxicating drugs/alcohol.
- All expenses arising out of any condition directly or indirectly caused to or associated with Human T–Cell Lymphotropic Virus type III (H T LB – III) or Lymphadinopathy Associated Virus (LAV) or the Mutants Derivative or Variations Deficiency Syndrome or any Syndrome or condition of a similar kind commonly referred to as Aids.
- Charges incurred at Hospital or Nursing Home primarily for diagnostic, X–ray or laboratory examinations not consistent with or incidental to the diagnosis and treatment of the positive existence or presence of any ailment, sickness or injury, for which confinement at a Hospital/Nursing Home
- Expenses on vitamins and tonics unless forming part of treatment for injury or disease as certified by the attending Physician.
- Injury or disease directly or indirectly caused by or contributed to by nuclear weapons/materials.
- Treatment arising from or traceable to pregnancy, childbirth including caesarian section.
- Voluntary medical termination of pregnancy during the first 12 weeks from the date of conception.
- Naturopathy treatment.