Terms and Conditions for Group Medical Plan
Throughout this Policy, where the context so admits, words embodying the masculine gender shall include the feminine gender,
and words indicating the singular case shall include the plural and vice-versa.
Accident – refers to an unforeseen and involuntary event which causes an Injury.
Age – means the age at the nearest birthday of the Insured on the Policy Effective Date or at renewal date.
Child – Any person who has attained the age of 15 days , has never married and is financially dependent upon an
Insured; and (a) who is under the Age of 18, or (b) who is under the Age of 23 and registered as a full time student at a
recognised educational institution.
Chinese Medicine Practitioner – A practitioner of Chinese medicine duly listed, licensed or registered to practise
Chinese Medicine by the relevant governing authorities and statutes at the place in which the Chinese medicine or
treatment is given but excluding a Chinese Medicine Practitioner who is the Insured himself, an insurance agent,
business partner(s) or employer/employee of the Insured or a member of the Insured ’s immediate family.
Co-Insurance – The Eligible Expenses which shall be borne by the Insured if so provided in the Schedule of Benefits.
Company – Blue Cross (Asia-Pacific) Insurance Limited
Confinement – Admitted in a Hospital for a continuous period of not less than six (6) hours of attended duration.
Congenital Conditions –
a) Medical abnormalities existing at the time of birth, as well as neo -natal physical abnormalities which become
apparent within 6 months of birth.
b) The following (but not to the exclusion of all others) are deemed to be congenital conditions:-
i) Hernias of all types up to age 8 (except those caused by a trauma after the Policy Effective Date).
ii) Epilepsy (Petit Mal or Grand Mal)(except those caused by a trauma after the Policy Effective Date).
v) Pre-auricular Sinus
vi) Arteriovenous Malformation
Deductible – An amount which pursuant to any provision of this Policy or a Schedule hereto is required to be deducted
from any Eligible Expenses payable.
Dependant – shall mean in the case of a married Insured, the spouse and all children; and upon specific r equest of the
Policyholder in the case of an unmarried person, the parents under the Age of 65 provided neither or the parents are in
Developmental Conditions – Disorders in which there is a delay in development compared to the normal healthy state
at the given age, level or stage of development.
Disability or Any One Disability – A Sickness, Disease, Illness, or an Injury arising from the same pathogenic cause
including any and all complications therefrom, up to ninety (90) days following the latest discharge from Hospital, or latest
medical consultation, or laboratory test, or completion of prescribed drugs course to that disability. Any subsequent
disability from the same pathogenic cause after the said period shall be considered as a new disability.
Eligible Expenses – Expenses for Medically Necessary Services provided with respect to a covered Disability up to the
specified maximum as stated in the Schedule of Benefits.
Eligible Public Hospital – An Eligible Public Hospital is one that is wholly owned or subvented by the Government of the
Hong Kong SAR and operated or supervised by the Hospital Authority.
Group – shall mean all the members of an organization or work-force or all the members of a bona-fide sub-division of such
organization or work-force.
Hospital – An establishment duly constituted and registered as a hospital for the care and treatment of sick and injured
persons as in-patients, and which:-
i) has facilities for diagnosis and major operations;
ii) provides 24 hours nursing services by licensed registered nurses;
iii) maintains a Physician; and
iv) is not primarily a clinic, a place for alcoholics or drug addicts, a nursing, rest or convalescent home , or
rehabilitation centre or home for the aged or similar establis hment.
Injury – means an abnormal bodily condition caused solely and directly by Accident , is independent of any other cause,
and is not due to illness or disease.
Insured – means a person named as Insured on the Policy Schedule.
Medically Necessary – means the need to have treatment or services for the purpose of treating the subject Disability in
accordance with the generally accepted standards of medical practice and such treatment or services must:
a) require the medical expertise of the medical practitioner;
b) be consistent with the diagnosis and necessary for the treatment of the condition;
c) be rendered in accordance with standards of good and prudent medical practice, and not be rendered primarily for the
convenience or the comfort of the Insured, his family, caretaker or his physician; and
d) be rendered in the most cost-efficient manner and setting appropriate in the circumstances.
Period of Insurance – The period of time specified in the Policy Schedule during which this Policy is Effective.
Physician, Registered Medical Practitioner, Surgeon or Doctor – A practitioner of western medicine duly registered at
the place where he renders medical or surgical services but excluding a Physician who is the Insured himself, an
insurance agent, business partner(s) or employer/employee of the Insured or a member of the Insured ’s immediate family.
Policy Effective Date – Starting date of the Period of Insurance specified in the Policy Schedule.
Policyholder – A person to whom the Policy h as been issued in respect of cover for persons specifically identified as
Insured under this Policy.
Pre-existing Conditions – Disabilities which presented signs or symptoms of which the Insured was aware or should
reasonably have been aware or for which t he Insured received medical or surgical care or treatment within 90 days
immediately preceding the effective date of coverage applicable to such Insured, unless the Insured has been covered
under the Policy for not less than 365 days.
Prescribed Medicines and Drugs – Medicines and drugs as prescribed by a Physician for the treatment of a covered
Reasonable and Customary – Refers to a charge for medical care which does not exceed the general level of charges being
made by medical service providers of similar standing in the locality where the charge is incurred for similar treatment, services
or supplies to individuals of the same sex and age, for a similar disease or injury. The Reasonable and Customary charges
shall not in any event exceed the actual charges incurred.
Registered Chiropractor – A person duly licensed or registered to practise chiropractor services by the relevant
governing authorities and statutes at the place in which the chiropractor service is given but excluding a Chiropr actor who
is the Insured himself, an insurance agent, business partner(s) or employer/employee of the Insured or a member of the
Insured’s immediate family.
Registered Physiotherapist – A person duly licensed or registered to practise physiotherapy services by the relevant
governing authorities and statutes at the place in which the physiotherapy service is given but excluding a Physiotherapist who
is the Insured himself, an insurance agent, business partner(s) or employer/employee of the Insured or a member of the
Insured’s immediate family.
Renewal or Renewed Policy - A Policy which has been renewed without any lapse of time upon the expiry of a
preceding Policy with similar content.
Sickness, Disease or Illness – A physical condition marked by a pathological deviation from the normal healthy state.
Specialist – Any Physician who is registered in the Specialist Registry of the Medical Council of Hong Kong or equivalent
and qualified to practise specialist care according to the qualified specialty.
Additions and Deletions
Subject to the conditions in this Policy, the Policyholder shall advise the Company of additional persons to be covered within a
Group or persons to be deleted from a Group and the Company shall credit or debit the Policyholder for premium on a daily pro-
rata basis. The Policyholder shall advise the Company in writing of the full details of additional persons to be included under
this Policy, stating:- a) Date of inclusion, b) Age, c) Sex, d) Date of Birth, e) Occupation or Occupational Class, f) Details of the
Benefit Plans for which he is to be covered (and likewise for the Insured’s dependants if they are to be included).
The Policyholder should notify the Company in writing within thirty (30) days from the date of addition, termination or any
changes of any Insured.
No alterations in the terms and conditions and provisions of this Policy shall be valid unless signed by an officer so authorised
by the Company. No Agent or other person has the authority to change or waive any provision of this Policy.
The Policyholder may cancel this Policy by giving no less than thirty (30) days ’ prior written notice to the Company by mail
addressed to the Company; and provided that all medical cards and coupons are returned and no claims have been made
under this Policy, the Policyholder shall be entitled to a refund of premium paid without interest in accordance with the
Period covered from the Policy Effective Date (not Premium to be Refunded
2 months 75% of annual premium
4 months 55% of annual premium
6 months 35% of annual premium
8 months 15% of annual premium
Over 8 months Nil
Notwithstanding anything to the contrary, any indebtedness which may be owing under this Policy shall be deducted from the
premium to be refunded.
If cancellation shall take place after this Policy has been renewed upon its expiry, no premium will be refunded to the
The Company may cancel cover on any Insured for failure to comply with requirements under this Policy and in such event, the
Company shall refund the premium to the Policyholder on a pro-rata basis for the unexpired Policy period.
The Company must be immediately notified by the Policyholder in the event of a change of address or occupation of an
Insured and the Policyholder shall pay any additional premium that may be required. Failure to pay such additional
premium shall entitle the Company to cancel the Policy with immediate effect.
Change of Benefits
On any policy anniversary or renewal, any change of benefits or coverage under this Policy as requested by the
Policyholder shall only take effect subject to the approval by the Company and on the Policy Anniversary or renewal.
If the eligible benefits under the terms of this Policy are increased by the Policyholder or the Company to a higher class
of benefit cover while the Policy is in force, and if an Insured was afflicted with a Disability at the time the benefits were
increased, the limit of benefits payable in respect of such Disability shall be that limit which was applicable prior to the
date the benefits were upgraded.
Currency of Payment
All amounts payable either to or by the Company shall be payable in Hong Kong dollars or the Currency specified in the
Eligibility for Group Coverage
i) If the premium for Group member is non-contributory, meaning that members of the Group are not required to
pay any part of the Premium, then 100% of eligible members of the Group shall be covered under the terms of
ii) If the premium for Group members are contributory, meaning the members of the Group are required to pay all
or part of the due premium, then not less than 75% of the eli gible members of the Group shall be covered under
the terms of this Policy or there shall be paid to the Company such extra premium as shall be required.
iii) If the premium for Group members are non-contributory and premium of their Dependants are contributor y, then
not less than 75% of the Dependants shall be covered under the terms of this Policy or there shall be paid to
the Company such extra premium as shall be required.
iv) Members of contributory groups shall be included under this Policy upon application to the Company provided
they submit such application within fourteen (14) days of becoming eligible for coverage. Group members who
submit such application later than fourteen (14) days after becoming eligible for coverage under this Policy may
be included for cover under this Policy at the Company’s option at a date not earlier than ninety (90) days from
the date of the application.
v) Insurance coverage under this Policy in respect of any Group member ’s Dependant(s) shall cease at the same
time as cover cease with respect to the Group member.
vi) Upon termination of coverage, members who re -apply for insurance coverage shall be considered as new
vii) Each Member shall be covered under this Policy on the first day on which he becomes eligible for coverage
provided written notification from the Policyholder has been received and approved by the Company. The date
on which a Member becomes eligible for coverage under this Policy shall be a date on which the Member is
actually performing his duties at work, pr ovided that he is either employed by the Policyholder on a full -time
basis or on a part-time basis with at least twenty (20) hours of work per week. Any member who is on vacation,
sick or absent from work for any other cause on the date on which, if prese nt, he would have become eligible
for coverage shall become eligible for coverage on the date of his returning to actual performance of his duties
Minimum and Maximum Age
Anyone who is (i) fifteen (15) days old or above and (ii) sixty-five (65) years of Age or below is eligible to enrol in this
Policy. Furthermore, no coverage shall be renewed for any Insured who, at the time of policy renewal, is over the Age of
When Maternity coverage is included in the Schedule of Benefits, no maternity benefits shall be payable unless an
Insured shall have been continuously insured under this Policy for the period of days as specified in the Schedule of
Benefits immediately preceding the delivery of the child or miscarriage or therapeutic abortion, as the case may be.
Notices to Company
All notices which the Company requires the Policyholder and / or the Insured to give must be in writing , addressed to and
received by the Company.
Ownership and Discharge under the Policy
Unless otherwise expressly provided, the Company shall treat the Policyholder designated in the Policy Schedule as the
absolute owner of the Policy, and the Company shall not be bound to recognise any equitable or other interest of any
other person in the Policy. The payment of any benefits hereunder to the Policyholder or Insured shall be deemed to be
full and effective discharge of the Company ’s obligations under the Policy.
The Company is entitled to proceed at its own expense in the name of the Insured or Policyholder against third parties
who may be responsible for an occurrence giving rise to a claim under this Policy.
Suits Against Third Parties
Nothing in this Policy shall render the Company liable to indemnify, join, respond to or defend any suit for damages for
any cause or reason which may be instituted by the Policyholder or an Insured against any Doctor or Hospital nominated
under this Policy, including without limitation to any suit for negligence, malpractice or unprofessional conduct or any
other causes in relation to or arising out of the treatment or examination of an Insured under the terms of this Policy.
Termination of Benefits
Unless renewed, the benefits under this Policy shall terminate at 0 0:00 hour (Hong Kong Time) on a policy anniversary
date provided that if an Insured is confined in a Hospital for a covered Disability at the time of such termination, then the
time of termination shall be extended to the time of discharge from the Hospital for the said Disability or the time the
Insured’s benefits for said Disability shall have been exhausted, whichever shall first occur.
Territorial Scope of Cover
All benefits described in this Policy are applicable worldwide except where otherwise stat ed.
This Policy is issued in consideration of all the statements and answers given by the Insured and the Policyholder (including but
not limited to) the Application, and Declaration and payment of premiums. The application for this Policy, any medical evidence,
written statements and declarations furnished as evidence of insurability, and the Policy document constitute the entire contract.
Our Company will provide insurance, subject to the limits, terms, conditions and exclusions set out in the Policy.
The truth of any statement or declaration made by an Insured or the Policyholder and the due observance and fulfilment
of the terms and conditions insofar as they relate to anything to be done or complied with by an Insured or the
Policyholder shall be a condition precedent to the liability of the Company to pay any claim hereunder.
The Company shall allow a Grace Period of thirty (30) days after the premium due date for payment of each premium after the
first. If a premium is still unpaid at the expiration of the Grace Period, the Policy shall cease to be in force.
Payment of Premiums
The amount of premium payable is specified in the Policy Schedule or any endorsement attached hereto. All premiums
of annual or lesser duration are payable in advance and, subject to the “Grace Period” provision of this Policy, shall be
paid before any insurance cover commences under this Policy.
Premium due dates, policy anniversaries and policy years are determined from the Policy Effective Date as shown on the Policy
Schedule. The first premium is due on the Policy Effective Date.
This Policy, subject to the payment of premiums, shall be in force for one (1) policy year, from the Policy Effective Date to
the day before the first anniversary of the Policy Effective Date. At each Policy anniversary the Policyholder may renew
the Policy for another Policy year by paying in advance the premium as determined by the Company fo r the Benefits
elected at the time of each such Renewal.
Revision of Benefit Structure
The Company reserves the right to revise the benefit structure under this Policy. The Company shall notify the
Policyholder in writing no less than thirty (30) days i n advance of the policy anniversary effecting such revision specifying
the revised Schedule of Benefits, the new premium and its effective date. The revised Schedule of Benefits and new
premium shall take effect on the date specified unless the Policyholde r declines in writing in which case this Policy shall
automatically terminate on the next premium due date following the date of such notification. Following each revision, an
endorsement shall be issued together with the revised Schedule of Benefits.
If the Company shall disclaim liability for any claim of the Insured, and such claim shall not have been referred to
Arbitration as described below within twelve (12) calendar months from date of such disclaimer, then the claim shall for
all purposes be considered abandoned and not recoverable.
All differences arising out of this Policy shall be determined by arbitration in accordance with Arbitration Ordinance and the laws
of Hong Kong. If the parties fail to agree upon the choice of the arbitrator, then the choice shall be referred to the Chairman for
the time being of the Hong Kong International Arbitration Centre. It is expressly stipulated that it shall be a condition precedent
to any right of action or suit upon this Policy that an arbitration award shall be first obtained.
Within ninety (90) days after clinical visit or discharge from the Hospital, any related claim of medical expenses incurred
must be notified and submitted to the Company, and in the prescribed form together with all necessary original
documents. Failure to give notice or submit a claim within the time period specified will result in rejection of such claim.
The Company may require further submission of information , certificates, evidence, medical reports, data or other
materials for claims assessment purpose. The Company shall not accept liability for any claim if the required information
is not received within sixty (60) days from the issue date of any written req uest(s) from the Company requesting such
further information, unless otherwise agreed and approved by the Company.
No legal action shall be brought against the Company, within sixty (60) days after the Insured's provision of satisfactory proof of
loss to the Company, nor later than two (2) years after the date proof of loss is required.
All Benefits Payable to the Insured pursuant to A) the Hospital and Surgical Section (Items 1-12) and B) Out-Patient Section
(Items 1-7) herein below are subject to the maximum limits as stated in the Schedule of Benefits for the Plan selected for the
Insured, AND subject to the terms, conditions and exclusions of the Policy herein. If during the Period of Insurance the Insured,
as a result of Sickness or Injury, is confined in a Hospital on the recommendation of a Registered Medical Practitioner as an in-
patient or is treated in a doctor’s clinic / Out-Patient Department of a Hospital as an outpatient, Eligible Expenses which are
Reasonable and Customary are payable for the following benefits. For benefits indicated with an asterisk (*), such benefits are
available only where the Insured has opted for those Benefits in the Plan Selected.
A. Hospital and Surgical
1. Room and Board – Hospital accommodation charges including meals and general nursing services incurred by an Insured
who is registered as a bed patient in a Hospital.
2. Miscellaneous Hospital Charges – hospital charges during the time that an Insured is an in-patient in a Hospital and is
rendered any hospital service which is regularly given by the Hospital for Medically Necessary treatment of that disability.
These charges include (but are not limited to) the following:
a) Road ambulance service to and / or from the Hospital;
b) Anaesthesia and oxygen and their administration;
c) Blood transfusion, except the charges for blood and blood plasma;
d) Dressing and plaster casts;
e) Drugs and medicine including chemotherapy drugs consumed during the Confinement;
f) Medical and Surgical appliances, implants and devices;
g) Medical and Surgical disposables and consumables used in ward;
h) Films, Imaging and X-ray and their interpretation;
i) Intravenous infusions including IV fluids;
j) Laboratory examinations;
k) Radioactive isotope, radiotherapy and related test;
l) CT Scan, Magnetic Resonance Imaging (MRI) and PET Scan service;
m) Rental of crutches and mechanical wheel chair;
n) Anaesthetist’s Fee and Operating Theatre Charges (if these benefits are not separately listed in the Schedule of
Note: Physiotherapy and Advanced Imaging services such as MRI, CT Scan and PET Scan which could have been done
in an outpatient facilities without the need to be admitted to Hospital as an in-patient are not considered payable when
admitted to Hospital as an in-patient.
3. Surgeon’s Fees – charges for any Medically Necessary surgical procedures performed on the Insured in the Hospital, with
or without confinement or in a doctor’s clinic.
The Surgeon's Fee shall be paid according to provisions and the relevant classification or percentage payable for such
operation pursuant to Surgical Schedule and Schedule of Benefits, subject to the maximum limits specified in both
Schedules. If the operation performed is not included in the Surgical Schedule, the Company reserves the right to
determine its classification or reimbursement percentage using as a basis an operation of equivalent difficulty and severity.
4. Anaesthetist’s Fee – charges for services rendered by the Anaesthetist in relation to the operation or procedure as per
5. Operating Theatre Charges – charges for the Insured's use of the operation room including but not limited to recovery
room, treatment room, room for the performance of endoscopic, laparoscopic and lithotripsy procedures, disposables;
consumables and equipments used during the operation or procedure as per surgical classification.
Note: For items 3, 4 and 5, for the avoidance of doubt, in the event of multiple surgical operations in respect of Any One
Disability, the total sum payable will not in any event exceed the maximum limit specified in the Schedule of Benefits
according to the Plan selected for which the highest classification or percentage payable for all relevant operations and
procedures specified in the Surgical Schedule shall be used for calculation.
6. Companion Bed For Child* – extra bed charges for the person who accompanies his/her Insured Child in a Hospital.
7. Physician’s Hospital Visits* – visiting charges by the attending Registered Medical Practitioner per day of hospitalization.
For all surgical hospital confinement, this benefit also includes charges for one pre-hospitalization clinic consultation and all
necessary clinic consultations up to a maximum of 6 weeks after discharge from Hospital provided the consultations are
directly related to and as a result of the diagnosis necessitating such confinement.
8. Specialist’s Fee* – charges for consulting the Specialist upon written recommendation by the attending Physician.
9. Intensive Care* – charges by the Hospital for the period during which the Insured is under Intensive Care.
10. Emergency Out-Patient Treatment* – charges for the treatment provided by the Out-patient Department of a Hospital or
by a Physician in his clinic within 24 hours of a covered Accident / Injury.
11. Daily Cash Benefit (For Government Hospital Wards Accommodation Only)* – The Company shall pay a daily cash
benefit amount as specified in the Schedule of Benefits provided that the Insured is confined as an in-patient in the general
ward of an Eligible Public Hospital. For the avoidance of doubt, the Daily Cash Benefit is in addition to and independent of
the Room and Board, and Hospital Services Benefit. This benefit shall not be applicable for confinements in any room type
other than the general ward of an Eligible Public Hospital.
12. Private Duty Registered Nurse* – The nursing fee as incurred by an Insured when confined as a bed patient in a Hospital
upon written referral by the attending Physician.
This Adjustment Factor applies to Major Medical Benefits Only.
In the event of hospitalization, if the Insured is confined to a higher level of Hospital facilities and services than that he is entitled
to, the respective adjustment factors applicable in addition to the reimbursement percentage are as follows:
Entitled Level Actual Level Reimbursement of Eligible Claims
of Accommodation of Accommodation (Adjustment Factor)
Ward Semi-Private 50%
Ward Private 25%
Ward Deluxe 12.5%
Semi-Private Private 50%
Semi-Private Deluxe 25%
Private Deluxe 50%
1. General Practitioner's Consultation – charges for the consultation and cost of medicine as charged by a Registered
2. Specialist’s Consultation – charges for the consultation and medicine as charged by a Specialist upon written
recommendation by another Physician.
3. Diagnostic X-rays and Laboratory Tests* – charges for X-rays; Ultrasounds; Advanced Imaging such as MRI, CT Scan,
PET Scan; Electrocardiogram and Laboratory tests upon written recommendation by a Registered Medical Practitioner for
4. Prescribed Medicine and Drugs* – charges for the cost of Medically Necessary western medication as prescribed by a
Registered Medical Practitioner and procured from an outside registered pharmacy.
5. Physiotherapy Services* – charges for the services charged by a Registered Physiotherapist upon written
recommendation by a Registered Medical Practitioner.
6. Chiropractic Services* – charges for the services by a Registered Chiropractor.
7. Chinese Medicine Practitioner Treatment* – charges for the consultation and medicine incurred by an Insured for a
Chinese Medicine Practitioner. Such treatment shall include Bonesetting and Acupuncture.
Unless specifically included in the Schedule of Benefits or by Endorsement, the Company shall not pay any claims, costs,
expenses in relation to or arising out of the following:
1. Where the loss, costs or expenses is recoverable under any law, medical program, or other insurance Policy
provided by any government, company, other insurers or any other third party.
2. Purchase of drugs, treatment or te sts which are not Medically Necessary; or are not prescribed; or not
performed by a Registered Medical Practitioner .
3. Hospitalization solely for the purpose of general checkup; diagnostic X -Ray; Advanced Imaging; Laboratory
tests; or Physiotherapy.
4. Treatment for Congenital or Developmental Conditions or disease of any kind.
5. Pre-existing Conditions.
6. Expenses directly or indirectly arising from Human Immunodeficiency Virus (HIV) and its related Disability,
including Acquired Immunization Deficiency Syndrome ( AIDS) and/or any mutations, derivation or variations
thereof, consequential upon an HIV infection occurring before the effective date of coverage applicable to such
Insured. For the purposes of this exclusion, an HIV related disability emerging within 5 ye ars after the Policy
Effective Date will be conclusively presumed to proceed from an HIV infection occurring prior to the effective
date of coverage of the Insured.
7. Treatment or disability directly or indirectly arising from or consequent upon:
the abuse of drugs or alcohol, self-inflicted injuries or attempted suicide, illegal activity, or driving whilst
exceeding the prescribed alcohol limit, or venereal and sexually transmitted disease or its sequelae .
8. Any charges in respect of services for beautification purposes; cosmetic surgery; including related and
associated medical conditions arising therefrom, hearing tests, routine blood tests, general check -ups,
vaccinations or inoculations, Hair Mineral Analysis (HMA), bird's nest, lingzhi, ginseng and other specialised
Chinese tonic medicine, health supplements (unless approved by the Company), eye refraction including
routine eye tests, fitting of spectacles or lens and any operational procedures and related services for the
purpose of correcting visual acuity or refractive errors.
9. Dental treatment and oral surgery except for emergency treatment arising from an accident received during
confinement. Follow up treatment from such hospital confinement relating to dental treatment or oral surgery
shall not be covered.
10. All investigation, treatment and counselling services relating to maternity and its complications, including
diagnostic tests for pregnancy or resulting childbirth, abortion or miscarriage; birth control or reversal of birth
control; sterilisation of either sex; infertility including in -vitro fertilisation or any other artificial method of
inducing pregnancy; sexual dysfunction including but not limited to impotence, erectile dysfunction, pre -mature
ejaculation regardless of cause.
11. Purchase of artificial limbs and prosthetic devices including those prosthetic devices that are surgically
implanted, and purchase of durable medical equipment or appliances including but not limited to the purchase
or rental of wheelchairs, hospital beds, CPAP machine, exercise equipment, spectacles, hearing aids, special
braces, crutches, over-the-counter drugs, air purifiers or conditioners, heat appliances or modifications made to
an Insured’s home.
12. Treatment directly or indirectly arising from any psychotic, psychological, or psychiatric condition of any and all kinds,
and any physiological or psychosomatic manifestations thereof.
13. Alternative treatment including but not limited to acupressure, Tui Nai, hypnotism, rolfing, massage therapy and
14. Experimental and / or new medical technology or procedure not yet approved by the Company.
15. Non-medical services, including but not limited to guest meals, radio or TV rentals, telephone charges, photocopy
charges, medical report charges, taxes and the like.
16. Treatment or disability directly or indirectly arising from war (declared or undeclared), civil war, invasion, acts of
foreign enemies, hostilities, rebellion, revolution, insurrection or military or usurped power.
17. Treatment or disability directly or indirectly resulting from radioactive contamination.
18. Treatment or disability directly or indirectly resulting from taking part in military, air force, naval and other disciplinary