SECTION G - EXCLUSIONS (WHAT YOUR POLICY DOES NOT COVER)
• Within the first three (3) years from the Policy Commencement Date , if any event or circumstance (including illness or injury) occurs or expense or cost is incurred, (which otherwise may have given rise to a claim under this Policy ) directly or indirectly arising out of, medically related to or in any way traceable to or connected to, a Pre-Existing Condition , the resulting claim will not be payable. For the purpose of this exclusion a Pre-Existing Condition is any symptom, illness, injury or medical condition of which prior to the Policy Commencement Date : a. You and/or the Insured Person(s) were aware of; or b. You and/or the Insured Person(s) displayed symptoms of, or c. You and/or the Insured Person(s) had a direct indication that something was wrong; or d. You and/or the Insured Person(s) sought treatment or medical advice for. • Ailments wholly or partially attributable to the misuse of alcohol and/or prescription drugs. • Ailments wholly or partially attributable to the use of non-prescription drugs. • Acquired immune deficiencies (AIDS) or associated ailments including HIV and related ailments EXCEPT where the virus can be proved, to Our satisfaction, to have been acquired by accidental means in the course of the Life Assured’s normal occupation, or via blood transfusion. Seroconversion to the HIV infection must be demonstrated by testing within six (6) months of the accident. (Any incident giving rise to a potential claim must be reported to Us within thirty (30) days of the event causing the claim and supported by a negative HIV antibody test taken from the Insured Person after the incident. We can independently test the blood samples used and can require additional samples to be taken and tested. Ailments arising from HIV transmission via any form of sexual activity and/or non- prescribed intravenous drug use are excluded.) • Appliances and or devices including, but not limited to, surgical, medical or dental appliances. • Bariatric surgery for any condition including but not limited to obesity, diabetes and sleep apnoea, except where coverage is expressly stated in this Policy . • Congenital ailments including, but not limited to, complications thereof and or sequelae except where coverage is expressly stated in this Policy . • Any form of psychiatric treatment and or psychological treatment including, but not limited to: medical psychotherapy; any form of therapy or counselling; in-patient care in a Private Hospital or clinic; prescription or non-prescription drugs. • Any mental disorder as defined in the Mental Health (Compulsory Assessment and Treatment) Act 1992 (or any subsequent Acts). • Any geriatric or senile condition or geriatric hospitalisation, and disability support services. • Any injury or disability as a consequence of war, warlike hostilities, civil war or civil commotion. • Cosmetic treatment including complications thereof. • Elective treatment (such as treatment of or for an ailment not materially detrimental to health) including complications thereof. • Treatment and investigations deemed not medically necessary by Us .
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PC-S3HC-04/2022
[AIA – INTERNAL]
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