a medical misadventure, then We are to be subrogated to all the rights which You have to claim against the health service provider(s) for recovery of those fees. We will pay all legal costs and related expenses in such recovery proceeding, but You must provide all reasonable assistance and co-operation and agree to Our use of Your name in those proceedings.
Please note for claims while residing in Australia, call collect on +64 9 488 8800. Please refer to the Claims Form checklist to ensure all relevant information is supplied to Us.
SECTION G - EXCLUSIONS (WHAT YOUR POLICY DOES NOT COVER)
• 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. • Any illness, injury or condition caused by or traceable to any medical condition of which You were aware or the Insured Person was aware, or displayed symptoms of, or for which treatment or medical advice had been sought prior to the Policy Commencement Date , which should have been disclosed to Us in the application form or by additional correspondence up to the date the Policy was issued (as per Your Duty of Disclosure outlined in Our application form and in this Policy document). Any ailment declared on Your application form which was not excluded by Us on Your Policy Schedule will be covered on this plan. • 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.
PC-SHC-04/2022
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