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United India Insurance Company - Senior Citizen Health insurance - Exclusions


Exclusions

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:-

1. Any pre-existing condition(s) as defined in the policy, until 48 months of continuous coverage of such insured person have elapsed, since inception of his/her first Policy with the Company. Pre-Existing Condition/Disease definition – Any condition, ailment or injury or related condition(s) for which insured person had signs or symptoms, and/or were diagnosed, and/or received medical advice/treatment, within 48 months prior to his/her first policy with the Company.

2. During the first two years of the operation of the policy, the expenses on treatment of diseases such as Cataract, Benign Prostate Hyperthrophy, Hysterectomy for Menorrhagia, or Fibromyoma, Hernia, Hydrocele, Congenital internal disease, Fistula in anus, piles, Sinusitis and related disorders, Gall Bladder Stone Removal, Gout & Rheumatism, Calculus Diseases, Joint Replacement due to Degenerative condition and age-related Osteoarthiritis & Osteoporosis are not payable. If these diseases (other than congenital internal disease) are pre-existing at the time of proposal they will not be covered even during subsequent period of renewal. If the insured is aware of the existence of congenital internal disease before inception of policy, the same will be treated as pre-existing.

3. Injury / disease directly or indirectly caused by or arising from or attributable to invasion, Act of Foreign enemy, War like operations (whether war be declared or not).

4. Cost of spectacles and contact lenses, hearing aids.

5. Dental treatment or surgery of any kind unless necessitated by accident and requiring hospitalization.

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6. 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 intoxication drugs / alcohol

7. All expenses arising out of any condition directly or indirectly caused to or associated with Human T-Cell Lymphotropic Virus Type III (HTLB -III) or lymphadenopathy Associated Virus (LAV) or the Mutants Derivative or Variation Deficiency Syndrome or any syndrome or condition of a similar kind commonly referred to as AIDS.

8. Charges incurred at Hospital or Nursing Home primarily for diagnosis x-ray or Laboratory examinations or other diagnostic studies not consistent with or incidental to the diagnosis and treatment of positive existence or presence of any ailment, sickness or injury, for which confinement is required at a Hospital / Nursing Home

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9. Expenses on vitamins and tonics unless forming part of treatment for injury or diseases as certified by the attending physician

10. Injury or Disease directly or indirectly caused by or contributed to by nuclear weapon/ materials

11. Treatment arising from or traceable to pregnancy (including voluntary termination of pregnancy) and childbirth, (including caesarean section)

12. Naturopathy Treatment, acupressure, acupuncture, experimental and unproven treatments/ therapies.

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13. External and or durable Medical/Non-medical equipment of any kind used for diagnosis and or treatment including CPAP, CAPD, Infusion pump etc. Ambulatory devices i.e., walker, crutches, Belts, Collars, Caps, Splints, Slings, Braces, Stockings, elastocrepe bandages, external Orthopaedic pads, sub cutaneous insulin pump etc., of any kind. Diabetic foot wear, Glucometer/Thermometer, alpha / water bed and similar related items etc., and also any medical equipment, which subsequently used at home etc.

14. Any kind of Service charges, Surcharges, Admission Fees/Registration Charges levied by the hospital.

Note: Please refer to the policy documents for the complete Insurance Policy subject to the insurance Company.

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