Liaison Student Travel Insurance
Exclusions and Limitations:
No Benefit shall be payable for Accident Medical, Sickness Medical, Mental Illness, Alcohol and Drug Abuse, Dental, Emergency Medical Evacuation/Repatriation, Return of Mortal Remains, and Emergency Medical Reunion, as the result of:
- Any Pre-existing Condition as defined hereunder. This exclusion does not apply to Emergency Medical Evacuation/ Repatriation or Return of Mortal Remains.
- Injury or Illness which is not presented to the Company for payment within 3 months of receiving Treatment;
- Charges for Treatment which is not Medically Necessary;
- Charges provided at no cost to you;
- Charges for Treatment which exceed Reasonable and Customary charges;
- Charges incurred for Surgery or Treatments which are, Experimental/Investigational, or for research purposes;
- Services, supplies or Treatment, including any period of hospital confinement, which were not recommended, approved and certified as Medically Necessary and reasonable by a Physician;
- Suicide or any attempts thereof, while sane or self destruction or any attempt thereof, while insane;
- Any consequence, whether directly or indirectly, proximately or remotely occasioned by, contributed to by, or traceable to, or arising in connection with:
Injury sustained while participating in professional athletics;
Routine physicals, immunizations or other examinations where there are no objective indications or impairment in normal health, and laboratory diagnostic or x-ray examinations, except in the course of a Disablement established by a prior call or attendance of a Physician;
Treatment of the Temporomandibular joint;
Vocational, speech, recreational or music therapy;
Services or supplies performed or provided by a Relative of yours, or anyone who lives with you;
Cosmetic or plastic Surgery, except as the result of a covered Accident; for the purposes of this Plan, Treatment of a deviated nasal septum shall be considered a cosmetic condition;
Elective Surgery which can be postponed until you return to your Home Country, where the objective of the trip is to seek medical advice, Treatment or Surgery;
Treatment and the provision of false teeth or dentures, normal ear tests and the provision of hearing aids;
Eye refractions or eye examinations for the purpose of prescribing corrective lenses for eyeglasses or for the fitting thereof, unless caused by Accidental bodily Injury incurred while covered hereunder;
Treatment in connection with alcoholism and drug addiction, or use of any drug or narcotic agent, unless otherwise covered under this policy;
Injury sustained while under the influence of or Disablement due wholly or partly to the effects of intoxicating liquor or drugs other than drugs taken in accordance with Treatment prescribed and directed by a Physician for a condition which is covered hereunder, but not for the Treatment of drug addiction;
Any Mental and Nervous disorders or rest cures, unless otherwise covered under this policy;
Congenital abnormalities and conditions arising out of or resulting there from;
Expenses which are non-medical in nature;
Expenses as a result of, or in connection with, intentionally self-inflicted Injury or Illness;
Expenses as a result of, or in connection with, the commission of a felony offense;
Injury sustained while taking part in mountaineering where ropes or guides are normally used; hang gliding, parachuting, bungee jumping, racing by horse, motor vehicle or motorcycle, snowmobiling, motorcycle/motor scooter riding, scuba diving involving underwater breathing apparatus, unless PADI or NAUI certified, snorkeling, water skiing, snow skiing, spelunking, parasailing and snow boarding;
Treatment paid for or furnished under any other individual or group policy or other service or medical prepayment plan arranged through an employer to the extent so furnished or paid, or under any mandatory government program or facility set up for Treatment without any cost to you;
Dental care, except as the result of Injury to natural teeth caused by Accident, unless otherwise covered under this Plan;
Routine Dental Treatment;
For Pregnancy or Illness resulting from Pregnancy, childbirth, or miscarriage, unless otherwise covered under this Plan;
Drug, Treatment or procedure that either promotes or prevents conception, or prevents childbirth, including but not limited to: artificial insemination, Treatment for infertility or impotency, sterilization or reversal thereof;
Treatment for human organ tissue transplants and their related Treatment;
Expenses incurred while in your Home Country, except as provided under the Home Country Coverage and Home Country Extension of Benefits Coverage;
Expenses incurred during a hospital emergency visit which is not of an emergency nature;
Injury sustained as the result of the Insured Person operating a motor vehicle while not properly licensed to do so in the jurisdiction in which the motor vehicle accident takes place;
Covered Expenses incurred for which the Trip to the Host Country was undertaken to seek medical Treatment for a condition;
Covered Expenses incurred during a Trip after your Physician has limited or restricted travel;
Sex change operations, or for Treatment of sexual dysfunction or sexual inadequacy;
Weight reduction programs or the surgical Treatment of obesity.
- war, invasion, act of foreign enemy hostilities, warlike operations (whether war be declared or not), or civil war.
- mutiny, riot, strike, military or popular uprising insurrection, rebellion, revolution, military or usurped power.
- acting on behalf of or in connection with any organization with activities directed towards the overthrow by force of the Government de jure or de facto or to the influencing of it by terrorism or violence.
- martial law or state of siege or any events or causes which determine the proclamation or maintenance of martial law or state of siege (hereinafter for the purposes of this Exclusion called the "Occurrences"). Any consequence happening or arising during the existence of abnormal conditions (whether physical or otherwise), whether directly or indirectly, proximately or remotely occasioned by, or contributed to by, traceable to, arising in connection with, any of the said Occurrences shall be deemed to be consequences for which the Plan shall not be liable for except to the extent that you prove that such consequence happened independently of the existence of such abnormal conditions.
Patient Protection and Affordable Care Act (“PPACA”): This insurance is not subject to, and does not provide certain of the insurance benefits required by, the United States PPACA. PPACA requires certain U.S. residents and citizens to obtain PPACA compliant insurance coverage. In certain circumstances penalties may be imposed on U.S. residents and citizens who do not maintain PPACA compliant insurance coverage. You should consult your attorney or tax professional to determine if PPACA’s requirements are applicable to you. The policy contains the plan benefits, including a lifetime maximum that you have selected. Please review your choices to ensure that you have sufficient coverage to meet your medical needs.