STANDARD EXCLUSIONS LIST UNDER MEDICLAIM POLICY |
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All diseases/ injuries which are pre-existing which the cover incepts for the first time. For the purpose of applying this condition, the date of inception of the initial Mediclaim policy taken from any of the Indian Insurance companies shall be taken, provided the renewals have been continuous and without any break.
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During the first year of the operation of the policy, the expenses on treatment of diseases such as Cataract, Benign-Prostatic Hypertrophy, Hysterectomy for Menorrhagia, or Fibromyoma, Hernia, Hydrocele, Congenital internal disease, Fistula in anus, Piles, Sinusitis and related disorders are not payable. If these diseases (other than congenital internal disease, Fistula in anus, Piles, Sinusitis and related disorders 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.
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Any disease other than stated above contracted by the Insured person during the first 30 days from the commencement date of policy.
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Injury / disease directly or indirectly caused by or arising from or attributable to invasion, Act or Foreign enemy, War like operations (whether war be declared or not).
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Circumcision unless necessary for treatment of a disease not excluded hereunder or as may be necessitate due to an accident, vaccination or inoculation or change of life or cosmetic or aesthetic treatment of any description, plastic surgery other than as may be necessitated due to an accident or as part of any illness.
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Cost of spectacles, contact lenses, hearing aids and cosmetic surgeries.
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Dental treatment or surgery of any kind unless requiring hospitalization. |
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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.
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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 Lymphadinopathy 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.
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Charges incurred at Hospital or Nursing Home primarily for diagnosis x-ray or Laboratory examinations or other diagnostic studies not consistant with or incidental to the diagnosis and treatment of positive existence of presence of any ailment, sickness or injury, for which confinement is required at a hospital/ nursing home.
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Expenses on vitamins and tonics unless forming part of treatment for injury or disease as certified by the attending physician.
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Injury or Disease directly or indirectly caused by or contributed to by nuclear weapon/ materials. |
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Treatment arising from or traceable to pregnancy (including voluntary termination of pregnancy and child birth, including caesarean section) and naturopathy treatment.
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LIST OF NON-MEDICAL ITEMS NOT COVERED UNDER THE INSURANCE SCHEME |
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Registration/ Admission Charges.
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Ambulance Charges. |
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Extra Bed for Attendant. |
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Expenses on luxury items like Radio/ TV/ AC/ Laundry/ Telephone. |
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Expenses on vitamins, tonics,if not related to treatment.
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Sanitary items. |
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Special duty nursing fee.
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Diet charge for patient unless specifically prescribed by the treating doctor. |
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Food and Beverages for Attendant.
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Xerox/ Certifying charges. |
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Vaccination/ Nutrition and Dietetics. |
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Expenses on spectacles/ hearing aids/ cervical collar. |
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Service charges/ Surcharge/ Service tax.
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Medical Instruments/ Equipments like Glucometer, BP Apparatus, Thermometer, Water Bed, Nebulizer machine etc. |
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