Under this plan, we will not cover conditions that result from any of the following events:
All benefits exclusions
Any claim directly or indirectly caused by AIDS or HIV.
Life insurance benefit exclusions
- Death caused by pre-existing conditions for which the insured employee showed symptoms or received treatment, diagnosis, consultation or prescribed drugs within 12 months before the effective date of the policy, whether directly or indirectly, wholly or partly, unless he/she has been insured under the policy continuously for 12 months.
- In case of suicide, whether while sane or insane, within 1 year from the effective date of the policy, we will only offer a refund limited to the total premiums paid for life insurance benefit for the insured employee. This also applies to any subsequent increase in life insurance benefit that comes into effect within 1 year.
Accident insurance benefits exclusions
- Racing on horse or wheels.
- Violation or attempted violation of the law, or resistance to arrest.
- Entering, operating or serving, riding in or on, ascending or descending from or with any aerial device, or conveyance except while the insured employee is a fare-paying passenger in an aircraft operated by a commercial passenger airline on a regular scheduled passenger trip over its established passenger route.
- Suicide, self-inflicted injuries or any related attempt, while sane or insane.
- Riot and civil commotion, strikes or terrorist activities.
- War, declared or undeclared, revolution or any warlike operations.
Medical benefits exclusions
Medical benefits include hospitalisation and post-hospitalisation benefits, surgical benefits, extended benefits, optional supplementary major medical benefits and optional outpatient benefits.
- any benefit not available under an insured member’s plan or charges exceeding the maximum limits specified in the benefits schedule.
- pre-existing conditions for which the insured member showed symptoms or received treatment, diagnosis, consultation or prescribed drugs within 12 months before the effective date of the policy, unless he/she has been insured under the policy continuously for 12 months.
- health services that are not medically necessary.
- special nursing care; general physical or medical check-ups or tests unrelated to treatment or diagnosis of an actual illness or injury, or are not medically necessary; immunisation, vaccination or inoculation.
- Chinese herbal medicine, bone-setting, acupuncture, tui na massage (unless covered under optional benefits), hypnotism, massage therapy, aroma therapy, and other forms of alternative treatments.
- psychological, emotional, mental or behavioural investigation and treatment; alcoholism or drug addiction; rest cure or sanitaria care; treatment of an optional nature; intentionally self-inflicted injuries while sane or insane.
- any dental or eye examination or treatment, surgical procedure for correction of eye refraction, cosmetic procedures or plastic surgery, unless it is necessary for the repair of damage caused by an accidental injury covered under the policy.
- services and supplies for quitting smoking and treatment of nicotine addiction.
- birth control measures, investigation or treatment for infertility, genetic testing or counselling, and treatment due to pregnancy, childbirth or abortion.
- purchase or use of special braces, appliances, equipment or prosthetic devices, implants, contact lenses, eye glasses, hearing aids or the fitting of the same and non-medical services such as television, telephone and the like.
- clinical home care, custodial care in any setting, day care, hospice, private nursing, and respite care, unless approved by the Company in advance.
- other education services such as speech improvement, diabetic classes and nutritional services, or group support services.
- any investigation, treatment or surgery for congenital defect that gives rise to signs or symptoms, or is diagnosed, before the insured member reaches the age of 17.
- services given by a doctor, surgeon or Chinese medicine practitioner, whether legally registered or not, who shares the same legal residence as the insured member, or is a member of the insured member’s family, including spouse, brother, sister, parent or child; or services delivered by a financial planner of the Company.
- experimental, investigational or unproven services, unless approved by us already.
- injuries directly or indirectly caused by war, declared or undeclared.
The above list is for reference only. Please refer to the policy contract of this plan for the complete list and details of exclusions.