Policy Exclusions

Exclusions applicable to Basic Hospitalisation Benefit:

30 Days exclusion
Medical charges incurred, except those arising out of accidental injuries, within the first 30 days from the start date of the policy are not covered. This clause does not apply for subsequent renewal (without a break) of this policy with us.

2 Years exclusions
Expenses incurred on treatment of following diseases within the first two years from the start date of the policy are not covered:

• Cataract
• Benign Prostatic Hypertrophy
• Myomectomy, Hysterectomy unless because of malignancy
• Hernia, Hydrocele
• Fistula in Anus, Piles
• Arthritis, Gout, Rheumatism
• Joint replacement, unless due to accident
• Sinusitis and related disorders
• Stone in the urinary and biliary systems
• Dilatation & Curettage
• Skin and all internal tumors / cysts / nodules / polyps of any kind, including breast lumps, unless malignant / adenoids and hemorrhoids
• Dialysis required for chronic renal failure
• Surgery on tonsils and sinuses
• Gastric and duodenal ulcers

These above diseases are covered from third year, if the policy is renewed with us for two consecutive years.

Permanent

• Any internal congenital illness
• Non-allopathic treatment, pregnancy and childbirth related diseases, cosmetic, aesthetic and obesity related treatment.
• Expenses arising from HIV or AIDS and related diseases, use or misuse of liquor, intoxicating substances or drugs as well as intentional self injury.
• War, riots, strike, terrorism acts, nuclear weapon induced treatment.

Exclusions applicable to OPD (Outpatient Department Expenses):

• Suicide or self-inflicted injury
• Alcohol or drug abuse
• War, riots, terrorism, nuclear related hospitalization
• Non-allopathic treatment, experimental and unproven treatment
• Expenses arising from treatment of HIV/ AIDS or related disease, use or misuse of alcohol and other intoxicating substances and intentional self-injury
• No claim shall be admissible under Outpatient Department cover, 30 days after expiry of the period of insurance.
• The Company shall not receive any claims prior to completion of 90 days of the commencement of the Policy

For more details, kindly refer to the Policy Wording.

Health Advantage Plus Product Code: Misc 63