No benefit shall be paid under this Contract for expenses or losses resulting from or incurred in connection with or in consequence of the following:
- The first BDT 500 per claim are excluded
- Policy liability for each confinement shall be limited to a maximum of 21 days. Successive periods of hospital confinement within 90 days due to the same disability are considered as a single period. But in no event shall the benefit exceed the limit set forth in the schedule of this policy.
- All pre-hospitalization expenses and any minor surgical operation are excluded where confinement in hospital is not necessary or performed as an out-door surgery
- if any insured is also covered for similar benefits under any other insurance policy then payment of the claim shall be made on a pro-rata basis after taking into account the coverage under all policies
- Any charges for food or food supplements (Horlicks, Viva, Bourn Vita etc.), cosmetic creams or oils of any nature, water purifiers etc. are excluded.
- Maternal benefits for pregnancy or child birth are covered only after 9 months from the commencement date of this policy. Nevertheless, emergency hospitalization arising from the following complications of pregnancy are covered: a)Hyper emesis gravid arum, b) Extras-uterine pregnancy, c) Eclipse of pregnancy, d) intra-abdominal surgery required for complications after termination of pregnancy.
- Any congenital infirmity
- All pre-existing conditions
- Mental, emotional or psychiatric disorders, alcoholism or any other narcotic addiction
- Circumcision, prophylactic and immunization procedures
- Any procedures which is experimental or not generally accepted by the medical profession viz. acupuncture, herbal/ayurvedic/homeopathy treatment and any Alternative Medical Care (AMC) etc.
- Obesity i.e., treatment for, or required as a result of obesity, any cosmetic or plastic treatment/surgery, unless required as reconstructive surgery as a consequence of an injury due to accidents, burns
- Rest, convalescence or rejuvenation cures, thermal baths, physiotherapy or confinement for the purposes of slimming or beautification
- Treatment of family planning purposes including termination of pregnancy during first twelve weeks from the date of conception, sterility or treatment related to assisted reproduction, cost of contraception, cost of female hygiene product like sanitary pads, etc.
- Self-inflicted injury or the commission of or attempted commission of an assault or any unlawful act, or being engaged in any illegal activity or felony
- By participating in any types of illegal activities
- The condition of Acquired Immune Deficiency Syndrome (AIDS), or any AIDS related illness or HIV virus
- Routine examination of eye and ear, fitting or replacement of eyeglasses (including Intra-ocular lens or contact lenses) or hearing aids, health screening including routine physical examinations (health check-ups), malignant cancer, radiotherapy, chemotherapy, dialysis and any dental treatment unless require hospitalization for re-constructive surgery as a consequence of an accident
- Routine physical examinations (health check-ups), radiotherapy (X-ray, radium, or radioactive isotopes treatment), chemotherapy or any form of treatment when not incidental or necessary to the treatment of the injury/illness which caused the hospitalization
- Any dental treatment
- Injury arising due to accident while participating in any unlawful activities (e.g., driving a car without a license), attempted suicide, violation or attempted violation of the law, injuries willfully or intentionally self-inflicted or due to insanity or under the influence of a drug
- Non-surgical care for tuberculosis
- injury or disease directly or indirectly attributed to or civil commotion
- injury, destruction or damage caused by nuclear fission, nuclear fusion or irradiation
- Treatment of a newborn child upto the age of 3 months