UltraCare
12
BE18
Bone marrow transplants, the costs of finding and obtaining an organ,
costs as a result of removing an organ from a donor, any costs related to the
transplant of an organ that is not obtained in accordance with the World Health
Organisation’s guidelines, costs of
removing an organ from
you
to transplant it
into another person, and any resulting complications.
BE19
Cryopreservation, implantation or re-implantation of living cells or living
tissue, whether taken from
your
own body or provided by a donor. Costs of
removing living cells or living tissue from
you
to implant or re-implant into another
person, and any resulting complications.
BE20
Foetal
treatment
.
BE21
Terminating a pregnancy.
BE22
Congenital abnormalities
or
birth defects
.
BE23
Suicide, attempted suicide or any deliberate, self-inflicted
medical
condition
.
BE24
Putting
yourself
in needless danger, except in an attempt to save human
life.
BE25
Any
medical condition
suffered by military, naval or air force personnel
engaging in any military, naval or air force operation or exercise.
BE26
Any
medical condition
you
suffer as a result of
taking part in, or engaging
in, any one or more of the following:
•
an illegal or criminal act;
•
military activity, war, riot, revolution, strike, lock-out or civil commotion;
•
terrorism, usurped power; or
•
any similar event.
BE27
Contamination from biological, chemical or nuclear materials, including
waste products from the combustion of nuclear fuel. Any biological, chemical or
nuclear weapon of mass destruction, whether or not as the result of an explosion.
BE28
Treatment
received and costs incurred outside
your area of cover
.
BE29
You
engaging in
professional sports
or using a weapon or firearm for any
purpose.
BE30
Sleep apnoea, sleep-related breathing disorders, snoring or insomnia.
BE31
Developmental disorders of the brain, learning disorders, learning
difficulties, speech problems and voice problems.
BE32
The costs of:
•
cosmetic, reconstructive or remedial
treatment
; or
•
replacing any implant;
including any related complications, whether or not the
treatment
, replacement or
complications are for psychological reasons.
We
will pay these costs if an in-patient or daycare surgical operation is needed as
the result of an eligible
medical condition
that first occurred after
your date of
joining
.
BE33
Removing fat from any part of the body, breast reduction or breast
enlargement.
BE34
Treatment
in a quarantine, isolation ward or unit, nursing home, hydro spa,
spa, health farm or similar facility.
BE35
Charges incurred for overdue payment of invoices.
BE36
Myopia, hypermetropia, astigmatism, natural or non-medical degenerative
sight or hearing disorders, aids to help with
your
sight or hearing, contact lens
solutions, eye drops, sunglasses or prescription sunglasses.
Preventative services
and examinations for sight or hearing.
BE37
Treatment
needed as a result of tattooing or piercing any part of the body.
BE38
Costs of:
•
precious crowns;
•
dental
implants;
•
removable bridges;
•
dentures; or
•
false teeth,
preventative dental services
, including but not limited to:
•
sealants;
•
fluoride
treatment
; or
•
scraping, cleaning and polishing, or
orthodontic treatment
.
BE39
Compulsive or addictive eating disorders or homesickness.
BE40
Obesity, special diet or weight control.
BE41
Costs of:
•
vitamin, mineral or organic supplements;
•
children’s food or baby supplies; or
•
products that can be obtained without a prescription, including, but not
limited to, mouthwash, toothpaste, antiseptic lozenges or sprays, shampoo
and sunscreen.
BE42
Supplying, fitting or maintaining any external prostheses, appliance or
device. The cost of renting or buying wheelchairs or other equipment, medical or
otherwise.
We
will pay for a spinal support, knee brace or air cast boot if it is part
of a surgical operation or part of the
treatment
of an eligible
medical condition
.
We
will also pay for crutches if medically necessary for the
treatment
of an
eligible
medical condition
.
BE43
Costs of:
•
completing
Claim
forms;
•
completing or obtaining any other documents;
•
hospital
administration fees; or
•
any registration fees.
BE44
Any
consequential loss
.
BE45
Costs
incurred before
your start date
or after
your end date
.
BE46
Any costs relating to
in-patient
,
daycare
or
out-patient treatment
in a
hospital
:
•
received at the time of
your start date
; or
•
that you were aware of at
your start date
;
whether the
treatment
was planned or not, unless
you
have told
us
about it and
we
have accepted it.
BE47
Drugs or dressings that:
•
are not recognised by the pharmaceutical regulator in the country where
treatment
is provided;
•
are available without prescription; or
•
are prescribed for a
medical condition
that is different to the one that
you
are claiming for.
BE48
Costs as a result of proven medical negligence or malpractice.
BE49
Any
deductible
that applies to
your plan
.
BE50
Costs of:
•
contraception or sterilisation;
•
treatment
for sexual problems, including impotence, whatever the cause;
•
fertility or infertility tests or
treatment
;
•
assisted reproduction; or
•
surrogacy.
BE51
Any
treatment
needed for a newborn child if the pregnancy was the result
of assisted conception.
BE52
Invoices,
Claim
forms, medical reports or any other documents that have
been altered or amended.
BE53
Travelling in, or on, a motorised
vehicle
as a driver or passenger:
•
if the driver does not have a valid licence as required by local law; or
•
you
are not wearing the necessary safety equipment.
BE54
Antenatal 3D or 4D ultrasound scans.
BE55
Health education programmes or services including, but not limited to,
family planning, antenatal classes and parenting classes.
BE56
Treatment
of birthmarks.
Extra benefit conditions and benefit exclusions for
add-on plans
The following extra
benefit
conditions and
benefit
exclusions apply to the add-on
plans
. If
you
have an add-on
plan you
will receive an additional Certificate of
insurance for this
plan
.
Extra benefit condition for the Maternity add-on plan
Claims
will only be paid under the
plan
if
you
meet the
benefit
conditions listed
in the ‘
Benefit
conditions’ section and the extra
benefit
condition listed below.
