Last Updated ( Tuesday, 06 January 2009 )
The LIFEBOAT Medical Insurance Plan
  1. Any injury or illness which meets the following criteria:
    1. A condition that would have caused a person to seek medical advice, diagnosis, care or treatment prior to the Effective Date of coverage under this Certificate.
    2. A condition for which medical advice, diagnosis, care or treatment was recommended or received prior to the Effective Date of coverage under this Certificate.

    However, Pre-existing Conditions that ARE disclosed on the application and accepted by the Company shall be considered covered. Exclusionary Riders may be issued by the Company for certain Pre-Existing Conditions.

  2. Pregnancy expenses, including complications of pregnancy;
  3. Injury or illness which is not presented to the Company for payment within ninety (90) days immediately following the incident.
  4. Charges for treatment which is not Medically Necessary.
  5. Charges provided at no cost to the Insured Person.
  6. Charges for treatment which exceed Reasonable and Customary charges.
  7. Charges incurred for Surgeries or treatments which are investigational, Experimental, or for research purposes.
  8. Services, supplies or treatment, including any period of Hospital confinement, which were not recommended, approved and certified as Medically Necessary and reasonable by a Physician.
  9. Suicide or any attempt there at, while sane or self destruction or any attempt there at, while insane;
  10. Any consequence, whether directly or indirectly, proximately or remotely occasioned by, contributed to by, or traceable to, or arising in connection with: a. war, invasion, act of foreign enemy hostilities, warlike operations (whether war be declared or not), or civil war. b. mutiny, riot, strike, military or popular uprising insurrection, rebellion, revolution, military or usurped power. c. any act of any person acting on behalf of or in connection with any organization with activities directed towards the overthrow by force of the Government de jure or de facto or to the influencing of it by terrorism or violence. d. martial law or state of siege or any events or causes which determine the proclamation or maintenance of martial law or state of siege (hereinafter for the purposes of this Exclusion called the "Occurrences").
  11. Injury sustained while participating in professional athletics;
  12. Routine physicals, immunizations, or other examinations where there are no objective indications or impairment in normal health, and laboratory diagnostic or x-ray examinations, except in the course of a Disablement established by a prior call or attendance of a Physician; or unless otherwise covered under this Certificate;
  13. Treatment of the Temporomandibular Joint.
  14. Vocational, Speech, Recreational or Music Therapy.
  15. Services or supplies performed or provided by a Relative of the Insured Person, or anyone who lives with the Insured Person.
  16. Cosmetic or plastic Surgery, except as the result of a covered Accident. For the purposes of this Insurance, treatment of a deviated nasal septum shall be considered a cosmetic condition.
  17. Treatment and the provision of false teeth or dentures, normal ear tests and the provision of hearing aids;
  18. Eye refractions or eye examinations for the purpose of prescribing corrective lenses for eye glasses or for the fitting thereof, unless caused by Accidental Bodily Injury incurred while insured hereunder;
  19. Injury sustained while under the influence of or Disablement due wholly or partly to the effects of intoxicating liquor or drugs, other than drugs taken in accordance with treatment prescribed and directed by a Physician for a condition which is covered hereunder. No coverage for treatment of drug addiction.
  20. Telephone consultations or failure to keep a scheduled appointment.
  21. Treatment while confined primarily to receive Custodial Care, educational or rehabilitative care, or nursing services.
  22. Congenital abnormalities and conditions arising out of or resulting therefrom, unless otherwise covered under this Certificate.
  23. Expenses which are non-medical in nature.
  24. The cost of the Insured Person's unused airline ticket for the transportation back to the Insured Person's Home Country, where an Emergency Medical Evacuation or Repatriation and/or Return of Mortal Remains benefit is provided.
  25. Expenses as a result or in connection with intentionally self-inflicted injury or illness;
  26. Expenses as a result or in connection with the commission of a felony offense;
  27. Injury sustained while taking part in mountaineering where ropes or guides are normally used, hang gliding, parachuting, bungee jumping, racing by horse, motor or motorcycle, scuba diving involving underwater breathing apparatus - unless PADI, DAN (or other) Certification;
  28. Treatment paid for or furnished under any other individual or group policy or other service or medical pre-payment plan arranged through the employer to the extent so furnished or paid, or under any mandatory government program or facility set up for treatment without cost to any individual;
  29. Injuries for which benefits are payable under any no-fault automobile insurance policy;
  30. Treatment of Venereal disease, sexually tranmitted disease, or expenses for a sex change;
  31. Dental care, except as the result of injury to sound, natural teeth caused by Accident;
  32. Routine Dental Treatment;
  33. Pregnancy expenses incurred by a Dependent Child;
  34. Drug, treatment or procedure that either promotes or prevents conception, or prevents childbirth, including but not limited to: artificial insemination, treatment for infertility or impotency, sterilization or reversal thereof, or abortion.

Exclusions Regarding the AD&D benefit are listed in the Certificate of Insurance.

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