Policy Conditions ( including glossary )
Art 12. Exceptions for reimbursement
12.1 The insurance shall not cover expenses incurred for any disease, illness or injury known to the policyholder and / or the insured at the time of application, unless agreed upon with the Company.
12.2 Furthermore, the Company shall not be liable to pay reimbursement for expenses which concern, are due to or are incurred as a result of:
a) cosmetic surgery and treatment unless medically prescribed and approved by the Company,
b) obesity surgery
c) venereal diseases, AIDS, AIDS-related diseases and diseases relating to HIV antibodies (HIV positive). However, diseases relating to AIDS and HIV antibodies (HIV positive) are covered if proven to be caused by a blood transfusion received after the commencement of the policy. The HIV virus will also be covered if proven to be contracted as the result of an accident occurring during the course of only the following occupations: doctors, dentists, nurses, laboratory personnel, ancillary hospital workers, medical and dental assistants, ambulance personnel, midwives, fire brigade personnel, policemen/women, and prison officers. The insured shall notify the Company within 14 (fourteen) days after such accident and at the same time provide a negative HIV antibody test.
d) abuse of alcohol, drugs and / or medicines,
e) intentional self-inflicted bodily injury,
f) contraception, including sterilisation,
g) induced abortion unless medically prescribed,
h) any kind of fertility test and / or treatment, including hormone treatment, insemination or examinations and any procedures related hereto, including expenses for pregnancy, pre- and post-natal treatments of the newborn child / children. An application must therefore be submitted for children born as a result of fertility treatment and / or born by a surrogate mother. The application will undergo the standard underwriting procedure, according to Art. 1.
i) treatment of sexual dysfunction
j) any kind of care which is experimental, not part of a medical or surgical treatment, including stays in nursing homes
k) treatment by naturopaths or homeopaths and naturopathic or homeopathic medications and other alternative methods of treatment, unless specified in the List of Reimbursements
l) health certificates,
m) treatment of diseases during military service,
n) treatment for sickness or injuries directly or indirectly caused while actively engaging in:
war, invasion, acts of a foreign enemy, hostilities (whether was has been declared or not), civil war, terrorist acts, rebellion, revolution, insurrection, civil commotion, military or usurped power, martial law, riots or the acts of any lawfully constituted authority, or army, naval or air services operations whether war has been declared or not,
o) nuclear reactions or radioactive fallout,
p) treatment performed by the insured, his / her spouse, parents or children or an enterprise owned by 1 (one) of the aforesaid persons,
q) epidemics which have been placed under the direction of public authorities,
r) treatment by a psychologist
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traducciones juradas (sworn translations)