- Suicide or any intentionally self-inflicted injury;
- Any drug, narcotic, gas or fumes, or chemical substance voluntarily taken, administered, absorbed or inhaled unless prescribed by, and taken according to the directions of a doctor (accidental ingestion of poisonous substance is not excluded);
- Commission, or attempt to commit a felony;
- Participation in a riot or insurrection;
- Driving under the influence of a controlled substance, unless administered on the advice of a doctor;
- Driving while intoxicated (determined by the laws in the jurisdiction of the geographical area where the loss occurs;
- Declared or undeclared war or act of war;
- Nuclear reaction or the release of nuclear energy. This exclusion will not apply if the loss is sustained within 180 days of the initial
accident and:
- The loss was cause by fire, heat, explosion, or other physical trauma which was a result of the release of nuclear energy; and
- The covered person was is 25-mile radius of the site of the release either at the time of the release, or within24-hours of the start of the release , or occurs while he/she is in the state where the original Certificate was issued.
- Routine health checkups or immunizations for Covered Person aged 6 and older; expenses for allergies, allergy serum or allergy
testing, unless specifically provided for in this Certificate;
- Surgery to correct vision or hearing, eyeglasses, contact lenses and hearing aids, braces, appliances, or examinations or
prescriptions;
- Dental care, X-rays, or treatment other than injury to sound, natural teeth and gums resulting from an accidental injury and
rendered within six months of the injury;
- Spinal manipulations and manual manipulative treatment or therapy;
- Weight loss or modification and complications arising from, including surgery and other form of treatment for the purpose of weight
loss or modification;
- Rest cures or custodial care, or treatment of sleep disorders;
- Treatment, services, or supplies received outside of the United States except for acute sickness or injury sustained during the first
thirty days of travel outside U.S.;
- Normal pregnancy or childbirth, except for complications of pregnancy;
- Any drug, treatment, or procedure that either promotes or prevents conception or childbirth regardless of what drug, treatment, or
procedure was originally prescribed or intended for;
- Treatment of temporomandibular joint (TMJ) disorders involving the installation of crowns, pontics, bridges or abutments, or the
installation, maintenance or removal of orthodontic or occlusal appliances or equilibration therapy;
- Cosmetic surgery. The following types of reconstructive surgery are not excluded:
- On an injured part of the body following trauma, infection, or other disease of the involved part;
- Of a congenital disease or anomaly of a covered dependent newborn or adopted infant; or on a non-diseased breast to restore and achieve symmetry between two breast following a covered mastectomy;
- The repair or replacement of existing artificial limbs, orthopedic braces, or orthotics devices, dentures, partial dentures, braces, or fixed or removable bridges;
- Treatment or removal of warts, boils, skin blemishes or birthmarks, bunions, acne, corns, calluses, the cutting and trimming of toenails, care for flat feet, fallen arches or chronic foot strain;
- Personal items such as television, telephone, lotions, shampoos, extra beds, meals for guests, take home items, or other items for comfort and convenience;
- Treatment of mental or nervous disorders, or alcohol or substance abuse; Prescription medicines;
- Prescription medicines;
- Any injury that is caused by flight or travel in or upon;
- An aircraft or other craft designed for navigation above or beyond the earth’s atmosphere except as a fare-paying passenger;
- An ultra light, hang-gliding, parachuting or bungi-cord jumping;
- A snowmobile;
- Any two or three wheeled motor vehicle;
- Any off-road motorized vehicle not requiring licensing as a motor vehicle;
- Any watercraft or other craft designed for water use above or beneath the water; except as a fare-paying passenger;
- Any accidental injury where the covered person is the operator of a motor vehicle and does not possess a current and valid motor vehicle operator's license (except in a Driver's Education Program);
- Services, treatment, or loss:
- Rendered in any Veterans Administration or Federal Hospital, except if there is a legal obligation to pay;
- Payable by any automobile insurance policy without regard to fault (unless prohibited by state law);
- Which a covered person would not have to pay if he/she did not have insurance;
- Provided by a doctor, nurse, or any other person who is employed or retained by a covered person or who is a member of a covered person’s immediate family;
- Covered by state or federal worker’s compensation, employers liability, occupational disease law, or similar laws;
- Injury or sickness sustained while on active duty in the armed forces of any country (does not include Reserve or National Guard duty for training).
- Elective treatment or surgery and treatment, procedures, products or services that are experimental or investigative. Experimental or investigative means a drug, device, or medical treatment or procedure that:
- Cannot lawfully be marketed without approval of the United States Food and Drug Administration and approval for marketing has not been given at the time of being furnished;
- Has Reliable Evidence indicating it is the subject of ongoing clinical trials or is under study to determine its maximum tolerated dose, toxicity, safety, efficacy, or as compared with the standard means of treatments or diagnosis; or
- has Reliable Evidence indicating that the consensus of opinion among experts is that further studies or clinical trials are necessary to determine its maximum tolerated dose, toxicity, efficacy, or its efficacy as compared with the standard means of treatment of diagnosis
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