All you want to know about the..... PREMIER HEALTH PLAN


Exclusions

This policy shall not cover:

  1. All Pre-Existing illnesses for the first twelve (12) months of insurance, subject to the pre-existing illnesses clause in the 'definition' section above.

  2. All specified illnesses for the first twelve (12) months of insurance, subject to the specific illnesses clause in the 'definition' section above.

  3. Illnesses that commenced within the Waiting Period of thirty (30) days, except for accidental injuries.

  4. Out-patient treatment not related to in-patient or day surgery, except as a result of an accident.

  5. Pregnancy, including childbirth, abortion, miscarriage, infertility and all complications arising therefrom.

  6. Conditions arising from surgical, mechanical or chemical contraception methods of birth control.

  7. Routine physical examinations, health check-up or any other tests where there are no objective indications of impairment of normal health or any treatment of a preventive nature including vaccinations, acupuncture, treatments specifically for weight reduction or any treatment which is not medically necessary.

  8. Treatment for congenital conditions and any physical birth defects arising out of or resulting therefrom.

  9. Non-hospital nursing care or ambulatory care, rest cures or sanitaria care, treatment arising from any geriatric, psycho-geriatric or psychiatric condition, treatment of alcohol dependence syndrome and drug addiction.

  10. Sickness or disease directly or indirectly arising from Human Immunodeficiency Virus (HIV), Acquired Immune Deficiency Syndrome (AIDS) or any HIV/AIDS related condition.

  11. Suicide or attempted suicide, self-inflicted injuries, self-destruction or any attempt thereat while sane or insane.

  12. Dental care and its related treatment except as necessitated by accidental bodily injury to sound natural teeth.

  13. Cosmetic or plastic surgery, circumcision, eye tests, refractive errors of the eyes, provision of appliances including spectacles, hearing aids, wheelchairs and prostheses including lenses.

  14. Sexually transmitted diseases.

  15. Hospitalisation primarily for diagnosis, X-ray examinations, general physical or medical check-up.

  16. Charges for telephone, television, radio, newspaper and other ineligible non-medical items whilst an in-patient or day-surgery.

  17. Sickness or injury arising from racing of any kind (except on foot), professional sports, parachuting, skydiving, boxing, wrestling, professional scuba-diving, bungee jumping and violation or attempt of violation of the law or resistance to lawful arrest.

  18. Flying or other aerial activity except as a fare paying passenger in a fully licensed aircraft operated by a licensed commercial air carrier or recognised charter company.

  19. Treatment arising from any consequence, whether direct or indirect of nuclear or chemical contamination, war, invasion, act of foreign enemy hostilities (whether war be declared or not), civil war, rebellion, revolution, direct participation in riot, strike and civil commotion, insurrection or military or usurped power, or active duty in any of the armed forces.

  20. Any person who resides outside Malaysia for more than six (6) months continuously while the policy is in force.

  21. Investigation and treatment of sleep and snoring disorders, treatment of Hepatitis B and Hepatitis C, and hormone replacement therapy for menopausal conditions.

  22. Psychotic, mental or nervous disorders (including any neuroses and their physiological or psychosomatic manifestations).

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