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Human Resources
General Policy Exclusions
Benefits will not be paid under the Policy and any attached Rider for any expenses which result from:
- Expenses incurred as the result of dental treatment, except as specifically provided for treatment resulting from Injury to natural teeth;
- Eyeglasses, radial keratotomy, contact lenses, hearing aids or prescriptions or examinations except as required for repair caused by a covered injury.
- Suicide, attempted suicide or intentionally self-inflicting injury while sane or insane ( in Missouri, while sane);
- Cosmetic surgery, except for the correction of birth defects, correction of deformities resulting from cancer surgery, or surgery that is required as a result of an Injury which necessitates medical treatment within 24 hours of the accident. Correction of deviated nasal septum shall be considered as cosmetic surgery for the purpose of the Policy;
- Elective Surgery or elective treatment;
- Riding as a passenger or otherwise in any vehicle or device for aerial navigation, except as a fare-paying passenger in an aircraft operated by a commercially scheduled airline. The exclusion does not apply to the insured students while taking flight instructions for University credit.
- Declared or undeclared war, riot, civil disobedience, civil commotion or acts of terrorism;
- Injury or sickness for which benefits are payable under any Workers Compensation or Occupational Disease Law;
- Injury sustained or Sickness contracted while in a service of the armed forces of any country. When an insured enters the armed forces, we will refund any unearned pro-rata premium with respect to such person;
- Treatment provided in a government hospital unless there is a legal obligation to pay such charges in the absence of other insurance.
- Injury resulting from the playing, practice, participating, or conditioning in any intercollegiate, interscholastic, intramural or club sport, contest or competition sponsored by the University, any professional or semi-professional sport, or Injury sustained while traveling to or from such a sport, contest or competition as a participant;
- Taking of any drug, medication, narcotic or hallucinogen, unless as prescribed by a Physician except as specifically provided under the Substance Abuse Benefit;
- Taking of alcohol in combination with any drug, medication or sedative except as specifically provided under the Substance Abuse Benefit.
- Expenses incurred within the Covered Persons home country or country of regular domicile other than the United States.
- Routine Physical Examinations, preventative testing or treatment, screening exams or testing in the absence of Sickness or Injury, pre-marital examinations, pre-employment examinations, health examinations or pre-school physical examinations and routine Papanicolaou cytology test;
- Expenses incurred in connection with weak, strained or flat feet, corns, calluses, bunions, or toenails;
- Expenses incurred in connection with sterilization reversal, including surgical procedures, exams, and devices;
- Committing or attempting to commit an assault or felony or fighting, except in self defense;
- Injury resulting from racing or speed con test, skin diving or sky diving, mountaineering (where ropes or guides are customarily used), or any other hazardous sport or hobby;
- Expenses resulting from a motor vehicle accident if the Covered Person is not properly licensed to operate the motor vehicle within the jurisdiction in which the accident takes place ( this exclusion will not apply to passengers if they are insured under the Policy);
- organ transplants;
- Expenses incurred for the treatment of an supplies for weight reduction; hair growth or removal, or smoking cessation;
- Services and supplies not Medically Necessary for the diagnosis recommended by the attending physician; and
- treatment for acne; breast implants; breast reduction; circumcision; deviated nasal septum, including submucous resection and/or other surgical correction thereof; family planning; infertility ( male or female) including any services or supplies rendered for the purpose or with the intent or inducing conception; learning disabilities; lesions; warts; obesity; sleep disorders; tubal ligation; and vasectomy.
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