Excluded Cases. Provided that IPA has first sought an agreement with the Insured and his/her Close Relative if the Insured and/or his/her Close Relative shall themselves be responsible for all reasonable costs incurred for such assistance, IPA will not be required to provide assistance to the following: • Pre-existing Illness or disabilities for which treatment are received prior to effective date of the Policy • Injuries due to insanity or self-infliction or conditions related to functional disorders of the mind; rest cure or sanatorium care; drug addiction or alcoholism; communicable diseases requiring by law isolation or quarantine • Congenital Abnormalities • Pregnancy and Maternity • Injuries arising directly or indirectly as a result of participation in any professional or competitive sports. • Injuries sustained contracted as a result of participation in illegal acts • Services rendered without the authorization and/or intervention of IPA • Costs which would have been payable if the event giving rise to the intervention of IPA had not occurred • Any expense more specifically covered under other insurance policy • Cases of minor Illness or injury which in the opinion of the IPA’s doctor can be adequately treated locally and which do not prevent the Insured from continuing their travels or work • Expenses incurred where the Insured in the opinion of the IPA’s doctor is physically able to return to his/her Place of Residence sitting as a normal passenger and without medical escort, unless deemed necessary by the IPA’s doctor • Cases related to psychiatric disorders • The Insured engages in any form of aerial flight except as a fare paying passenger on a regular scheduled airline or licensed charter aircraft over an established route • Infectious or Contagious Disease Exclusion during a PHEIC
Excluded Cases. Services and assistance under this Section D shall not be available with respect to Bodily Injury or Sudden Illness of the Member arising from:
Excluded Cases. This release shall not apply to any pending or future claim, overpayment request or other action to recover for fraud, waste, abuse, or overpayment against any third person, including any vendor, contractor, provider or Class Member, except as set forth in Section 12.6.A above, Section 12.8 below and Section 12.9 below. A list of pending actions to which this exclusion applies is attached as Exhibit F.
