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EXCLUSIONS
The Company shall not cover nor pay any expenses related to the
following exclusions:
1. Treatment of injuries and/or sicknesses resulting from the participation of the
Eligible Plan Member either as amateur or professional, in hazardous sports such
as motorcar or motorbike race, deep sea diving, snorkelling, parachuting, hang
gliding, delta plane etc.
2. Treatment of injuries and /or sickness consequent to participation of the Eligible
Plan Member in warlike activities.
3. Any case resulting from alcoholism, addiction to drugs and like substances, abuse of
medicines under no medical supervision and all consequences arising there from.
4. Injuries arising from the Eligible Plan Member taking part in crimes or breaking
the law or regulations.
5. Treatment due to ionic radiation, chemical or atomic pollution.
8

27.
28.
29.

6. Suicide, self-destruction or intentional self-inflicted injury or any attempt hereto,

while sane or insane.
7. Sexually transmitted diseases, A.I.D.S and its derivatives and/or complications,
including diagnostic tests as well as their medications and treatment.
8. All mental and/or psychological disorders/diseases, depression, psychological tests
and their evaluation.
9. Congenital defects, malformations, handicaps and/or diseases whether they are
apparent at birth or might become apparent later. This exclusion does not apply to
certain congenital cases: Hernia, Thyroglossal cyst, Pyloric Stenosis, Urinary and
Gastroesophageal reflux.
10. Hair Loss, Baldness, Alopecia.
11. All tests and treatments related to Acne.
12. All preventive and non-mandatory treatments.
13. Sight correction surgery.
14. Routine health tests (General check-ups).
15. Rest cures, sanitation or custodial care of periods of quarantine or isolation and
all expenses related to convalescence.
16. Desensitisation and allergen tests unless for the treatment of a different kind of
sickness.
17. Plastic and cosmetic surgeries unless directly related to an accident or following
surgery, both covered under the health plan and occurring within the policy
period. And further provided that such surgery is carried out at a medically
suitable stage after the accident or surgery has occurred. In all cases, a written
approval from Prime Health is a pre-requisite.
18. All Kinds of organ and/or bone marrow transplantation
19. Treatment administered by chiropractors, osteopaths, homeopaths and
acupuncturists or any other alternative medicine not officially recognized
20. Treatment of obesity and diet control in general, Loss of appetite, Anorexia,
Bulimia.
21. All Interferon and similar drugs treatments and their related investigations.
22. In-vitro fertilisation (IVF), ovulation induction and all contraceptive measures
and all artificial insemination procedures.
23. All Drugs, medicines and alternative drugs that are not prescribed by a physician
either in the medical Network or outside the Network.
24. All tonics and vitamins unless necessary and prescribed by the doctor for the
treatment of a specific illness; weight-loss products, milk for babies, cosmetic
products, soaps, toothpaste and contraceptive products.
25. Handicapped equipment and prostheses.
26. Treatment of impotence in all its forms and from whatever cause and all related
drugs
Infertility for both genders and all related investigations and treatments.
Hormonal treatments for menopause and osteoporosis.
Epidemic and/or endemic diseases

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