Exclusions

Unless otherwise agreed in writing by the Insurer, no benefit or reimbursement shall be paid by the Insurer under this Policy in respect of claims arising from :

1. Any kind of Covered Condition detected within the first :
   1. 1. Thirty (30) days from the Original Inception Date
   2. All Covered Conditions which occur/arise within 30 (thirty) days from the Original Inception Date, unless caused by an Accident.
   1. 2. Twelve (12) months from the Original Inception Date for all of the following:
      1. 2. 1. Multiple Sclerosis
      1. 2. 2. Asthma, Tuberculosis (TBC)
      1. 2. 3. Varicose veins, haemorrhoids, etc
      1. 2. 4. Cardio Vascular Disease, hypertension and hypotension, Coronary Heart Disease, Heart Disease (MCI),
      2. Heart Attack, etc
      1. 2. 5. Cerebrovascular Disorder (stroke)
      1. 2. 6. Epilepsy
      1. 2. 7. Cancer of all types and tumors of all kinds.
      1. 2. 8. Thyroid gland disorders/mumps such as hypothyroidsm, hyperthyroidism (thyroid gland
      2. enlargement),
      1. 2. 9. Hepatitis B, Hepatitis Non A Non B, Hepatitis C.
      1. 2. 10. Gastro-intestinal disorders, including stomach disorders, Large Intestine, Small Intestine, Appendix /,
      2. Liver, Gall Bladder(example: Inflammation of Bile Stone) dyspepsia and other Digestive Tract Disorders.
      1. 2. 11. Diabetes Mellitus and other metabolic diseases
      1. 2. 12. Diseases such as urinary tract / Ureter, Renal (kidney stones, colic), Vesica urethra urinary stones in
      2. the urinary tract including the above.
      1. 2. 13. Joint disorders (rheumatic / Gout) or Bone Disorders (Osteoporosis) and other muscle diseases.
      1. 2. 14. Cataracts
      1. 2. 15. Abnormalities in the nasal septum or turbinates and sinuses, such as septum deviation.
      1. 2. 16. Tonsils where tonsil Surgery is required.
      1. 2. 17. Any type of hernia (example: HNP or nucleus pulposus hernia)
      1. 2. 18. Ani fistula.
      1. 2. 19. Reproductive Tract Disease in women (Endometriosis, Cysts, myomas) and in men (Enlarged
      2. Prostate,Varicocele,hydrocele), etc.
      1. 2. 20. Skin abnormalities that do not require antibiotics for treatment.
      1. 2. 21. Any other illness/disease which is considered Chronic Disease.
2. Suicide or self-inflicted injuries or any attempt thereat, whether sane or insane
3. Violation or any attempt of violation of the law or resistance to lawful arrest.
4. Injuries and sickness arising directly or indirectly from war, any act of war (declared or not), terrorist activities, full-time service in any of the armed forces, direct participation in riot, strike and civil commotion or insurrection or criminal acts by the Insured Person.
5. Any dental work, dental treatment or dental surgery including the excision of impacted tooth except as necessitated by an Accident.
6. Cost of Glasses, eye examinations or refractions for the purpose of their fitting of glasses and eye glasses.
7. All kinds of refractive surgery and LASIK surgery (including its consequences)
8. Hearing Aids or the fitting thereof.
9. Pregnancy, childbirth including caesarean section, miscarriage, any abortion (and its consequence) unless it has been confirmed by a Physician to be Medically Necessary), pre-natal or post-natal care and all complications therefrom. Any treatment relating to surgical, mechanical or chemical contraceptive methods of birth control, treatment pertaining to infertility and treatment of menstrual disorders.
10. Communicable diseases requiring (by law) isolation or quarantine, and epidemic diseases (ie : Severe Acute Respiratory Syndrome/SARS)
11. Any treatment or surgery to Congenital Conditions. Congenital Conditions are deemed to include hereditary conditions, such as :
    11. 1. Thalassemia
    11. 2. Hemofilia
    11. 3. Congenital Hemangioma
    11. 4. Polydactil
    11. 5. Congenital Hydrocephalus
    11. 6. Atresia Ani
    11. 7. Atresia Billier
    11. 8. Congenital Strabismus
    11. 9. Fistula Pre-Auriculer
    11. 10. Congenital Glaucoma Infantile
    11. 11. Hypospadia
    11. 12. Mamae Aberans
    11. 13. Plano Valgus
    11. 14. Plano Valus
    11. 15. Thyroglossal Duct Cyst
    11. 16. Dermoid Cyst
    11. 17. Diabetes Juvemile
    11. 18. Atrial Septal Defect
    11. 19. Ventricular Septal Defect
    11. 20. Patent Ductus Arteriosus
    11. 21. Any Illness or other medical abnormalities categorized as Congenital Conditions
12. Any hernia prior to 12 years old and epilepsy except when caused by trauma which occurs after the Original Inception Date of this policy.
13. Any cosmetic/beauty treatment/therapy/operation including non medically necessary reconstruction Surgery, plastic Surgery for any reason
14. Any treatment for weight gain/loss
15. Special nursing fees or purchases of any appliance or prosthetic devices except for the rental of these devices during Hospitalization.
16. All type of claim submissions which are paid under BPJS Ketenagakerjaan/BPJS Kesehatan Insurance Policy or Social Benefit Organization/other institution. The Insurer will only responsible for paying the remainder bills, or pay the claim submission subject to Policy Schedule, whichever is lower.
17. Any expenses not related to treatment, such as telephone, television, and similar facilities.
18. Examination/therapy which is related to psychological (stress) including any related treatment for physical function disorder or mental including physiology or psychosomatic; or any condition caused by neuron Disease (neurosis).
19. Any routine medical or physical check-up, physical therapy, that is not Medically Necessary
20. Any preventive treatments/medicines/ examinations
21. Treatment by any person other than a registered medical practitioner.
22. No benefit shall be paid as a result of Confinement in any Hospital where care was provided to the Insured Person without charge.
23. Conditions related to Sexually Transmitted Diseases/Veneral Diseases and their sequel.
24. AIDS (Acquired Immune Deficiency Syndrome) and ARC (AIDS Related Complications) including HIV or any sequel.
25. Ionizing radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from process or fission or from nuclear weapons material.
26. Injury caused by participation any kind of competition (except running), including, but not limited to diving that requires respiratory apparatus, rafting, edge climbing, hunting, polo, horse jumping or racing, car/motor racing winter sports and professional sports
27. Injury, Sickness or Disease as a result of flying in an aircraft unless as a passenger on a commercial flight with a licensed carrier
28. Any routine examination for preventive purposes, such as Pap's smear examination to determine the presence of cancer cells.
29. Any examination and treatment that is not recognized in western medicine, including, but not limited to acupuncture, chiropractic, shin she, traditional examination, herbs and others, including the consequences thereof.
30. Rest cures or sanitaria care including treatment for recuperative purposes such as mental or physical fatigue; veneral diseases; drug abuse or alcoholism
31. Injury, Sickness or Disease as a result of natural disasters, earthquakes, tsunamis, volcanic eruptions, hurricanes, storms, floods or geological or other meteorological phenomena.
32. Cryo preservation or introduction or re-introduction of living cells
33. The acquisition and implantation of artificial heart and mono or bi-ventricular devices
34. Travelling specifically to obtain medical treatment unless agreed by the Insurer