Loyal American Life Insurance Company Cash Advantage Exclusions and Limitations

      

 AK, AL, AR, AZ, HI, IA, KY, LA, ME, MI, MS, ND, NV, OH, RI, SC, TN, WI, WV

Pre-Existing Conditions
The benefits of this Policy will not be payable during the first twelve (12) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Preexisting Condition means a condition diagnosed or for which medical advice or treatment was recommended
by or received from a Physician within the twelve (12) months prior to the Effective Date of coverage.

This policy only pays for loss resulting from covered conditions, Policy does not cover:

  1. intentionally self-inflicted Injury or Sickness;
  2. suicide or attempted suicide, while sane or insane;
  3. treatment of Mental or Nervous Disorders without demonstrable organic disease, alcoholism or chemical dependency;
  4. loss that begins prior to the Effective Date of coverage;
  5. care and treatment received outside the United States or its territories;
  6. Injuries or Sickness due to an act of declared or undeclared war;
  7. any Injury or Sickness sustained or contracted due to an Insured Person’s being intoxicated, influence of any narcotic unless administered under the advice of a physician;
  8. any Injury or Sickness incurred while committing or attempting to commit a felony or engaging in an illegal occupation or activity;
  9. Injuries or Sickness due to participation in any sport or sporting activity for wage, compensation or profit;
  10. Injuries or Sickness due to operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven;
  11. Injury or Sickness as a result of engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot air ballooning;
  12. Injuries or Sickness due to riding in or driving any motor-driven vehicle in a race, stunt show or speed test; or
  13. any illness specifically excluded from the definition of any Specified Critical Illness.
Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

In addition to the Limitations and Exclusions described above, if selected, the Hospital Indemnity Benefit Rider is subject to the following: PRE-EXISTING CONDITION(S): Benefits will not be payable during the first twelve (12) months that coverage is in force for a loss caused by Pre-Existing Condition(s). A Pre-Existing Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician, or for which signs and symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment within the twelve (12) months prior to the Effective Date of this rider. No benefits are payable for:
  1. The following conditions if they are diagnosed within six months after the Effective Date unless Confinement is on an emergency basis; a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  2. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  3. An elective abortion;
  4. Dental treatment unless due to Injury;
  5. Treatment for which no charges are made by the provider of same;
  6. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery;
  7. Services which are primarily for rest care, convalescent care or for rehabilitation;
  8. Treatment in a Hospital outside the United States or its possessions, except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure; or
  9. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law
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CO

Exclusions and Limitations

Pre-Existing Conditions
The benefits of this Policy will not be payable during the first twelve (12) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Preexisting Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician within the twelve (12) months prior to the Effective Date of coverage. 

This policy only pays for loss resulting from covered conditions, Policy does not cover:

  1. intentionally self-inflicted Injury or Sickness;
  2. suicide or attempted suicide while sane;
  3. treatment of Mental or Nervous Disorders without demonstrable organic disease, alcoholism or chemical dependency;
  4. loss that begins prior to the Effective Date of coverage;
  5. care and treatment received outside the United States or its territories;
  6. Injuries or Sickness due to an act of declared or undeclared war;
  7. any Injury or Sickness sustained or contracted due to an Insured Person’s being intoxicated, influence of any narcotic unless administered under the advice of a physician;
  8. any Injury or Sickness incurred while committing or attempting to commit a felony or engaging in an illegal occupation or activity;
  9. Injuries or Sickness due to participation in any sport or sporting activity for wage, compensation or profit;
  10. Injuries or Sickness due to operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven;
  11. Injury or Sickness as a result of engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot air ballooning;
  12. Injuries or Sickness due to riding in or driving any motor-driven vehicle in a race, stunt show or speed test; or
  13. any illness specifically excluded from the definition of any Specified Critical Illness.
Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

In addition to the Limitations and Exclusions described above, if selected, the Hospital Indemnity Benefit Rider is subject to the following: PRE-EXISTING CONDITION(S): Benefits will not be payable during the first twelve (12) months that coverage is in force for a loss caused by Pre-Existing Condition(s). A Pre- Existing Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician, or for which signs and symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment within the twelve (12) months prior to the Effective Date of this rider. No benefits are payable for:
  1. The following conditions if they are diagnosed within six months after the Effective Date unless Confinement is on an emergency basis; a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  2. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  3. An elective abortion;
  4. Dental treatment unless due to Injury;
  5. Treatment for which no charges are made by the provider of same;
  6. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery;
  7. Services which are primarily for rest care, convalescent care or for rehabilitation;
  8. Treatment in a Hospital outside the United States or its possessions, except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure; or
  9. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law

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DE

Exclusions and Limitations 

Pre-Existing Conditions
The benefits of this Policy will not be payable during the first six (6) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Pre-existing Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician within the six (6) months prior to the Effective Date of coverage

This policy only pays for loss resulting from covered conditions, Policy does not cover:

  1.  intentionally self-inflicted Injury or Sickness;
  2. suicide or attempted suicide, while sane or insane;
  3. treatment of Mental or Nervous Disorders without demonstrable organic disease, alcoholism or chemical dependency;
  4. loss that begins prior to the Effective Date of coverage;
  5. care and treatment received outside the United States or its territories;
  6. Injuries or Sickness due to an act of declared or undeclared war;
  7. any Injury or Sickness sustained or contracted due to an Insured Person’s being intoxicated, influence of any narcotic unless administered under the advice of a physician;
  8. any Injury or Sickness incurred while committing or attempting to commit a felony or engaging in an illegal occupation or activity;
  9. Injuries or Sickness due to participation in any sport or sporting activity for wage, compensation or profit;
  10. Injuries or Sickness due to operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven;
  11. Injury or Sickness as a result of engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot air ballooning;
  12. Injuries or Sickness due to riding in or driving any motor-driven vehicle in a race, stunt show or speed test; or
  13. any illness specifically excluded from the definition of any Specified Critical Illness.

Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

In addition to the Limitations and Exclusions described above, if selected, the Hospital Indemnity Benefit Rider is subject to the following: PRE-EXISTING CONDITION(S): Benefits will not be payable during the first twelve (12) months that coverage is in force for a loss caused by Pre-Existing Condition(s). A Pre-Existing Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician, or for which signs and symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment within the twelve (12) months prior to the Effective Date of this rider. No benefits are payable for:
  1. The following conditions if they are diagnosed within six months after the Effective Date unless Confinement is on an emergency basis; a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  2. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  3. An elective abortion;
  4. Dental treatment unless due to Injury;
  5. Treatment for which no charges are made by the provider of same;
  6. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery;
  7. Services which are primarily for rest care, convalescent care or for rehabilitation;
  8. Treatment in a Hospital outside the United States or its possessions, except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure; or
  9. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law
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ID

Exclusions and Limitations 

Pre-Existing Conditions
The benefits of this Policy will not be payable during the first twelve (12) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Preexisting Condition means a condition diagnosed or for which medical advice or treatment was recommended
by or received from a Physician within the six (6) months prior to the Effective Date of the policy.

This policy only pays for loss resulting from covered conditions, Policy does not cover:

  1. intentionally self-inflicted Injury or Sickness;
  2. suicide or attempted suicide, while sane or insane;
  3. treatment of Mental or Emotional Disorders without demonstrable organic disease, alcoholism or chemical dependency;
  4. loss that begins prior to the Effective Date of coverage;
  5. care and treatment received outside the United States or its territories;
  6. Injuries or Sickness due to an act of declared or undeclared war;
  7. any Injury or Sickness sustained or contracted due to an Insured Person’s being intoxicated, influence of any narcotic unless administered under the advice of a physician;
  8. any Injury or Sickness incurred while committing or attempting to commit a felony or engaging in an illegal occupation or activity;
  9. any illness specifically excluded from the definition of any Specified Critical Illness.
Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

In addition to the Limitations and Exclusions described above, if selected, the Hospital Indemnity Benefit Rider is subject to the following: PRE-EXISTING CONDITION(S): Benefits will not be payable during the first twelve (12) months that coverage is in force for a loss caused by Pre-Existing Condition(s). A Pre-Existing Condition means an Injury or Sickness diagnosed or for which medical advice or treatment was recommended by or received from a Physician, or for which signs and symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment within the six (6) months prior to the Effective Date of this rider. No benefits are payable for:
  1. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  2. An Elective Abortion;
  3. Dental treatment unless due to Injury;
  4. Treatment for which no charges are made by the provider of same;
  5. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery. Medically necessary reconstructive surgery is defined as:
  6. a. surgery as a result of injury; or
  7. b. surgery to restore a normal bodily function; or
  8. c. surgery for medically necessary care and treatment of congenital anomalies; or
  9. d. breast reconstruction following mastectomy;
  10. Services which are primarily for rest care, convalescent care or for rehabilitation;
  11. Treatment in a Hospital outside the United States or its possessions, except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure; or
  12. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law.

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IL

Exclusions and Limitations

Pre-Existing Conditions
The benefits of this Policy will not be payable during the first twelve (12) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Preexisting Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician within the twelve (12) months prior to the Effective Date of coverage.

This policy only pays for loss resulting from covered conditions, Policy does not cover:

  1. intentionally self-inflicted Injury or Sickness;
  2. suicide or attempted suicide, while sane or insane;
  3. treatment of Mental or Nervous Disorders without demonstrable organic disease, alcoholism or chemical dependency;
  4. loss that begins prior to the Effective Date of coverage;
  5. care and treatment received outside the United States or its territories;
  6. Injuries or Sickness due to an act of declared or undeclared war;
  7. any Injury or Sickness incurred while committing or attempting to commit a felony or engaging in an illegal occupation;
  8. any Injury or Sickness sustained or contracted due to an Insured Person’s being intoxicated, influence of any narcotic unless administered under the advice of a physician;
  9. any illness specifically excluded from the definition of any Specified Critical Illness.
Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

In addition to the Limitations and Exclusions described above, if selected, the Hospital Indemnity Benefit Rider is subject to the following: PRE-EXISTING CONDITION(S): Benefits will not be payable during the first twelve (12) months that coverage is in force for a loss caused by Pre-Existing Condition(s). A Pre-
Existing Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician, or for which signs and symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment within the twelve (12) months
prior to the Effective Date of this rider. No benefits are payable for:
  1. The following conditions if they are diagnosed within six months after the Effective Date unless Confinement is on an emergency basis; all types of hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  2. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  3. An elective abortion;
  4. Dental treatment unless due to Injury;
  5. Treatment for which no charges are made by the provider of same;
  6. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery;
  7. Services which are primarily for rest care, convalescent care or for rehabilitation;
  8. Treatment in a Hospital outside the United States or its possessions, except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure; or
  9. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law

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KS

Exclusions and Limitations 

Pre-Existing Conditions  

The benefits of this Policy will not be payable during the first twelve (12) months that coverage is in force for a loss caused by a Pre-existing condition(s). If, as of the date of application, You are replacing or have an existing Specified Disease Policy, You shall be given credit for the expired portion of any Pre-existing Conditions limitation of that policy. A Pre-existing Condition means a  condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician within the twelve (12) months prior to the Effective Date of coverage.

This policy only pays for loss resulting from covered conditions, Policy does not cover:

  1. intentionally self-inflicted Injury or Sickness;
  2. suicide or attempted suicide, while sane or insane;
  3. treatment of Mental or Nervous Disorders without demonstrable organic disease, alcoholism or chemical dependency;
  4. loss that begins prior to the Effective Date of coverage;
  5. care and treatment received outside the United States or its territories;
  6. Injuries or Sickness due to an act of declared or undeclared war;  
  7. any Injury or Sickness sustained or contracted due to an Insured Person’s being intoxicated, influence of any narcotic unless administered under the advice of a physician;
  8. any Injury or Sickness incurred while committing or attempting to commit a felony or engaging in an illegal occupation or activity;
  9. Injuries or Sickness due to participation in any sport or sporting activity for wage, compensation or profit;
  10. Injuries or Sickness due to  operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven;
  11. Injury or Sickness as a result of engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot air ballooning;
  12. Injuries or Sickness due to riding in or driving any motor-driven vehicle in a race, stunt show or speed test; or
  13. any illness specifically excluded from the definition of any Specified Critical Illness.

Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

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MO

Exclusions and Limitations 

Pre-Existing Conditions 
The benefits of the Policy will not be payable during the first twelve (12) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Preexisting Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician within the twelve (12) months prior to the Effective Date of coverage.

The policy only pays for loss resulting from covered conditions. Policy does not cover:

  1. intentionally self-inflicted Injury or Sickness;
  2. suicide or attempted suicide, while sane;
  3. treatment of Mental or Nervous Disorders without demonstrable organic disease, alcoholism or chemical dependency;
  4. loss that begins prior to the Effective Date of coverage;
  5. care and treatment received outside the United States or its territories;
  6. Injuries or Sickness due to an act of declared or undeclared war;
  7. any Injury or Sickness sustained or contracted due to an Insured Person’s being intoxicated or under the influence of any narcotic unless administered under the advice of a physician;
  8. any Injury or Sickness incurred while committing or attempting to commit a felony or engaging in an illegal occupation or activity;
  9. Injuries or Sickness due to participation in any sport or sporting activity for wage, compensation or profit;
  10. Injuries or Sickness due to operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven;
  11. Injury or Sickness as a result of engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot air ballooning;
  12. Injuries or Sickness due to riding in or driving any motor-driven vehicle in a race, stunt show or speed test; or
  13. any illness specifically excluded from the definition of any Specified Critical Illness.
Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

In addition to the Limitations and Exclusions describe above, if selected, the Hospital Indemnity Benefit Rider is subject to the following: PRE-EXISTING CONDITION(S): Benefits will not be payable during the first twelve (12) months that coverage is in force for a loss caused by Pre-Existing Condition(s). A Pre-Existing Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician, or for which signs and symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment within the twelve (12) months prior to the Effective Date of this rider. No benefits are payable for:
  1. The following conditions if they are diagnosed within six months after the Effective Date unless Confinement is on an emergency basis; a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  2. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  3. An elective abortion;
  4. Dental treatment unless due to Injury;
  5. Treatment for which no charges are made by the provider of same;
  6. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery;
  7. Services which are primarily for rest care, convalescent care or for rehabilitation;
  8. Treatment in a Hospital outside the United States or its possessions, except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure; or
  9. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law
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MT

Exclusions and Limitations 

Pre-Existing Conditions
The benefits of this Policy will not be payable during the first twelve (12) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Preexisting Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician within the twelve (12) months prior to the Effective Date of coverage.

This policy only pays for loss resulting from covered conditions, Policy does not cover:
  1. intentionally self-inflicted Injury or Sickness;
  2. suicide or attempted suicide, while sane or insane;
  3. treatment of Mental or Nervous Disorders without demonstrable organic disease, alcoholism or chemical dependency;
  4. loss that begins prior to the Effective Date of coverage;
  5. care and treatment received outside the United States or its territories;
  6. Injuries or Sickness due to an act of declared or undeclared war;
  7. any Injury or Sickness sustained or contracted due to an Insured Person’s being intoxicated, influence of any narcotic unless administered under the advice of a physician;
  8. any Injury or Sickness incurred while committing or attempting to commit a felony or engaging in an illegal occupation or activity;
  9. Injuries or Sickness due to participation in any sport or sporting activity for wage, compensation or profit;
  10. Injuries or Sickness due to operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven;
  11. Injury or Sickness as a result of engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot air ballooning;
  12. Injuries or Sickness due to riding in or driving any motor-driven vehicle in a race, stunt show or speed test; or
  13. any illness specifically excluded from the definition of any Specified Critical Illness.
Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

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NC

Exclusions and Limitations

Pre-Existing Conditions
The benefits of this Policy will not be payable during the first twelve (12) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Pre-existing Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician within the twelve (12) months prior to the Effective Date of coverage.

This policy only pays for loss resulting from covered conditions, Policy does not cover:
  1. intentionally self-inflicted Injury or Sickness;
  2. suicide or attempted suicide, while sane or insane;
  3. treatment of Mental or Nervous Disorders without demonstrable organic disease, alcoholism or chemical dependency;
  4. loss that begins prior to the Effective Date of coverage;
  5. care and treatment received outside the United States or its territories;
  6. Injuries or Sickness due to an act of declared or undeclared war (not to include acts of terrorism);
  7. any Injury or Sickness sustained or contracted due to an Insured Person’s being intoxicated, influence of any narcotic unless administered under the advice of a physician;
  8. any Injury or Sickness incurred while committing or attempting to commit a felony or engaging in an illegal occupation or activity;
  9. Injuries or Sickness due to participation in any sport or sporting activity for wage, compensation or profit;
  10. Injuries or Sickness due to operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven;
  11. Injury or Sickness as a result of engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot air ballooning;
  12. Injuries or Sickness due to riding in or driving any motor-driven vehicle in a race, stunt show or speed test; or
  13. any illness specifically excluded from the definition of any Specified Critical Illness.

Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

In addition to the Limitations and Exclusions described above, if selected, the Hospital Indemnity Benefit Rider is subject to the following: PRE-EXISTING CONDITION(S): Benefits will not be payable during the first twelve (12) months that coverage is in force for a loss caused by Pre-Existing Condition(s). A Pre-Existing Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician within the twelve (12) months prior to the Effective Date of this rider. No benefits are payable for:
  1. The following conditions if they are diagnosed within six months after the Effective Date unless Confinement is on an emergency basis; a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  2. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  3. An elective abortion;
  4. Dental treatment unless due to Injury;
  5. Treatment for which no charges are made by the provider of same;
  6. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery;
  7. Services which are primarily for rest care, convalescent care or for rehabilitation;
  8. Treatment in a Hospital outside the United States or its possessions, except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure; or
  9. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law when the employee, employer, or carrier is liable or responsible according to a final adjudication of the claim under that Article or an order of the North Carolina Industrial Commission approving a settlement agreement entered into under that Article. 

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NE

Exclusions and Limitations 

Pre-Existing Conditions
The benefits of this Policy will not be payable during the first twelve (12) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Pre-existing Condition means a  condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician within the twelve (12) months prior to the Effective Date of coverage.

This policy only pays for loss resulting from covered conditions, Policy does not cover:
  1. intentionally self-inflicted Injury or Sickness; 
  2. suicide or attempted suicide, while sane or insane; 
  3. treatment of Mental or Nervous Disorders without demonstrable organic disease, alcoholism or chemical dependency; 
  4. loss that begins prior to the Effective Date of coverage; 
  5. care and treatment received outside the United States or its territories; 
  6. Injuries or Sickness due to an act of declared or undeclared war;  
  7. any Injury or Sickness sustained or contracted due to an Insured Person’s being intoxicated, influence of any narcotic unless administered under the advice of a physician; 
  8. any Injury or Sickness incurred while committing or attempting to commit a felony or engaging in an illegal occupation; 
  9. Injuries or Sickness due to participation in any sport or sporting activity for wage, compensation or profit;
  10. Injuries or Sickness due to  operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven; 
  11. Injury or Sickness as a result of engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot air ballooning; 
  12. Injuries or Sickness due to riding in or driving any motor-driven vehicle in an organized race, stunt show or speed test; or 
  13. any illness specifically excluded from the definition of any Specified Critical Illness.
Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

In addition to the Limitations and Exclusions described above, if selected, the Hospital Indemnity Benefit Rider is subject to the following: PRE-EXISTING CONDITION(S): Benefits will not be payable during the first twelve (12) months that coverage is in force for a loss caused by Pre-Existing Condition(s). A Pre-Existing Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician , within the twelve (12) months prior to the Effective Date of this rider. No benefits are payable for:
  1. The following conditions if they are diagnosed within six months after the Effective Date unless Confinement is on an emergency basis; a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  2. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  3. An elective abortion;
  4. Dental treatment unless due to Injury;
  5. Treatment for which no charges are made by the provider of same;
  6. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery;
  7. Services which are primarily for rest care, convalescent care or for rehabilitation;
  8. Treatment in a Hospital outside the United States or its possessions, except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure; or
  9. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law

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NH

Exclusions and Limitations

Pre-Existing Conditions
The benefits of this Policy will not be payable during the first six (6) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Pre-existing Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician within the six (6) months prior to the Effective Date of coverage This policy only pays for loss resulting from covered conditions, Policy does not cover:

  1. intentionally self-inflicted Injury or Sickness;
  2. suicide or attempted suicide, while sane or insane;
  3. treatment of Mental or Nervous Disorders without demonstrable organic disease, alcoholism or chemical dependency;
  4. loss that begins prior to the Effective Date of coverage;
  5. care and treatment received outside the United States or its territories;
  6. Injuries or Sickness due to an act of declared or undeclared war;
  7. driving while legally intoxicated;
  8. any Injury or Sickness incurred while committing or attempting to commit a felony;
  9. Injuries or Sickness due to participation in any sport or sporting activity for wage, compensation or profit;
  10. Injuries or Sickness due to operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven;
  11. Injury or Sickness as a result of engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot air ballooning;
  12. Injuries or Sickness due to riding in or driving any motor-driven vehicle in a race, stunt show or speed test; or
  13. any illness specifically excluded from the definition of any Specified Critical Illness.
Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis. 

In addition to the Limitations and Exclusions described above, if selected, the Hospital Indemnity Benefit Rider is subject to the following: PRE-EXISTING CONDITION(S): Benefits will not be payable during the first twelve (12) months that coverage is in force for a loss caused by Pre-Existing Condition(s). A Pre-
Existing Condition means a condition diagnosed or for which medical advice or treatment was recommended from a Physician within the six (6) months prior to the Effective Date of the policy. No benefits are payable for:
  1. The following conditions if they are diagnosed within six months after the Effective Date unless Confinement is on an emergency basis; a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  2. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  3. An elective abortion;
  4. Dental treatment unless due to Injury;
  5. Treatment for which no charges are made by the provider of same;
  6. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery;
  7. Services which are primarily for rest care, convalescent care or for rehabilitation;
  8. Treatment in a Hospital outside the United States or its possessions, except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure; or
  9. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law

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NM

Exclusions and Limitations 

Pre-Existing Conditions
The benefits of this Policy will not be payable during the first six (6) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Pre-existing Condition means a  condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician within the six (6) months prior to the Effective Date of coverage.

This policy only pays for loss resulting from covered conditions, Policy does not cover:
  1. intentionally self-inflicted Injury or Sickness; 
  2. suicide or attempted suicide, while sane or insane; 
  3. treatment of Mental or Nervous Disorders without demonstrable organic disease, alcoholism or chemical dependency; 
  4. loss that begins prior to the Effective Date of coverage; 
  5. care and treatment received outside the United States or its territories; 
  6. Injuries or Sickness due to an act of declared or undeclared war;  
  7. any Injury or Sickness sustained or contracted due to an Insured Person’s being intoxicated, influence of any narcotic unless administered under the advice of a physician; 
  8. any Injury or Sickness incurred while committing or attempting to commit a felony or engaging in an illegal occupation or activity; 
  9. Injuries or Sickness due to participation in any sport or sporting activity for wage, compensation or profit;
  10. Injuries or Sickness due to  operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven; 
  11. Injury or Sickness as a result of engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot air ballooning; 
  12. Injuries or Sickness due to riding in or driving any motor-driven vehicle in a race, stunt show or speed test; or 
  13. any illness specifically excluded from the definition of any Specified Critical Illness.
Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

In addition to the Limitations and Exclusions described above, if selected, the Hospital Indemnity Benefit Rider is subject to the following: PRE-EXISTING CONDITION(S): Benefits will not be payable during the first six (6) months that coverage is in force for a loss caused by Pre-Existing Condition(s). A Pre-Existing Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician, or for which signs and symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment within the six (6) months prior to the Effective Date of this rider. No benefits are payable for:
  1. The following conditions if they are diagnosed within six months after the Effective Date unless Confinement is on an emergency basis; a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  2. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  3. An elective abortion;
  4. Dental treatment unless due to Injury;
  5. Treatment for which no charges are made by the provider of same;
  6. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery;
  7. Services which are primarily for rest care, convalescent care or for rehabilitation;
  8. Treatment in a Hospital outside the United States or its possessions, except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure; or
  9. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law 
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OK

Exclusions and Limitations 

Pre-Existing Conditions
The benefits of this Policy will not be payable during the first twelve (12) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Pre-existing Condition means a  condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician within the twelve (12) months prior to the Effective Date of coverage.

This policy only pays for loss resulting from covered conditions, Policy does not cover:
  1. intentionally self-inflicted Injury or Sickness; 
  2. suicide or attempted suicide, while sane or insane; 
  3. treatment of Mental or Nervous Disorders without demonstrable organic disease, alcoholism or drug addiction; 
  4. loss that begins prior to the Effective Date of coverage; 
  5. care and treatment received outside the United States or its territories; 
  6. Injuries or Sickness due to an act of declared or undeclared war while serving in the military or an auxiliary unit attached to the military or working in an area of war whether voluntarily or as required by an employer;  
  7. any Injury or Sickness sustained or contracted due to an Insured Person’s being under the influence of any narcotic unless administered under the advice of a physician; 
  8. any Injury or Sickness incurred while committing or attempting to commit a felony or engaging in an illegal occupation or activity; 
  9. Injuries or Sickness as a result of certain aviation activities; and; 
  10. any illness specifically excluded from the definition of any Specified Critical Illness.
Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

In addition to the Limitations and Exclusions described above, if selected, the Hospital Indemnity Benefit Rider is subject to the following: PRE-EXISTING CONDITION(S): Benefits will not be payable during the first twelve (12) months that coverage is in force for a loss caused by Pre-Existing Condition(s). A Pre-Existing Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician, or for which signs and symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment within the twelve (12) months prior to the Effective Date of this rider. No benefits are payable for:
  1. The following conditions if they are diagnosed within six months after the Effective Date unless Confinement is on an emergency basis; a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  2. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  3. An elective abortion;
  4. Dental treatment unless due to Injury;
  5. Treatment for which no charges are made by the provider of same;
  6. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery;
  7. Services which are primarily for rest care, convalescent care or for rehabilitation;
  8. Treatment in a Hospital outside the United States or its possessions, except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure; or
  9. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law
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OR

Exclusions and Limitations 

Pre-Existing Conditions
The benefits of this Policy will not be payable during the first twelve (12) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Pre-existing Condition means a  condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician within the twelve (12) months prior to the Effective Date of coverage

This policy only pays for loss resulting from covered conditions, Policy does not cover:
  1. intentionally self-inflicted Injury or Sickness; 
  2. suicide or attempted suicide, while sane or insane; 
  3. treatment of Mental or Nervous Disorders without demonstrable organic disease, alcoholism or chemical dependency; 
  4. loss that begins prior to the Effective Date of coverage; 
  5. care and treatment received outside the United States or its territories; 
  6. Injuries or Sickness due to an act of declared or undeclared war;  
  7. any Injury or Sickness incurred while committing or attempting to commit a felony, if convicted of such felony, or engaging in an illegal occupation or activity; 
  8. Injuries or Sickness due to participation in any sport or sporting activity for wage, compensation or profit;
  9. Injuries or Sickness due to  operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven; 
  10. Injury or Sickness as a result of engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot air ballooning; 
  11. Injuries or Sickness due to riding in or driving any motor-driven vehicle in a race, stunt show or speed test; or 
  12. any illness specifically excluded from the definition of any Specified Critical Illness.
Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

In addition to the Limitations and Exclusions described above, if selected, the Hospital Indemnity Benefit Rider is subject to the following: PRE-EXISTING CONDITION(S): Benefits will not be payable during the first twelve (12) months that coverage is in force for a loss caused by Pre-Existing Condition(s). A Pre-Existing Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician, or for which signs and symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment within the twelve (12) months prior to the Effective Date of this rider. No benefits are payable for:
  1. The following conditions if they are diagnosed within six months after the Effective Date unless Confinement is on an emergency basis; a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  2. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  3. An elective abortion;
  4. Dental treatment unless due to Injury;
  5. Treatment for which no charges are made by the provider of same;
  6. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery;
  7. Services which are primarily for rest care, convalescent care or for rehabilitation;
  8. Treatment in a Hospital outside the United States or its possessions, except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure; or
  9. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law
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SD

EXCLUSIONS AND LIMITATIONS

Pre-Existing Conditions
The benefits of this Policy will not be payable during the first twelve (12) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Pre-Existing Condition means a condition for which medical advice, diagnosis, care or treatment was recommended or received during the twelve (12) months immediately preceding the Effective Date of the policy.

This policy only pays for loss resulting from covered conditions, Policy does not cover:

  1. intentionally self-inflicted Injury or Sickness; 
  2. suicide or attempted suicide, while sane or insane; 
  3. treatment of Mental or Nervous Disorders without demonstrable organic disease, alcoholism or chemical dependency; 
  4. loss that begins prior to the Effective Date of coverage; 
  5. care and treatment received outside the United States or its territories; 
  6. Injuries or Sickness due to an act of declared or undeclared war;   
  7. any Injury or Sickness incurred while committing or attempting to commit a felony or engaging in an illegal occupation or activity; 
  8. Injuries or Sickness due to participation in any sport or sporting activity for wage, compensation or profit;
  9. Injuries or Sickness due to  operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven; 
  10. Injury or Sickness as a result of engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot air ballooning; 
  11. Injuries or Sickness due to riding in or driving any motor-driven vehicle in a race, stunt show or speed test; or 
  12. any illness specifically excluded from the definition of any Specified Critical Illness.
Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

In addition to the Limitations and Exclusions described above, if selected, the Hospital Indemnity Benefit Rider is subject to the following: PRE-EXISTING CONDITION(S): Benefits will not be payable during the first twelve (12) months that coverage is in force for a loss caused by Pre-Existing Condition(s). A Pre-Existing Condition means a condition that would have caused an ordinarily prudent person to seek medical advice, diagnosis, care or treatment during the twelve (12) months immediately preceding the Effective Date of this rider or received during the twelve (12) months immediately preceding the Effective Date of coverage of this rider. No benefits are payable for:
  1. The following conditions if they are diagnosed within six months after the Effective Date unless Confinement is on an emergency basis; a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  2. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  3. An elective abortion;
  4. Dental treatment unless due to Injury;
  5. Treatment for which no charges are made by the provider of same;
  6. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery;
  7. Services which are primarily for rest care, convalescent care or for rehabilitation;
  8. Treatment in a Hospital outside the United States or its possessions, except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure; or
  9. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law
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TX

EXCLUSIONS AND LIMITATIONS 

Pre-Existing Conditions
The benefits of this Policy will not be payable during the first twelve (12) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Pre-existing Condition means a  condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician within the twelve (12) months prior to the Effective Date of coverage

This policy only pays for loss resulting from covered conditions, Policy does not cover:
  1. intentionally self-inflicted Injury;
  2. suicide while sane or any attempt or threat to commit suicide; 
  3. loss that begins prior to the Effective Date of coverage; 
  4. loss sustained or contracted in consequence of an Insured Person being intoxicated or under the influence of any narcotic unless the narcotic is administered on the advice of a Physician; 
  5. Injuries or Sickness due to war, declared or undeclared, or any act thereof;   
  6. any Injury or Sickness incurred while committing or attempting to commit a felony or engaging in an illegal occupation;  
  7. any illness specifically excluded from the definition of any Specified Critical Illness or as specifically described in any exclusionary endorsement issued with this policy.
Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

In addition to the Limitations and Exclusions described above, if selected, the Hospital Indemnity Benefit Rider is subject to the following: PRE-EXISTING CONDITION(S): Benefits will not be payable during the first twelve (12) months that coverage is in force for a loss caused by Pre-Existing Condition(s). A Pre-Existing Condition means any condition diagnosed or for which medical advice or treatment was recommended  by or received from a Physician within the twelve (12) months prior to the Effective Date of the rider. No benefits are payable for:
  1. The following conditions if they are diagnosed within six months after the Effective Date unless Confinement is on an emergency basis; a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  2. Mental, emotional or functional nervous disorders without demonstrable organic disease;
  3. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  4. Dental treatment unless due to Injury;
  5. Services for which no charge is made in the absence of insurance;
  6. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery;
  7. Services which are primarily for rest care, convalescent care or for rehabilitation;
  8. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Occupational Disease, Employer’s Liability Law or similar law, unless prohibited by law.

YOU HAVE THE RIGHT TO EXAMINE THIS POLICY FOR THIRTY (30) DAYS. Please read Your policy carefully. If You are not satisfied with Your policy for any reason, You may return the policy to us. It must be returned within thirty (30) days from receipt of this policy. If returned, the policy will be void from its beginning as though the policy was never issued. Any premium paid on this policy will be refunded.

To be used with accompanying outline of coverage.

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UT

Exclusions and Limitations

Pre-Existing Conditions
The benefits of this Policy will not be payable during the first six (6) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Pre-existing Condition means a  condition which first manifested itself within six (6) months prior to the Effective Date of the policy or which was Diagnosed by a Physician at any time prior to the Effective Date of the policy.

 This policy only pays for loss resulting from covered conditions, Policy does not cover:
  1. intentionally self-inflicted Injury or Sickness; 
  2. suicide or attempted suicide, while sane or insane; 
  3. treatment of Mental or Nervous Disorders without demonstrable organic disease, alcoholism or chemical dependency; 
  4. loss that begins prior to the Effective Date of coverage; 
  5. care and treatment received outside the United States or its territories; 
  6. Injuries or Sickness due to an act of declared or undeclared war;  
  7. any Injury or Sickness sustained or contracted due to an Insured Person’s being intoxicated, influence of any narcotic unless administered under the advice of a physician; 
  8. any Injury or Sickness incurred while committing or attempting to commit a felony or engaging in an illegal occupation or activity; 
  9. Injuries or Sickness due to participation in any sport or sporting activity for wage, compensation or profit;
  10. Injuries or Sickness due to  operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven; 
  11. Injury or Sickness as a result of engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot air ballooning; 
  12. Injuries or Sickness due to riding in or driving any motor-driven vehicle in a race, stunt show or speed test; or 
  13. any illness specifically excluded from the definition of any Specified Critical Illness.
Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

 In addition to the Limitations and Exclusions described above, if selected, the Hospital Indemnity Benefit Rider is subject to the following: PRE-EXISTING CONDITION(S): Benefits will not be payable during the first twelve (12) months that coverage is in force for a loss caused by Pre-Existing Condition(s). A Pre-Existing Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician, or for which signs and symptoms existed which would have caused an ordinarily prudent person to have sought diagnosis, advice or treatment within the twelve (12) months prior to the Effective Date of this rider. No benefits are payable for:
  1. The following conditions if they are diagnosed within six months after the Effective Date unless Confinement is on an emergency basis; a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  2. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  3. An elective abortion;
  4. Dental treatment unless due to Injury;
  5. Treatment for which no charges are made by the provider of same;
  6. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery;
  7. Services which are primarily for rest care, convalescent care or for rehabilitation;
  8. Treatment in a Hospital outside the United States or its possessions, except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure; or
  9. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law

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WY

Exclusions and Limitations

Pre-Existing Conditions
The benefits of this Policy will not be payable during the first twelve (12) months that coverage is in force for a loss caused by a Pre-existing condition(s). A Pre-existing Condition means a  condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician within the six (6) months prior to the Effective Date of policy.

This policy only pays for loss resulting from covered conditions, Policy does not cover:
  1. intentionally self-inflicted Injury or Sickness; 
  2. suicide or attempted suicide, while sane or insane; 
  3. treatment of Mental or Nervous Disorders without demonstrable organic disease, alcoholism or chemical dependency; 
  4. loss that begins prior to the Effective Date of coverage; 
  5. care and treatment received outside the United States or its territories; 
  6. Injuries or Sickness due to an act of declared or undeclared war;  
  7. any Injury or Sickness sustained or contracted due to an Insured Person’s being intoxicated, influence of any narcotic unless administered under the advice of a physician; 
  8. any Injury or Sickness incurred while committing or attempting to commit a felony or engaging in an illegal occupation or activity; 
  9. Injuries or Sickness due to participation in any sport or sporting activity for wage, compensation or profit;
  10. Injuries or Sickness due to  operating, learning to operate, serving as a crew member of or jumping or falling from any aircraft. Aircraft includes those which are not motor-driven; 
  11. Injury or Sickness as a result of engaging in hang gliding, bungee jumping, parachuting, sailgliding, parakiting, or hot air ballooning; 
  12. Injuries or Sickness due to riding in or driving any motor-driven vehicle in a race, stunt show or speed test; or 
  13. any illness specifically excluded from the definition of any Specified Critical Illness.
Guaranteed Renewable to Age 75
The policyowner has the right to continue this policy to age 75 as long as the premiums are paid on time. After the policy has been in force for twelve months, Premium rates may be changed on a premium class basis.

In addition to the Limitations and Exclusions described above, if selected, the Hospital Indemnity Benefit Rider is subject to the following: PRE-EXISTING CONDITION(S): Benefits will not be payable during the first twelve (12) months that coverage is in force for a loss caused by Pre-Existing Condition(s). A Pre-Existing Condition means a condition diagnosed or for which medical advice or treatment was recommended by or received from a Physician within the six (6) months prior to the Effective Date of this rider or as to pregnancy existing on the effective date of this rider.
No benefits are payable for:
  1. The following conditions if they are diagnosed within six months after the Effective Date unless Confinement is on an emergency basis; a hernia, adenoids, tonsils, varicose veins, hemorrhoids, disorder of the reproductive organs, or elective sterilization;
  2. Routine pregnancy; however, Complications of Pregnancy will be considered the same as any other Sickness;
  3. An elective abortion;
  4. Dental treatment unless due to Injury;
  5. Treatment for which no charges are made by the provider of same;
  6. Cosmetic care, except when the Hospital Confinement is due to medically necessary reconstructive plastic surgery;
  7. Services which are primarily for rest care, convalescent care or for rehabilitation;
  8. Treatment in a Hospital outside the United States or its possessions, except for emergency care for acute onset of Sickness or accidental Injury sustained while traveling for business or pleasure; or
  9. Any Injury or Sickness paid for under any state or federal Worker’s Compensation, Employer’s Liability Law or similar law
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