Daiichi Life

Common Exclusions-Eng

Exclusions

Daiichi Life will not pay any benefit of this Policy if an event is caused to the Life Insured directly or indirectly by any one of the following. Instead, Daiichi Life may refund any premiums paid in respect of the relevant period (less any claim paid), at the time of claim unless the claim is fraudulent mispresentation.

General Exclusions

  1. Pre-existing Conditions which the Life Insured did not declare and, if knowing this information, Daiichi Life would not approve insurance; or Pre-existing Conditions which are declared to and not accepted by Daiichi Life at the time of underwriting this policy; or  
  2. All expenses incurred by a Life Insured for the period of Hospital Confinement if admission into a hospital prior to the Policy Effective Date or any reinstatement date; or  
  3. Death caused by premeditated self-infliction, attempted suicide, or suicide, regardless of the mental condition of the Life Insured; or  
  4. Hospitalisation, hospital, clinic, or laboratory services, resulted from premeditated self-infliction, attempted suicide regardless of the mental condition of the Life Insured; or
  5. Any death, or any expenses incurred from hospitalisation, hospital, clinic, or laboratory services resulted from the criminal/unlawful act committed by the Policy Owner, the Life Insured, or the Beneficiary(s); or while Life Insured is being arrested, under arrest or escaping the arrest; or
  6. Any death or any expenses incurred from hospitalisation, hospital, clinic, or laboratory services while the Life Insured performing duty as military armed forces, police or volunteers and participating in war or crime suppression; or
  7. Any death, or any expenses incurred from hospitalisation, hospital, clinic, or laboratory services caused by disease which the Life Insured knew s/he has, before buying policy but did not disclose at the time of applying for the Policy, where disclosure was required by Daiichi Life; or
  8. Any death, or any expenses incurred from hospitalisation, hospital, clinic, or laboratory services caused by the disability arises prior to the Policy Effective Date or any reinstatement date, unless it had been disclosed and accepted by Daiichi Life or where the disclosure was not required by Daiichi Life; or  
  9. Any death, or any expenses incurred from hospitalisation, hospital, clinic, or laboratory services caused by the Life Insured’s participation in aviation activities except as a fare-paying passenger on a multi-engine, scheduled and licensed commercial aircraft; or
  10. Any death, or any expenses incurred from hospitalisation, hospital, clinic, or laboratory services caused by any activity OR hobbies such as dangerous sports activities including but not limited to scuba diving, mountain climbing, parachuting or any high-speed races, or in professional sport activities, or professional activity of clearing unexploded ordnances and those which were not disclosed at the time of application or which are declared to and not accepted by Daiichi Life at the time of underwriting this policy, unless specifically accepted by the underwriter; or
  11. Any death, or any expenses incurred from hospitalisation, hospital, clinic, or laboratory services caused by war or war-like conflicts, aggressive acts, including invasions, acts of foreign countries, enemy’s acts (whether with or without war declaration), civil wars, insurrections, revolutions, riots, interference by military authorities or usurpation

Specific medical exclusions

  1. Any death, or any expenses incurred from hospitalisation, hospital, clinic, or laboratory services caused by or associated with any Human Immunodeficiency Virus (HIV) and/or any HIV-related illnesses including Acquired Immune Deficiency Syndrome (AIDS) and/or any disorders thereof; or
  2. Any death, or any expenses incurred from hospitalisation, hospital, clinic, or laboratory services resulted from the abuse of drugs, or any other illegal addictive substances or abusively using alcohol or driving vehicles under the influence of alcohol as defined in the current laws and regulations; or  
  3. Any death, or any expenses incurred from hospitalisation, hospital, clinic, or laboratory services caused by or associated with pregnancy, surrogacy, IVF (In vitro fertilization), elective C-sections, giving birth, miscarriage, intentional abortion or any of their complications; or  
  4. Any death, or any expenses incurred from hospitalisation, hospital, clinic, or laboratory services caused by or associated with the event(s) fall under waiting periods clause or
  5. Any death, or any expenses incurred from hospitalisation, hospital, clinic, or laboratory services caused by or associated with mental or psychiatric illness, anxiety, or nervous disorders; or
  6. Any medical/surgical treatment and/or routine health screening which is NOT Medically Necessary. For elective surgical operations and/or hospitalisation/clinic/laboratory services due to elective surgical operations, Daiichi Life reserves the right to get the second opinion from the respective specialist(s); or
  7. If Life Insured is currently receiving treatment for any mental or physical disability, or manifesting signs or symptoms of any mental or physical disability prior to the Policy Effective Date or effective date of latest Policy reinstatement date whichever happens later; or  
  8. Hospitalisation due to medical check-up and rest; or 
  9. Check-up, screening, general health check, convalescence care including rest cures and recovery; or  
  10. Treatment at a healthcare facility which is NOT a registered hospital, clinic, or laboratory; or  
  11. Hospitalisation or any hospital/clinic/laboratory services related to fertility treatment and sterilization treatment; or  
  12. Dental surgery and treatment unless due to accident; or 
  13. Optical examination, surgery, and treatment or Treatment of their complications unless due to accident; or 
  14. Cosmetic surgery or Treatment, or Treatment of their complications, with the exception of reconstructive surgery due to accident; or 
  15. Congenital diseases or any birth defects; or
  16. Obesity treatment; or 
  17. Nervous disorders, neurasthenia, sleep disorders, insomnia, mental disorders, anxiety, psychiatric problems, personality disorders, speech disorders, autism, stress, eating disorders, anorexia and attention deficit hyperactivity disorder (ADHD); or  
  18. Everything which is not medically necessary (Daiichi Life reserves the right to appoint medical expert(s) to examine the Life Insured, and to obtain any relevant information pertaining to the claim including from the Life Insured’s attending Doctor(s)); or  
  19. Anything which is fraudulent claim; or 
  20. Virtual/Online consultation apart from getting treatment via Telemedicine (provided that the consultation is made for the ‘Pre & Post–hospitalization’, for the same cause of the hospitalization, and consulted from the registered medical doctor(s)); or  
  21. All the medical or laboratory receipts which are not original and physical; or 
  22. The total eligible claim amount across the insurance companies (when multiple policies are in-force either with Daiichi Life or any other insurance companies) exceeding the actual eligible cost incurred; or  
  23. Any other specific exclusion(s) imposed by Daiichi Life