Download Exclusions

EXCLUSIONS FROM INSURED ACCIDENTS
(items numbering is preserved in accordance to the Insurance Agreement)
12.1.
Unless otherwise is stipulated by the Program, the INSURER shall not be responsible
(shall not realize insurance payouts) if the INSURED PERSON applies in connection with:
12.1.1.
the disease, accident or other injury to health that occurred as the result of using alcohol,
drugs, toxic substances or medical preparations without doctor’s prescription;
12.1.2.
suicidal attempt, excluding the cases when the INSURED PERSON was brought to such
state by illegal actions of third persons as certified by authorized official bodies; deliberate
causing a bodily injury by the INSURED PERSON to himself/herself;
12.1.3.
disease and trauma received as the result of the INSURED PERSON’s actions connected
with unjustified risk (driving without the required license, personal participation in military
activities, civil commotions, strikes), as well as the risk intrinsic to his/her daily vital and
professional activity, involvement in dangerous sports (alpinism, speleology, sky surfing,
parachuting);
12.1.4.
receiving medical aid not stipulated by the PROGRAM or when the medical aid was
received in medical institutions not specified by the AGREEMENT without preliminary
agreement with the INSURER or the assistance company, excluding the cases when it was
rendered for life-saving indications;
12.1.5.
self-treatment or treatment using the methods of non-traditional medicine (phytotherapy,
acupuncture, hydro-colonotherapy, osteopathy, microwave information therapy, VollNakatani diagnostics and treatment, efferent therapy, hypnosis, treatment with food
additives and bioactive additives), experimental treatment;
12.1.6.
preventive and medical health-improving servicing; taking medications intended for
prophylaxis: biostimulants, immunization, inoculation;
12.1.7.
issuing certificates for traffic police, licenses for carrying guns, admission to
educational/children’s institutions;
12.1.8.
participation of the INSURED PERSON in sporting events and competitions or in the
course of training for them in all kinds of sports;
12.1.9.
disease, trauma and other injury to the body connected with nuclear explosion, radiation of
nuclear energy, radio-active radiation, contact of radio-active isotopes with skin,
gastrointestinal tract, lungs and other organs and tissues and/or the consequences thereof;
12.1.10.
diagnostics, prescription of treatment schemes and direct treatment of classic venereal
diseases (gonorrhea, syphilis, venereal lymphogranulomatosis,), as well as diagnostics and
treatment of predominantly sexually transmitted infections according to the WHO
classification (gardnerelesis, genital herpes, cytomegalovirus infection, mycoplasmosis,
papilloma-viral infection, trichomoniasis, ureaplasmosis, clamidiosis, excluding candidal
vulvovaginitis and balanoposthitis), TORCH-infections (toxoplasmosis, cytomegalovirus,
herpes virus, Epstein-Barr virus) excluding the rubella virus;
12.1.11.
invasive diseases of gastro-intestinal tract (amebiasis, lambliasis, ascaridiasis, etc.);
12.1.12.
treatment connected with inherited and genetic diseases, defects and abnormalities;
12.1.13.
expenses and medical services, medications, and medical goods stipulated by the
Insurance program but not prescribed by the doctor, medications purchased outside the
pharmaceutical network of Ukraine, nursing means (surgical corset, elastic bandage,,
crutches, etc.), cosmetic and sanitary agents;
12.1.14.
cosmetic, plastic, reconstructive surgery (including planned hernioplasty and rhinoplasty),
operations on heart and vessels excluding the cases connected with the recovery of the
functions affected as the result of the accident that occurred during the period of validity of
the Insurance agreement; transplantation of organs or tissues, freezing and transplantation
of live cells, including when performing artificial insemination, transplantation of bone
marrow; purchasing organs for transplantation, search, delivery, remuneration for donors;
12.1.15.
prevention, diagnostics and treatment of AIDS (HIV), including the diseases being a
mutation or variants of AIDS or any other syndrome with corresponding name;
12.1.16.
diseases that acquired the character of epidemics or pandemics in case of introducing by
the authorized state bodies a complex of quarantine measures and specifically dangerous
infections (natural smallpox, plaque, cholera, yellow fever, tularemia, anthrax); excluding
epidemics of influenza;
12.1.17.
contraception,
sterilization,
infertility,
menstrual
irregularities,
endometriosis,
metrofibromyoma
(excluding
surgical
treatment),
mastopathy,
galactorrhea,
hyperandrogenism, excluding the cases of exacerbation, determining hormonal profile
more than once within the term of validity of the agreement, impotency, climax, sexual
dysfunctions;
12.1.18.
artificial insemination, abortion without medical indications, excluding extrauterine
pregnancy, carrying out non-traditional delivery (in water, at home, etc.);
12.1.19.
operations for changing weight or treating obesity (lipidogram, etc.), modification of a
human body with the purpose of improving psychological, mental or emotional state,
including transsexual surgery;
12.1.20.
psychic diseases, psychopathy, neurosis, sleeplessness (including soporific drugs),
epilepsy, speech disturbance, consultation of psychologist, psychotherapist, psychoanalyst
and prescription of psychotropic drugs;
12.1.21.
purchasing prosthetics of various character and purpose, devices replacing or correcting
the functions of injured organs (including heart valves prosthetics), artificial pacing lead,
operations with the use of artificial blood circulation apparatus;
12.1.22.
complex treatment of the states that require the use of replacement therapy during the
period exceeding one month (including hormone, enzymatic agents) with the use of
analogous preparations of gonadotropin-releasing hormone (Zoladex, Diphereline, etc);
using the preparations that reduce the level of lipids in blood during the period exceeding 1
(one) month within the period of validity of the Agreement;
12.1.23.
taking medications necessary for prolonged administration in case of chronic diseases
(excluding the stage of exacerbation when all expenses are coved till the state improves –
up to 30 days);
12.1.24.
treatment of mycoses, onychomycoses, psoriasis, eczema, seborrhea of any type, acne,
demodicosis, scabies, pediculosis, alopecia, molluscum contagiosum, vitiligo; control
consultations and diagnostics;
12.1.25.
manual therapy or medical massage of all types with the total course exceeding 10 (ten)
sessions during the period of insurance;
12.1.26.
professional diseases according to the conclusion of the Scientific and research institute of
professional pathology;
12.1.27.
malignant oncologic diseases, including oncohematologic diseases; hematologic diseases
connected with abnormalities of blood-forming organs (unless otherwise is stipulated by the
Insurance program);
12.1.28.
systemic diseases of connective tissue, including collagenosis, systemic abdominal lupus,
dermatosclerosis, periarteritis nodosa, rheumatoid joint inflammation, demyelimisating
diseases; sarcoidosis, mucoviscidosis, idiopathic fibrosing alveolitis, excluding the cases of
exacerbation;
12.1.29.
age-depending degenerative-dystrophic changes; and diseases (cataract, cadiac- and
pneumosclerosis, atherosclerosis, Kashin-Beck disease, osteoporosis);
12.1.30.
diseases of blood, chronic diseases of peripheral vessels (varicose disease, obliterating
atherosclerosis), excluding urgent situations;
12.1.31.
pancreatic diabetes and its complications, excluding life threatening situations; tuberculosis
and its complications excluding life-threatening situations (unless otherwise is stipulated by
the Insurance program);
12.1.32.
chronic kidney insufficiency that requires hemodialysis (artificial kidney);
12.1.33.
diagnostics and treatment of viral hepatitises (except for viral hepatitis type A); cirrhosis,
hepatosis;
12.1.34.
apparatus-controlled treatment of heterotropy, astigmatism, the use of laser technologies,
including preventive laser coagulation of retina;
12.1.35.
planned dental aid;
12.1.36.
orthodontia, including bracket-systems, trainers, cups, etc., treatment of periodontium with
the “Vector” apparatus.
Validity of your medical insurance is printed on your personal card. Please also note that
medical insurance program can be terminated from our side if you leave from V.Ships.