General Exclusions

INJURIES

• Any medical service required or injuries sustained as a result of Military, Para Military or Militant service or operations;
• Any medical service required or injuries sustained as a result of Hazardous sports including but not limited to water sports, mountaineering, hunting, motor racing, riding or driving in any kind of race and professional participation in leagues of any sport;
• Any medical service required or injuries sustained as a result of War (declared or undeclared), riot, strike, and civil commotion; or acts of God or acts of terrorism
• Any medical service required or injuries sustained as a result of Intentional self-injury, suicide or attempted suicide (whether sane or insane), chronic venereal disease, member’s own criminal act, intoxication, the use of drugs not prescribed by a physician or injury sustained whilst in a state of insanity, alcoholism or costs resulting from dependency on or abuse of drugs or other addictive substances and drug rehabilitation
• Any injury, illness or disease specified as an exclusion and complications caused by a condition that is excluded or follow up treatments or investigations that are due to a condition that is excluded; 

OTHERS 

• Psychiatric Institutionalization
• Consultations or treatment by chiropractors, acupuncturists, herbalists, complimentary/traditional medical practitioners or unrecognized consultants, hospitals, family doctors, therapists, dental practitioners
• Any medical treatment required, relating to an accident or illness which may have occurred before the effective date or to any illness where it was within the knowledge of a member that was suffering from it at the effective date
• Overseas Treatment/ Investigations Organ Surgery and Transplants
• Plastic/Cosmetic Surgeries and/or Treatments
• Embalmment, Autopsies, Mortuary Services
• Cancer Investigation or Treatment such as chemotherapy or radiotherapy
• Investigations not as listed under covered services or Treatments for problems relating to infertility,g. IVF, GIFT, Artificial Insemination; and Virility Enhancing Drugs; Neonatal Care not listed under services
• Speech Disorder
• Treatment of Obesity & Weight Loss Renal Dialysis UP TO COVERED LIMIT
• Herbal Drugs, Non-Prescription Drugs, Food Supplements, Dietary and Nutrition Supplements, Experimental Drugs and Treatments;
• Dental treatment unless otherwise stated to be covered by the specific plan Optical services unless otherwise stated to be covered by the specific plan Hearing tests or costs of hearing aids 
• Birth defects, congenital condition or illness, autoimmune disorders, conditions and illnessesrelated to genetic disorders
• Home Care, Domiciliary Care Joint Replacements
• Supply of Prosthesis (Artificial Limbs, Dental Prosthesis) Hormonal Replacement Therapy
• All expenses in respect of illnesses/conditions that were subject to waiting periods when the member and dependants joined the plan
• Treatment protocols that are not normal customary or standard practice within Nigeria Any condition, treatment, procedure, or service that is related, is in connection with or is required as a follow-up to the exclusion
• Room upgrades beyond that specified in the plan benefits
• Consultations with unrecognized consultants, hospitals, family doctors, therapists, dental practitioners, or complementary medicines practitioners
• Any other treatment, service, procedure, or investigation not listed in the schedule of covered medical services

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1. Please note that when an insured enrollee exceeds the maximum limit, the excess of the medical expenses is borne by the enrollee.
2. The maximum principal age limit is 60 years and dependent age limit is 18 
3. The following benefits will not be covered or provided in the first 3 months of the scheme: optical care, dental care, and antenatal care.