GC 3100.27B SECTION 9 - EXCLUSIONS 2005 (3/12) (Prudent: Not Included) SECTION 9 - EXCLUSIONS GENERAL EXCLUSIONS: This Group Policy does not cover any Disability caused by, contributed to by, or resulting from: 1) participation in war or any act of war, declared or undeclared; 2) active participation in a riot; 3) attempted suicide, regardless of mental capacity; 4) attempted or actual self-inflicted bodily injury or self-destruction, including but not limited to the voluntary inhaling or taking of: a) a prescription drug in a manner other than as prescribed by a Physician; b) any federal or state regulated substance in an unlawful manner; c) non-prescription medicine in a manner other than as indicated in the printed instructions; d) poison; and e) toxic fumes; 5) commission of or attempt to commit a criminal act under relevant state law; 6) Cosmetic Surgery. However, Cosmetic Surgery will be covered when it is due to: a) reconstructive surgery incidental to, or follows surgery resulting from, trauma, infection or other diseases of the involved part; or b) congenital disease or anomaly that has resulted in a functional defect; 7) caused by a Person legally intoxicated as defined by the law of the jurisdiction in which the incident occurs; 8) that occurs while a Person is incarcerated in a penal or correctional institution; 9) participation in autoerotic asphyxiation; 10) elective surgery except when required for the Person’s Regular Attendance as a result of the Person’s Injury or Sickness; 11) traveling or flying on any aircraft operated by or under authority of military or any aircraft being used for experimental purposes; or 12) engaging in any illegal or fraudulent occupation, work, or employment. PRE-EXISTING CONDITION EXCLUSION: Benefits will not be paid if the Person’s Disability begins in the first 12 months, following the effective date of the Person’s coverage; and the Person’s Disability is caused by, contributed to by, or the result of a condition, whether or not that condition is diagnosed at all or is misdiagnosed, for which the Person received medical treatment, consultation, care or services, including diagnostic measures, or was prescribed drugs or medicines in the three (3) months just prior to the Person’s Individual Effective Date of Insurance.
Certificate of Insurance for Group Long Term Disability Income Insurance Page 41 Page 43