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What you should know about Your Critical Illness Cover: The exclusions to your policy

Get to know your insurance policies. It is important to know what they will cover and what they will not cover. That way, you know what to expect when you need to make a claim.

Here are some exclusions that are commonly included in most critical illness policies:

  • Self-inflicted injuries, including attempted suicide.
  • Injuries that result from illegal or criminal acts. This means that if you are involved in a criminal act and are injured in the process, the policy will not pay your claim.
  • Injuries resulting from abuse of prohibited and prescription drugs, as well as alcohol and solvents. Medications may only be taken with your doctor’s advice and prescription.
  • Medical conditions resulting from unreasonable failure to follow the doctor’s advice. This will also include your failure to obtain any medical advice after you have noticed some symptoms.
  • Injuries that you incur while being involved in hazardous activities, sports and pastimes. These include activities such as mountaineering, caving, boxing, climbing, martial arts, jet skiing, underwater diving and pot-holing. Critical illness policies will also exclude racing, trial or timed motor sports such as yacht racing or power-boat racing, as well as horse-racing.
  • Injuries resulting from civil commotion, riot or war.
  • Conditions due to HIV/AIDS.
  • Pre-existing conditions. Please note that you need to disclose of any pre-existing conditions that you have. Otherwise, the insurance company reserves the right to cancel your policy and refund your premiums. The insurance company may also deny you any future claims due to your failure to disclose of key information regarding your application.
  • Aviation. This means any flying that you do other than as a passenger of a commercial flight. If you are operating a private aircraft as a pilot or passenger, this is commonly not included in the policy.

Please note that these exclusions may vary depending on the insurance company issuing the policy. So the best thing is to read your policy, including the fine print.

 

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