All you want to know about the..... SKHPPA (SKIM KEMASUKAN HOSPITAL & PEMBEDAHAN PEKERJA ASING)


EXCLUSIONS

This scheme does not cover any hospitalization, surgery or charges caused directly or indirectly, wholly or partly, by any one (1) of the following occurrences:-

  1. Pre-existing illness
  2. Specified illnesses occurring during the first 120 days of continuous cover of the Insured Person. Specified illnesses shall mean the following disabilities and its related complications:- 1) Cardiovascular Disease; and 2) All Cancers.
  3. Plastic/cosmetic surgery, circumcision, eye examination, glasses and refraction or surgical correction of near-sightedness (Radial Keratotomy) and the use or acquisition of external prosthetic appliances or devices such as spectacles, wheelchairs, artificial limbs, hearing aids, implanted pacemakers and prescriptions thereof.
  4. Dental conditions including dental treatment or oral surgery except as necessitated by Accidental Injuries to sound natural teeth occurring wholly during the Period of Insurance.
  5. Private nursing, rest cures or sanitaria care, illegal drugs, intoxication, sterilisation, venereal disease (VD) and its sequelae, AIDS (Acquired Immune Deficiency Syndrome) or ARC (AIDS Related Complex) and HIV (Human Immunodeficiency Virus) related diseases, and any communicable diseases required quarantined by law.
  6. Any treatment or surgical operation for congenital abnormalities or deformities including hereditary conditions.

  7. Pregnancy, child birth (including surgical delivery), miscarriage, abortion and prenatal or postnatal care and surgical, mechanical or chemical contraceptive methods of birth control or treatment pertaining to infertility. Erectile dysfunction and tests or treatment related to impotence or sterilisation.

  8. Hospitalisation primarily for investigatory purposes, diagnosis, X-ray examination, general physical or medical examinations, not incidental to treatment or diagnosis of a covered Disability or any treatment which is not Medically Necessary and any preventive treatments, preventive medicines or examinations carried out by a physician, and treatments specifically for weight reduction or gain.

  9. Suicide, attempted suicide or intentionally self-inflicted injury while sane or insane.

  10. War or any act of war, declared or undeclared, criminal or terrorist activities, active duty in any armed forces, direct participation in strikes, riots and civil commotion or insurrection.

  11. Ionising radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from process of nuclear fission or from any nuclear weapons material.

  12. Expenses incurred for donation of any body organ by an Insured Person and costs of acquisition of the organ including all costs incurred by the donor during organ transplant and its complications.

  13. Investigation and treatment of sleep and snoring disorders, hormone replacement therapy and alternative therapy such as treatment, medical service or supplies other than Western Medicines, including but not limited to chiropractic services, acupuncture, acupressure, reflexology, bonesetting, herbalist treatment, massage or aromatherapy or other alternative treatment.

  14. Care or treatment for which payment is not required or to the extent which is payable by any other insurance or indemnity covering the Insured and Disabilities arising out of duties of employment or profession that is covered under a Workmen's Compensation Insurance Contract.

  15. Psychotic, mental or nervous disorders (including any neuroses and their physiological or psychosomatic manifestations)

  16. Cost/expenses of services of a non-medical nature, such as television, telephones, telex services, radios or similar facilities, admission kit/pack and other ineligible non-medical items.

  17. Sickness or injury arising from racing of any kind (except foot racing), hazardous sports such as but not limited to skydiving, water skiing, underwater activities requiring breathing apparatus, winter sports, professional sports and illegal activities.

  18. Private flying other than as a fare-paying passenger in any commercial scheduled airlines licensed to carry passengers over established routes.

  19. Expenses incurred for sex changes.


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