Exclusion of benefits: all you need to know

There is no insurance cover for losses:

• caused deliberately by the insured person
• which the insured person caused by or during the deliberate commission of a criminal offence or the deliberate attempt to commit such an offence
• caused by nuclear energy

Exclusions of benefi ts in health insurance:

No cover exists for:

• Illness and disorders which existed or were known or diagnosed (even by tentative diagnosis) at the start of the insurance and in each case at the start of the extension of the contract and their consequences, as well as consequences or illnesses and accidents that have been treated during the time of six months before the insurance application. In divergence from this exclusion, cover is granted for treatments to eliminate life-threatening conditions which became acute during the stay abroad.
• Losses which could very probably have been anticipated by the insured person
• Treatment abroad which was the sole reason or one of the reasons for undertaking the journey
• Losses attributable to causes of which the insured person was aware before residence abroad commenced
• Treatment or accommodation rendered necessary by longterm illness, a requirement for nursing care or accommodation
• Spa and sanatorium treatment and rehabilitation measures
• Outpatient treatment at a spa. This restriction will be waived if the treatment is rendered necessary by an accident which occurred there. It will be waived in cases of illness if the insured person was only at the spa temporarily and not for the purposes of treatment
• Dependency treatment including withdrawal treatment at a spa
• Alcohol, drug or solvent abuse or claims due to the infl uence of alcohol or drugs
• Abortions, unless medically prescribed
• Examinations or treatments owing to disruptions to the functions, or defects, of reproduction organs
• Losses, including their consequences, and accidents directly or indirectly attributable to acts of war or civil war. However, insurance cover will exist if the insured person is surprised by acts of war or civil war while travelling abroad. Insurance cover will terminate at the end of the seventh day following the outbreak of a war or civil war on the territory of the state in which the insured person is staying. The extension does not apply to travel to or through states on the territory of which war or civil war is already being waged. Neither will it exist for active participation in war or civil war or for losses or accidents caused by NBC weapons and in connection with a war or hostilities between China, Germany, France, Great Britain, Japan, Russia or the USA
• Treatment by spouses, parents or children as well as members of the host family in which an insured person is living. Substantiated material expenses will be refunded
• Costs exceeding the amount mentioned in the policy in respect of expenses for psychiatric or psychotherapeutic treatments
• Appliances (e.g. spectacles, pads, surgical stockings, etc. and health requisites such as heat lamps and thermometers)
• Certificates, reports and examinations for the purpose of obtaining a residence permit
• Screening and precautionary examinations (e.g. cancer screening, vaccinations, laboratory screening and allergy tests)
• Cosmetic treatment (including e.g. acne, hair loss, mole and wart removal)
• False teeth (except dental prostheses as a result of an accident up to the amounts as stated in the benefit schedule), pivot teeth, bridges, crowns and orthodontic treatment.
• Computer tomography, magnetic resonance imaging and sintigraphy, with the exception of life-threatening accidents or illnesses or with the consent of the insurer/incident manager
• Physiotherapy except after accidents
• Treatment by non-medical practitioners
• Expenses incurred by methods of treatment and medicines which are not generally scientifically recognised either in the Federal Republic of Germany or at the place of residence
• Treatments or other measures which exceed what is medically necessary. In this case we are entitled to reduce the payment to an appropriate level.

Exclusion of benefits in private liability, accident, household contents and baggage insurance

Please see section no. 4 of the respective conditions (foreign private liability insurance page, foreign accident insurance page, household contents and baggage insurance).