Express Assist Center

Exceptions from the insurance covering.

• this insurance scheme does not accept as insurance case and does not cover
• insurance company can refuse to cover the expenses if the insured or his representative
• insurance company can also refuse to cover the expenses if some actions take place during validity of the insurance contract

Exceptions from the insurance covering.
This insurance scheme does not accept as insurance case and does not cover:

• expenses connected with the treatment of chronic diseases;
• expenses connected with the treatment of worsening of chronic diseases which the insurance company (or insured) did not put it in the insurance application, insurance contract, insurance policy, written request of the insurance company;
• expenses connected with the buying of medicine without any prescription of a doctor;
• expenses connected with the buying of medicine if it is prescribed but which composition is concealed by producer and also expenses connected with the buying of foodstuffs, restorative products, weight loss drugs and laxatives that can be get by prescription, cosmetic products, mineral water and additions to bath water;
• expenses connected with providing of medical service if the tour was planned in order to undergo a course of medical treatment;
• expenses connected with the treatment of oncological diseases;
• expenses connected with the course of treatment that is started before the travel and continued during validity of the insurance contract and if a tour was done in spite of doctor’s contra-indications;
• expenses connected with the treatment of diseases of nervous system, mental diseases and suicide attempt;
• expenses connected with the treatment of painful condition caused by taking psychotropic, narcotic, toxic matters, alcohol and also with the treatment of traumas got by the insured under the influence of above-mentioned matters;
• expenses connected with the treatment of alcoholism, drug addiction and drug abuse;
• expenses connected with pregnancy over 12 weeks term and abortions (with an exclusion of miscarriage caused by accident);
• expenses connected with the treatment of traumas, diseases caused by direct or indirect impact of any radiation including sun one;
• expenses connected with the buying of glasses, contact lenses, aerophones, prosthetic devices and also expenses regarding all kinds of prosthesis;
• expenses connected with the treatment in sanatoriums and preventoriums;
• expenses connected with the treatment of sexually transmitted diseases and AIDS;
• expenses connected with holding of preventive vaccinations and medical examinations;
• expenses connected with cosmetic and plastic surgery;
• expenses connected with acupuncture, physiotherapy and other kinds oа restoration treatment;
• expenses connected with the treatment of diseases which appearing could be prevented by preliminary vaccination;
• expenses connected with the treatment of traumas, diseases caused by going in for sport with the exception of payment of additional premium informing insurance company;
• expenses connected with the treatment of traumas, diseases caused by going in for airsport, parachute jumps, mountaineering, motor-cycle races and other dangerous kinds of sport with the exception of payment of additional premium informing insurance company;
• expenses connected with the treatment of traumas, diseases caused by taking part in officially held competitions with the exception of payment of additional premium informing insurance company;
• expenses connected with the treatment of diseases and traumas caused by civil wars, national disorders, military actions, revolts, rebellions, states of emergency and other similar events;
• expenses connected with surgeries and treatment that can be postponed till return of the insured to his native country and also that is not approved by insurance company or service center;
• expenses connected with the examinations and treatment of diseases by scientifically unrecognized methods and also expenses for buying certificateless medicines;
• expenses connected with the treatment of traumas and diseases caused by criminal actions of the insured;
• expenses connected with the treatment of traumas and diseases got in motor accident if the insured drew the car without driving license;
• expenses appeared due to breaking of behavior norms

Insurance company can refuse to cover the expenses if the insured or his representative:

• did not provide all necessary documents for decision making about insurance payment;
• did not tell the insurance company about all the data important for evaluating of degree of risk;
• if the insurance case occurred through employer’s fault;
• if the insurance case occurred during journey-work (if it is not foreseen by insurance contract)

Insurance company can also refuse to cover the expenses if some actions take place during validity of the insurance contract:

• intentional actions of insurance company or insured leading to insurance case;
• if insurance company, the insured made a deliberate crime connected with appearance of insurance case;
• if the insured provide the insurance company with false information about his/her health or the cost of medical service