Group Accident Insurance Certificate

COMMON EXCLUSIONS

Exclusions and Limitations In addition to any benefit-specific exclusions, benefits will not be paid for any Covered Injury or Covered Loss which, directly or indirectly, in whole or in part, is caused by or results from any of the following unless coverage is specifically provided for by name in the Description of Benefits section: 1. intentionally self-inflicted Injury, suicide or any attempt thereat while sane or insane; 2. commission or attempt to commit a felony or an assault; 3. declared or undeclared war or act of war; 4. a Covered Loss that occurs while on active duty service in the military, naval or air force of any country or international organization. Reserve or National Guard active duty training is not excluded unless it extends beyond 31 days; 5. voluntary ingestion of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage; 6. operating any type of vehicle while under the influence of alcohol or any drug, narcotic or other intoxicant including any prescribed drug for which the Covered Person has been provided a written warning against operating a vehicle while taking it. Under the influence of alcohol, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Loss occurred. 7. bungee jumping; parachuting; skydiving; parasailing; hang-gliding; 8. flight in, boarding or alighting from an Aircraft or any craft designed to fly above the Earth’s surface: a. except as a fare-paying passenger on a regularly scheduled commercial airline; b. being flown by the Covered Person or in which the Covered Person is a member of the crew; c. being used for: i. crop dusting, spraying or seeding, giving and receiving flying instruction, fire fighting, sky writing, sky diving or hang-gliding, pipeline or power line inspection, aerial photography or exploration, racing, endurance tests, stunt or acrobatic flying; or ii. any operation that requires a special permit from the FAA, even if it is granted (this does not apply if the permit is required only because of the territory flown over or landed on); d. designed for flight above or beyond the earth’s atmosphere; e. an ultra-light or glider; f. being used for the purpose of parachuting or skydiving; g. being used by any military authority, except an Aircraft used by the Air Mobility Command or its foreign equivalent; 9. travel in any Aircraft owned, leased or controlled by the Subscriber, or any of its subsidiaries or affiliates. An Aircraft will be deemed to be ''controlled'' by the Subscriber if the Aircraft may be used as the Subscriber wishes for more than 10 straight days, or more than 15 days in any year; 10. in addition, benefits will not be paid for services or treatment rendered by a Physician, Nurse or any other person who is: a. employed or retained by the Subscriber; b. providing homeopathic, aroma-therapeutic or herbal therapeutic services; c. living in the Covered Person’s household; d. a parent, sibling, spouse or child of the Covered Person; 11. sickness, disease, bodily or mental infirmity, bacterial or viral infection or medical or surgical treatment thereof, except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food.

GAI-00-1400.00

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