Exclusions

No benefits are payable under this plan for charges for care, services or supplies:

1. that were furnished without the recommendation and approval of a Physician acting within the scope of his license;
2. that are not medically necessary, such as but not limited to, charges for a surgical procedure or treatment performed primarily for cosmetic purposes, or charges for Hospital confinement for such surgical procedure or treatment;
3. if payment is prohibited by law;
4. that an insured person may obtain as a benefit under any governmental plan or law;
5. for occupational injury or disease covered by Workplace Safety and Insurance law or similar legislation;
6. for which no charge would  have been made in the absence of this insurance;
7. for dental work, except as provided under the Dental Care for Accidental Injury;
8. for any drugs or services that are not approved by Health and Welfare Canada, or are experimental or limited in use whether or not so approved;
9. for experimental procedures or treatment not approved by the Canadian Medical Association or the appropriate medical specialty society;
10. for health examinations that are requested by a third party;
11. for broken appointments, travel, communication costs, filling in of forms or Physician’s supplies.
12. which were considered an insured service of any provincial government plan at the time this plan/benefit was issued and subsequently were modified, suspended or discontinued. 

No amount will be paid for any charge incurred that results from or is contributed by:

1. war, whether declared or not; 
2. insurrection, rebellion or participation in a riot or civil commotion;
3. purposely self-inflicted injury; or
4. the insured person’s commission of, or attempt to commit, an assault or a criminal offence.