EMPLOYEE HEALTH VALUE+ PORTABLE PLAN

Pre-existing Medical Conditions means any Bodily Injury or Sickness sustained or suffered by the Person Insured which has been diagnosed or has exhibited symptoms or has occurred or required medical advice and/or treatment and/or the prescriptions of drugs before the Issue Date or the Commencement Date (whichever is the later).

Notwithstanding the foregoing, “Pre-existing Medical Conditions” shall not include Bodily Injury or Sickness which:

1. has been fully disclosed in the Application Form and/or the Statement(s), and the Company agrees not to classify it as an exclusion under the Policy; and/or
2. the Person Insured affected by this condition has/had been continuously insured under the Former Group Policy and/or under Group Policy and/or under this Policy for a total duration of at least 12 Calendar Months. For the avoidance of doubt, unless otherwise specified by the Company, Pre-existing Medical Conditions shall be covered from the date on which the Person Insured has been continuously insured for a total duration of 12 Calendar Months under the Former Group Policy and/or under the Group Policy and/or under this Policy.

The following list is for reference only and it is not a full list of exclusions. Please refer to the policy provisions for the complete list and details of exclusions.

Cigna shall not be liable to pay any claim or expenses incurred directly or indirectly resulting from or consequent upon or contributed by the following items:

1. Pre-existing Medical Conditions except being waived by the Company;
2. Any special exclusion(s) set out under this Policy;
3. War, invasion, act of foreign enemy, hostilities (whether war is declared or not), Civil Commotion, rebellion, revolution, insurrection, military or usurped power or Terrorism;
4. The Person Insured’s engaging in or taking part in:
1. Naval, military or air force service or operations, armed force or service with the police of any nation;
2. Professional sports or hazardous activities such as but not limited to rock climbing or mountaineering, parachuting, hang-gliding (whether powered or not), para-gliding, bungi-jumping or any kind of race other than by foot;
3. Cave, wreck or free diving, professional diving, diving without holding the correct diving certification such as a Professional Association of Diving Instructors (PADI) and diving at depths below 40 meters;
4. professional, semiprofessional or competitive winter sports, cross country skiing or snowboarding, ski or snowboard jumping, heli-skiing, off piste skiing or snowboarding, Speed Skiing;
5. Working at height (over 20 feet);
6. Operating heavy machinery;
7. Aviation or aerial activities except air travel as a fare-paying passenger in or as a member of the aircrew of a properly licensed, fixed-wing multi-engined aircraft constructed to carry passengers and operated by a licensed commercial air carrier or in a helicopter owned and operated by a commercial concern which is licensed for the regular transportation of fare-paying passengers provided such helicopter is operating only between commercial airports and／or licensed commercial heliports and provided further that in either event such travel is not for the purpose of any trade or technical operation in or on the aircraft; or
8. Manufacture, storage, filling, breakdown, handling and transport of any explosive (including but not limited to firework or firecracker) or chemical material;
5. The Person Insured's suicide, attempted suicide or intentionally self-inflicted injuries, whether sane or insane;
6. The Person Insured being under the influence of alcohol or drugs unless, in the case of drug consumption, it is proven that such drug was taken in accordance with proper medical prescription by a Physician other than for the treatment of drug addiction;
7. Any act of the Person Insured being contrary to the law of the country or territory in which the Bodily Injury or Sickness occurs as a result of such act;
8. Pregnancy, childbirth and miscarriage of or abortion by the Person Insured, including complications resulting therefrom notwithstanding that such incident may have been accelerated or induced by Bodily Injury or Sickness;
9. Infection with Human Immunodeficiency Virus (HIV) or variants including Acquired Immune Deficiency Syndrome (AIDS) and AIDS-related complex (ARC);
10. Sexually-transmitted diseases or treatment thereof;
11. Infertility or sterilization or any type of fertility;
12. Birth defects, Congenital Conditions, Hereditary Conditions or any disabilities arising therefrom;
13. Cosmetic and elective surgery including but not limited to:
1. facelifts (rhytidectomy);
2. nose reshaping (rhinoplasty);
3. liposuction and other procedures which remove fat tissue;
4. hair transplants; and
5. surgery to change the shape of, enhance or reduce breast (other than breast reconstruction following treatment for breast cancer);
14. Eye refraction error and the treatment(s) of which involve but not limited to, laser treatment, refractive keratotomy or photorefractive keratectomy, except due to Bodily Injury. The Company shall pay for treatment to correct or restore eyesight if it is Medically Necessary as a result of a Sickness or Bodily Injury, such as cataracts or a detached retina;
15. Routine eye／ear examinations, cost of spectacles, contact lenses, hearing aids and artificial lens except such occurrence are covered under the “Medical Appliances” section of the Basic Policy and the Wellness Benefits (optional benefit);
16. Vaccination and immunisation injections except such occurrence are covered under the Wellness Benefit (optional benefit);
17. All dental treatment prescribed by dentist except emergency treatments by a Physician during Hospital Confinement due to Bodily Injury. No claims shall be payable for any follow up treatment from such Hospital Confinement. This exclusion is not applicable to Dental Benefits (optional benefit);
18. All organ transplantation, transplant procedures and acquisition of the organ itself to be used for organ transplantation;
19. Treatment for a related condition resulting from addictive conditions and disorders, including but not limited to smoking cessation;
20. Not Medically Necessary;
21. Non medical services, including but not limited to guest meals, radio, telephone, photocopy, taxes, medical report charges, fax and the like; or
22. Developmental Conditions including but not limited to:
1. learning difficulties such as dyslexia;
2. behavioral problems such as autism or attention deficit disorder (ADHD); or
3. physical development problems such as short height;

The following exclusions are applicable to Dental Benefits:

We cannot cover any claim that directly or indirectly results from or is consequent upon or contributed to by:

1. Filling for cosmetic reasons or non-decayed cases of trauma, erosion, attrition, abrasion and others;
2. Dislodged fillings/replacement which is not caused by tooth decay;
3. Extraction of retained roots, wisdom teeth, extraction of teeth for cosmetic or orthodontic purpose;
4. All re-treatment or any Endodontic, Periodontal, Prosthodontics and Oral Surgery conditions requiring specialist treatment; or
5. Specialist treatment fee.