GapCo Sub Exclusions

Ward fees, theatre fees and medicines are excluded on this policy.

Cura shall not be liable for hospitalisation, bodily injury, sickness or disease directly or indirectly caused by, related to, or in consequence of:

• Exposure to discharged nuclear weaponry fallout or nuclear material or by ionising radiation or contamination by radioactivity from any nuclear fuel or from any nuclear waste from the combustion of nuclear fuel. For the purpose of this exception combustion shall include any self-sustaining process of nuclear fission;
• Investigations, treatment or surgery for obesity, directly or indirectly attributed to, or related to, or in consequence of cosmetic surgery. Other than as a result of an insured authorised event;
• Cosmetic surgery shall include surgery for breast reduction or reconstruction unless necessary subsequent to having undergone a mastectomy due to cancer;
• A routine physical or any procedure of a purely diagnostic nature, or any other examination where there is no indication of impaired health nor laboratory diagnostics or X-rays, except in the course of a previously diagnosed condition;
• Suicide, attempted suicide or intentional self-injury;
• Consumption of any drug or narcotic unless prescribed by and taken in accordance with the instructions of a registered medical practitioner (other than the insured person) or any illness caused by alcohol abuse;
• Drug addiction;
• An event directly attributable to the insured individual having a blood alcohol concentration exceeding the legal permitted level;
• Participation in:

1. Active military duty, police duty, police reservist duty, civil commotion, labour disturbances, riot, strike or the activities of locked out workers;
2. Aviation other than as a passenger;
3. Any form of race or speed test (other than on foot or involving any non-mechanically propelled vehicle, vessel, craft or aircraft);

• Any procedure not covered or declined by the medical scheme;
• No benefits shall be payable for an insured event for which the insured person received treatment or advice twelve (12) months prior to becoming an insured person. This exclusion applies to the first twelve (12) months of cover only;
• No benefits shall be payable for pregnancy or childbirth for a period of nine (9) months from inception of the policy;
• Investigations, treatment or surgery for artificial insemination or hormone treatment for infertility;
• Depression, insanity or mental stress or psychotic/psychoneurotic disorders;
• No benefits shall be payable in the event of fraudulent claim submission;
• Cura benefits do not apply in any territory outside of the Republic of South Africa, Botswana, Lesotho, Swaziland and Namibia.