Accident Medical Terms & Conditions

Accident Medical Exclusions - Gold & Platinum Memberships

The Policy does NOT provide benefits for:

- Treatment, services or supplies which:

• Are not Medically Necessary;
• Are not prescribed by a Doctor as necessary to treat an Injury;
• Are determined to be Experimental/Investigational in nature;
• Are received without charge or legal obligation to pay;
• Are received from persons employed or retained by any Family Member, unless otherwise specified; or
• Are not specifically listed as Covered Charges in the Policy.

- Injury by acts of war, whether declared or not.
- Injury received while traveling or flying by air, except as a fare-paying passenger and not as a pilot or crew member, on a regularly scheduled commercial airline.
- Injury covered by Worker's Compensation, Employer Liability law or Occupational Disease Act or Law.
- Dental treatment, except as specifically stated.
- Injury sustained while committing or attempting to commit a felony.
- Prescription Drugs except as specifically stated.
- Suicide or attempted suicide while sane or insane.
- Intentionally self-inflicted Injury.
- Loss resulting from being legally intoxicated or under the influence of alcohol as defined by the laws of the state or jurisdiction in which the Injury occurs.
- Loss resulting from being under the influence of any drugs or narcotic unless administered on the advice of a Doctor.
- Injury sustained while participating in or practicing for any professional, intercollegiate or club sports activity, except as specifically provided.
- Injury which occurs while a Covered Person is on active duty service in any armed forces. Reserve or National Guard active duty for training is not excluded unless it extends beyond 31 days.
- Injury sustained flying in an ultra light, hang gliding, parachuting or bungee-cord jumping, by flight in a space craft or any craft designed for navigation above or beyond the earth's atmosphere.
- Injury sustained while driving or riding on vehicles for off-road use including but not limited to all-terrain vehicles (ATV's).
- Injury sustained where a Covered Person is the operator and does not possess a current and valid motor vehicle operator's license, except in a Driver's Education Program.
- Treatment in any Veteran's Administration or federal Hospital, except if there is a legal obligation to pay;
- Cosmetic surgery, except for reconstructive surgery on an injured part of the body.
- Covered Charges incurred outside of the United States or its possessions.
- Competing in motor sports races or competitions;
- Competing in water sports races or competitions;
- Testing cars/trucks on any racetrack or speedway;
- Handling, storing or transporting explosives;
- Scaling up cliffs or mountain walls;
- Spelunking (exploring caves);
- Handling or working with dangerous animals.
- Injury sustained while water skiing or surfboarding;
- Injury sustained while snow skiing or snowboarding;
- Injury sustained while roller blading or skateboarding;
- Injury sustained while participating in a rodeo.
- Repetitive motion injuries, strains, hernia, tendonitis, bursitis and heat exhaustion not related to a specific Injury.

The Accident Insurance benefit provided in this program may be duplicative of services and products offered by a Member's health insurance plan if the Member has health insurance. The accident medical insurance rate included in your monthly cost of membership, depending on the level you choose, is as follows: Gold Membership ($8.70) - Platinum Membership ($17.20)

The Accidental Death and Dismemberment and the Accident Medical Expense benefit insurance is subject to the terms, definitions, conditions, exclusions and limitations of the group policy. All Gold and Platinum members of CBA are eligible to receive these benefits. These insurance benefits are underwritten by Guarantee Trust Life Insurance Company policy form MP-1300 issued to CBA. Coverage becomes effective on the date provided in your membership material.