Exclusions and Limitations
Blue Cross will not pay benefits for any condition that results, directly or indirectly, from any of the following causes:
a) a Pre-Existing Condition, unless the covered condition occurs after 24 consecutive months of coverage;
b) an Accident, unless the covered condition is a Severe Burn;
c) attempted suicide or voluntary injury or Illness;
d) use of any poison, intoxicant or drug, unless prescribed by a Physician and used as directed;
e) participation in a criminal act or an attempt to commit a criminal act, regardless of whether charges are laid or a conviction is obtained;
f) any Accident or injury occurring while operating a vehicle under the influence of drugs (including marijuana) or with a blood alcohol level in excess of the legal limit in the jurisdiction in which the Accident occurs; or
g) insurrection, war (declared or not), the hostile action of the armed forces of any country or participation in any riot or civil commotion.
Any condition for which, during the 24 months immediately before the effective date of this benefit, the participant has:
- had a medical consultation
- been prescribed or taken medication or
- received treatment, including diagnostic measures for any symptom or medical problem that leads to a diagnosis of or treatment for a covered condition
This definition does not apply to a Child born while Child optional critical illness coverage is in force.
The continuous period of time between the date the definition of a covered condition is met and the date the benefit is payable. The survival period is 30 consecutive days unless otherwise specified in the details of the covered condition.