SOMPO Health

SOMPO Health is a comprehensive health insurance policy which covers hospitalisation & surgical expenses due to accident and illness, with guaranteed renewal up to 100 years old.

General Exclusions

This Policy does not cover :-

  1. Pre-existing illnesses.
  2. Specified Illnesses occurring during the first 120 days of continuous cover.
  3. Any medical or physical conditions arising within the first 30 days of the Insured Person's cover or date reinstatement whichever is later except for accidental injuries.
  4. Care or treatment for which payment is not required or to the extent which is payable by any other insurance or indemnity covering the Insured and Disabilities arising out of duties of employment or profession that is covered under a Workman's Compensation Insurance Contract.
  5. Dental conditions including dental treatment or oral surgery except as necessitated by Accidental Injuries to sound natural teeth occurring wholly during the Period of Insurance.
  6. Private nursing, rest cures or sanitaria care, illegal drugs, intoxication, sterilisation, venereal disease and its sequelae, AIDS (Acquired Immune Deficiency Syndrome) or ARC (AIDS Related Complex) and HIV related diseases, and any communicable diseases required quarantine by law.
  7. Any treatment or surgical operation for congenital abnormalities or deformities including hereditary conditions.
  8. Pregnancy, child birth (including surgical delivery) and its related complications, miscarriage, abortion and prenatal or postnatal care and surgical, mechanical or chemical contraceptive methods of birth control or treatment pertaining to infertility. Erectile dysfunction and tests or treatment related to impotence or sterilisation.
  9. Psychotic, mental or nervous disorders, (including any neuroses and their physiological or psychosomatic manifestations).
  10. Hospitalisation primarily for investigatory purposes, all diagnostic tests including and not limited to Positron Emission Tomography (PET) Scan, Computed Tomography (CT) Scan, Computed Axial Tomography (CAT) Scan, Magnetic Resonance Imaging (MRI), X-ray examination, general physical or medical examinations, not incidental to treatment or diagnosis of a covered Disability or any treatment which is not Medically Necessary and any preventive treatments, preventive medicines or examinations carried out by a Physician, and treatments specifically for hyperhidrosis, weight reduction or gain.
  11. Costs/expenses of services of a non-medical nature, such as television, telephones, telex services, radios or similar facilities, admission kit/pack and other ineligible non-medical items.
  12. Sickness or Injury arising from racing of any kind (except foot racing), hazardous sports such as but not limited to skydiving, water skiing, underwater activities requiring breathing apparatus, winter sports, professional sports and illegal activities.
  13. Suicide, attempted suicide or intentionally self-inflicted injury while sane or insane.
  14. Private flying other than as a fare-paying passenger in any commercial scheduled airlines licensed to carry passengers over established routes.
  15. War or any act of war, declared or undeclared, criminal or terrorist activities, active duty in any armed forces, direct participation in strikes, riots and civil commotion or insurrection.
  16. Ionising radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from process of nuclear fission or from any nuclear weapons material.
  17. Expenses incurred for donation of any body organ by an Insured Person and costs of acquisition of the organ including all costs incurred by the donor during organ transplant and its complications.
  18. Expenses incurred for sex changes
  19. Investigation and treatment of sleep and snoring disorders, hormone replacement therapy and stem cell treatment.
  20. Treatment directed towards development delay / or learning disabilities in children (including dyslexia)
  21. Plastic/Cosmetic surgery, circumcision, eye examination, glasses and refraction or surgical correction of nearsightedness (Radial Keratotomy or Lasik) and the use or acquisition of prosthetic appliances or devices such as artificial limbs, hearing aids and prescriptions thereof.