Sohoj Family Care (Gold)

No benefit shall be paid under this Contract for expenses or losses resulting from or incurred in connection with or in consequence of the following:

Core Exclusions:

• 15 days waiting period after registration will be applied for all types of claims
• 90 days waiting period will be applied for maternity claims
• 24 hours hospital waiting period after admission will be applied for IPD coverage
• Maximum 3-day coverage at a stretch will be considered as a single confinement for IPD
• Only MBBS doctor's prescriptions will be valid for OPD claims

General Exclusions:

• Any congenital infirmity;
• Any minor surgery, daycare treatment
• Circumcision, prophylactic and immunization procedures;
• Mental, emotional or psychiatric disorders, alcoholism or any other narcotic addiction;
• Obesity i.e., treatment for, or required as a result of obesity, any cosmetic or plastic treatment/surgery, unless required as reconstructive surgery as a consequence of an injury due to accidents, burns;
• Any procedures which is experimental or not generally accepted by the medical profession viz. acupuncture, SAAOL, CERAGEM, herbal/ayurvedic/unani/natural/homeopathy treatment and any Alternative Medical Care (AMC) etc.;
• Treatment or advice by a person or professional not registered under BMDC (Bangladesh Medical & Dental Council)
• Rest, convalescence or rejuvenation cures, thermal baths, physiotherapy or confinement for the purposes of slimming or beautification;
• Fracture and trauma due to physical assault, injury arising due to accident while participating in any unlawful activities (e.g., driving a car without a license), attempted suicide, violation or attempted violation of the law, injuries willfully or intentionally self-inflicted or due to insanity or under the influence of a drug;
• Assembly of artificial limbs & necessary treatment of the said artificial limbs (unless required due to accident)
• Routine examination of eye and ear, fitting or replacement of eyeglasses (including Intra-ocular lens or contact lenses) or hearing aids, health screening including routine physical examinations (health check-ups), malignant cancer, radiotherapy, chemotherapy, dialysis, and any dental treatment unless require hospitalization for re-constructive surgery as a consequence of an accident;
• Non-surgical care for tuberculosis, hepatitis B & C and any other vaccinations, all expenses incurred in connection with the donor for any treatment, AIDS and HIV diseases, lupus and other connective tissue and autoimmune disorders and costs of prostheses, corrective devices;
• Sleep disorders i.e., treatment for insomnia, sleep apnoea, snoring, or any other sleep related breathing problem;
• IgE Test, vitamin test



Natural Life, Accidental Life, Disability and Critical illness:

• Any pre-existing disability, condition or any complication arising from it.
• Murder by a beneficiary or heirs.
• Execution of a judicial capital sentence.
• War, invasion, act of foreign enemy, hostilities (whether war be declared or not), civil war, rebellion, revolution, insurrection, mutiny or usurped power, military or popular uprising.
• Insanity, suicide (whether sane or insane), intentional self-inflicted injuries or any attempt threat.
• Any form of disease, infection or parasites and Acquired Immune Deficiency Syndrome (AIDS) or AIDS Related Complex (ARC) or Human Immunodeficiency Virus Infection (HIV).
• Intoxication by alcohol or drugs.
• Childbirth, miscarriage, pregnancy or any complications thereof.
• Provoked murder or assault.
• While travelling in an aircraft or sea vessel as a member of the crew, except only as a fare paying passenger in an aircraft or sea vessel licensed for passenger service.
• While committing or attempting to commit any unlawful act.
• While participating in any professional sports.
• Martial arts or boxing, aerial activities including parachuting and hang-gliding, underwater activities exceeding fifty (50) meters in depth, mountaineering involving the use of ropes or mechanical guides.
• Racing (other than on foot), pace-making, speed or reliability trials.
• Ionization, radiation or contamination by radioactivity, nuclear weapons material. • Riding/driving without a valid driving license.
• Death or Disablement or any other loss consequent upon the Insured Person involved in any of the occupations mentioned hereunder: a) Police, army/military and law enforcement officers b) Aircraft testers, pilots or crew c) Divers d) Racing drivers e) Jockeys f) Person engaged in professional sports activities g) Persons engaged in underground mining and tunneling h) Fireman i) Seamen and sea fishermen j) War correspondents k) Oil rig workers l) Steeplejacks m) Stevedores n) Persons engaged in demolition of buildings o) Persons engaged in ambulance services p) Sawyers, timer logging workers, drivers/attendants of timer lorries and winches q) Wood working machinists - using wood working machinery driven by mechanical power r) Explosive handlers s) Quarrymen t) Railway manual worker u) Animal trainers v) Security personnel (with firearms) w) Building cleaners (exceeding 9m)