EXCLUSIONS

The Accidental Dental Expense Benefit 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 farepaying 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.
  • 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 or intercollegiate 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 participating in a rodeo.
  • Re-injury or complications of an Injury caused or contributed to by a condition that existed Before the Accident.
  • Injury to teeth which is caused from biting, chewing or grinding teeth.
  • Injury to teeth with gross decay or advanced periodontal disease;
  • Orthodontic therapy to correct a condition that existed prior to the Accident.
  • Injury to teeth not firmly attached to the maxilla and/or mandible immediately prior to the time of the Accident.
  • Dental treatment and services performed or supplies used in conjunction with but not due to the covered Accident.
  • Excluded states: CO, KS, ME, MD, MN, MO, MT, NV, NH, NM, NY, NC, OR, SD, TX, UT