No benefits are payable under this plan for charges for care, services or supplies:

• that were furnished without the recommendation and approval of a Physician acting within the scope of his license;
• that are not Medically Necessary, such as but not limited to, charges for a surgical procedure or treatment performed primarily for beautification, or charges for Hospital confinement for such surgical procedure or treatment;
• if payment is prohibited by law;
• that an Insured Person may obtain as a benefit under any governmental plan or law;
• for occupational injury or disease covered by Workplace Safety and Insurance law or similar legislation;
• for which no charge would have been made in the absence of this insurance;
• for dental work, except as provided under the Dental Care for Accidental Injury;
• for any drugs or services that are not approved by Health and Welfare Canada, or are experimental or limited in use whether or not so approved;
• for experimental procedures or treatment not approved by the Canadian Medical Association or the appropriate medical specialty society;
• for health examinations that are requested by a third party;
• for broken appointments, travel, communication costs, filling in of forms or Physician’s supplies.
• which were considered an insured service of any provincial government plan at the time this plan/benefit was issued and subsequently were modified, suspended or discontinued.

No amount will be paid for any charge incurred that results from or is contributed by:

• war, whether declared or not;
• insurrection, rebellion or participation in a riot or civil commotion;
• purposely self-inflicted injury; or
• the Insured Person’s commission of, or attempt to commit, an assault or a criminal offence.