Exclusions and Limitations
The plan does not cover any disabilities due to any of the following:
- War or any act of war
- Intentionally self-inflicted injuries
- Active participation in a riot
- The committing of or attempting to commit a felony
- Cosmetic surgery unless surgery is in connection with an injury or sickness sustained while you are covered by the plan
You will not receive a payment for any period of disability during which you are incarcerated as a result of a conviction.
Pre-existing Conditions
The plan does not cover a disability which:
- Is caused by a pre-existing condition or medical or surgical treatment of a pre-existing condition, and
- Begins in the first 12 months immediately after your effective date of coverage.
A pre-existing condition is a physical or mental condition, whether diagnosed or undiagnosed, resulting from an injury or sickness for which you received physician's advise or treatment within three months before your effective date of coverage in this plan.
For purposes of this provision, treatment means receiving care or services by or under the direction of a physician, including diagnostic measures that result in a positive diagnosis, being prescribed drugs or medicines, and taking drugs or medicines.
If there is an increase in your benefits due to an amendment of the plan, or your enrollment in another plan option, a benefit limit will apply if your disability is due to a pre-existing condition. You will be limited to the benefits you had on the day before the increase if your disability begins during the 12 month period starting with the date the increase in benefits would have been effective. The increase will not take effect until your disability ends.
If you were covered by the Company's prior LTD plan on the day before this plan became effective, and you became covered under this plan within thirty-one days of its effective date, then if the change from the prior plan to this plan of coverage would result in an increase in your amount of benefits, the benefits for your disability that is due to a pre-existing sickness or injury will not increase. Instead the benefits are limited to the amount you had on the day before the plan change.