Exclusions


Non-NY Residents:

Exclusions (AD&D and Accident Medical


Benefits will not be paid for any Covered Injury; Covered Loss or Covered Expense which directly or indirectly, in whole or in part, is caused by or results from any of the following:
1. Intentionally self-inflicted Injury, suicide or any attempt thereat while sane or insane;
2. commission or attempt to commit a felony or an assault;
3. commission of or active participation in a riot or insurrection;
4. bungee-cord jumping, parachuting, skydiving, parasailing, and hang-gliding;
5. declared or undeclared war or act of war;
6. flight in, boarding or alighting from an Aircraft [or any craft designed to fly above the Earth’s surface:
   a. except as a fare-paying passenger on a regularly scheduled commercial airline;
   b. being flown by the Insured or in which the Insured is a member of the crew;
   c. being used for:
      i. crop dusting, spraying or seeding, giving and receiving flying instruction, fire fighting, sky writing, sky diving or hang-gliding, pipeline or power line inspection, aerial photography or exploration, racing, endurance tests, stunt or acrobatic flying; or
      ii. any operation that requires a special permit from the FAA, even if it is granted.
   d. designed for flight above or beyond the earth’s atmosphere;
   e. an ultra-light or glider;
   f. being used for the purpose of parachuting or skydiving;
   g. being used by any military authority, except an Aircraft used by the Air Mobility Command or its foreign equivalent;
7. travel in or on any on-road and off-road motorized vehicle that does not require licensing as a motor vehicle;
8. participation in any motorized race or contest of speed;
9. an Accident if the Insured is the operator of a motor vehicle and does not possess a valid motor vehicle operator's license, unless: (a) the Insured holds a valid learners permit and (b) the Insured is receiving instruction from a Driver's Education Instructor;
10.Sickness, disease, bodily or mental infirmity, bacterial or viral infection or medical or surgical treatment thereof, including exposure, whether or not accidental, to viral, bacterial or chemical agents]except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
11. release, whether or not accidental, or by any person unlawfully or intentionally, of nuclear energy or radiation, including Sickness or disease resulting from such release;
12. medical or surgical treatment, diagnostic procedure, administration of anesthesia, or medical mishap or negligence, including malpractice unless it occurs during treatment of injuries sustained in a Covered Accident;
13. travel or activity outside the contiguous United States, Alaska, Hawaii, Canada or Mexico;
14. the Insured being legally intoxicated as determined according to the laws of the jurisdiction in which the Covered Accident occurred;
15. voluntary ingestion of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
16. injuries compensable under Workers’ Compensation law or any similar law;
17. occupational injuries for which benefits are not paid under the Workers’ Compensation Law or any similar law;
18. a Covered Accident that occurs while on active duty service in the military, naval or air force of any country or international organization. Upon Our receipt of proof of service, LINA will refund any premium paid for this time. Reserve or National Guard active duty training is not excluded unless it extends beyond 31 days;
19. operating any type of vehicle while under the influence of alcohol or any drug , narcotic or other intoxicant including any prescribed drug for which the Insured has been provided a written warning against operating a vehicle while taking it. Under the influence of alcohol, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident occurred

In addition, benefits will not be paid for services or treatment rendered by any person who is
   1. living in the Insured’s household;
   2. a parent, sibling, spouse or child of either the Insured or the Insured’s spouse;
   3. the Insured.

LINA will not pay benefits for the Insured’s Covered Loss if:

   1. the Insured was driving a Private Passenger Automobile at the time of the Covered Accident that resulted in the Covered Loss; and
   2. the Insured was intoxicated, as that term is defined by the laws of the state in which the Covered Accident occurred.



Non-NY Residents:
All benefits provided by this insurance are subject to the terms, definitions, conditions, exclusions and limitations, of the group policy # GDE-001105, which is issued to American Advantage Association. To obtain more information about this insurance, please call 1-800-561-4480 and ask to speak to a licensed agent or click on the link above. All members of American Advantage Association, under age 65, who have purchased the Qualified Health Medical Discount Program, are eligible to enroll in the Accidental Death & Dismemberment/ Accident Medical Expense Benefits Program. The insurance benefits are underwritten by Life Insurance Company of North America (LINA), a CIGNA Company. NAIC #65498. LINA is domiciled in the State of Pennsylvania with the principal place of business of 1601 Chestnut Street, Philadelphia PA 19192. Coverage becomes effective on the date provided in your membership materials. THIS OFFER PROVIDES INSURANCE BENEFITS FOR SPECIFIC LOSSES FROM ACCIDENTS ONLY. IT DOES NOT PAY BENEFITS FOR LOSSES CAUSED BY SICKNESS. Medical Expense Benefits are only payable in excess of other insurance coverage(s). The coverage is available to you as long as you remain a member of the Association in good standing.

New York Residents:

Exclusions (AD&D and Accident Medical)


1. intentionally self-inflicted Injury, suicide or any attempt thereat;
2. commission or attempt to commit a felony;
3. Parachuting and/or skydiving;
4. declared or undeclared war or act of war;
5. aviation, except as a fare -paying passenger on a scheduled commercial or charter flight operated by a scheduled airline;
6. participation in any motorized race or contest of speed;
7. Sickness, disease, bodily or mental infirmity, bacterial or viral infection or medical or surgical treatment thereof ,including exposure, whether or not accidental, to viral, bacterial or chemical agents except for any bacterial infection resulting from an accidental external cut or wound or accidental ingestion of contaminated food;
8. travel outside the United States, its possessions, or the countries of Canada and Mexico;
9. the Insured being legally intoxicated as determined according to the laws of the jurisdiction in which the Covered Accident occurred;
10. voluntary ingestion of any narcotic, drug, poison, gas or fumes, unless prescribed or taken under the direction of a Physician and taken in accordance with the prescribed dosage;
11. injuries compensable under Workers’ Compensation law or any similar law;
12. occupational injuries for which benefits are not paid under the Workers’ Compensation Law or any similar law;
Benefits will not be paid for services rendered by a Physician, Nurse or other person who is Employed or retained by the Policyholder.

New York Residents:
All benefits provided by this insurance are subject to the terms, definitions, conditions, exclusions and limitations, of the Group Policy No. AGV-001210, which is issued to American Advantage Association. To obtain more information about this insurance, please call 1-888-561-4480 and ask to speak to a licensed agent or click on the link above. All members of American Advantage Association, under age 65, who purchased the Qualified Health Medical Discount Program, are eligible to enroll in the Accidental Death & Dismemberment/ Accident Medical Expense Benefits Program. The insurance benefits are underwritten by CIGNA Life Insurance Company of New York (CLICNY), a CIGNA Company. NAIC #65498. CLICNY is domiciled in the State of New York with a principal place of business of 140 East 45th Street, New York, NY 10017. .Coverage becomes effective on the date provided in your membership materials. THIS OFFER PROVIDES INSURANCE BENEFITS ONLY FOR ACCDIENTS. IT DOES NOT PROVIDE BASIC HOSPITAL, BASIC MEDICAL OR MAJOR MEDICAL INSURANCE, AS DEFINED BY THE NEW YORK STATE INSURANCE DEPARTMENT. THIS OFFER DOES NOT PROVIDE COVERAGE FOR SICKNESS. Medical Expense Benefits are only payable in excess of other insurance coverage(s).
Qualified Health is NOT insurance. It is a medical discount program that brings you the same negotiated rates that the large insurance companies have enjoyed for years! See here for important disclosures.