DEFINITIONS
Please see the Master Policy or your evidence of insurance coverage for individual state details.
Accident - Bodily injury, directly caused by a specific accidental contact with another body or object that is unrelated to any Pre-Existing Condition and causes Loss beginning while insured under the Policy.
Consultant Doctor Services - A one on one consultation with a Doctor for the purpose of obtaining a second opinion regarding the Insured's Accident or Sickness. The Insured must be referred to the Consultant Doctor by their primary Doctor. Consultant Doctor Services does not include Doctor's Services for interpretation of diagnostic testing.
Elective Surgery and Elective Treatment - Surgery or medical treatment which is not necessitated by a pathological change occurring after the Insured's Effective Date of Coverage. Elective surgery includes, but is not limited to: tubal ligation; vasectomy; breast reduction; cosmetic surgery; sexual reassignment surgery; and submucous resection and/or other surgical correction for deviated nasal septum, other than for necessary treatment of covered acute purulent sinusitis. Elective treatment includes, but is not limited to: treatment for acne; weight reduction; infertility; learning disabilities; and routine physical examinations.
Pre-Existing Condition - Any Accident or Sickness that originated, was diagnosed, treated or recommended for treatment before the Effective Date of Coverage under the Policy.
Sickness - Illness, disease, pregnancy, or Mental Disorder which: (1) is first contracted or conceived while covered under the Policy; (2) is unrelated to any Pre-Existing Condition; and which (3) causes Loss beginning while covered under the Policy. Sickness includes trauma-related disorders due to injuries sustained while insured which otherwise do not meet the definition of Accident.