In Arkansas, Riders CIRIDERAR, CIRIDERHAR. In Oklahoma, Riders CIRIDEROK, CIRIDERHOK. In New Jersey, Riders CIRIDERNJ and CIRIDERHNJ. In Oregon, Riders CIRIDEROR, CIRIDERHOR. In TX, Riders CIRIDERTX, CIRIDERHTX. The Aflac Plus Riders are not available for residents in Idaho, New York, Pennsylvania or Virginia.
Coverage is underwritten by Aflac. WWHQ | 1932 Wynnton Road | Columbus, GA 31999
EXCEPTIONS, REDUCTIONS, AND LIMITATIONS OF THE RIDER (THAT IS NOT A DAILY HOSPITAL EXPENSE PLAN) FOR RESIDENTS OF ARIZONA:
- Aflac will not pay benefits for any loss that is caused by a Pre-existing Condition, unless the Onset Date is more than 12 months after the Effective Date of coverage. Benefits are payable for only one covered loss at a time per Covered Person. Aflac will not pay benefits for any condition when diagnosis occurred prior to the Effective Date of coverage.
- Aflac will not pay benefits for any loss that is diagnosed or treated outside the territorial limits of the United States or its possessions.
- Aflac will not pay benefits whenever coverage provided by the rider is in violation of any U.S. economic or trade sanctions. If the coverage violates U.S. economic or trade sanctions, such coverage shall be null and void.
- For any benefit to be payable, the Onset Date of the loss must occur on or after the Effective Date of coverage and while coverage is in force. If more than one loss per Covered Person occurs on the same day, only the highest eligible benefit will be paid.
- Aflac will not pay benefits whenever fraud is committed in making a claim under the coverage or any prior claim under any other Aflac coverage for which benefits were received that were not lawfully due and that fraudulently induced payment.
- The rider does not cover loss caused by or resulting from:
- Participating in any activity or event, including the operation of a vehicle, while under the influence of a controlled substance (unless administered by a Physician and taken according to the Physician's instructions) or while intoxicated (“intoxicated” means that condition as defined by the law of the jurisdiction in which the accident occurred);
- Using any drug, narcotic, hallucinogen, or chemical substance (unless administered by a Physician and taken according to the Physician's instructions), or voluntarily taking any kind of poison or inhaling any kind of gas or fumes;
- Participating in, or attempting to participate in, an illegal activity that is defined as a felony ("felony" is as defined by the law of the jurisdiction in which the activity takes place), or being incarcerated in any detention facility or penal institution;
- Intentionally self-inflicting a bodily injury or committing or attempting suicide, while sane or insane;
- Being exposed to war or any act of war, declared or undeclared; or
- Actively serving in any of the armed forces or units auxiliary thereto, including the National Guard or Reserve.
PRE-EXISTING CONDITIONS LIMITATION
A “Pre-existing Condition” is any illness, disease, infection, disorder, or injury for which, within the 12-month period before the Effective Date of coverage, prescription medication was taken or medical testing, medical advice, consultation, or treatment was recommended or received, or for which symptoms existed that would ordinarily cause a prudent person to seek diagnosis, care, or loss that is caused by a Pre-existing Condition will not be covered unless the Onset Date is more than 12 months after the Effective Date of coverage.
EXCEPTIONS, REDUCTIONS, AND LIMITATIONS OF THE RIDER (THAT IS NOT A DAILY HOSPITAL EXPENSE PLAN) FOR RESIDENTS OF NEW JERSEY:
- Aflac will not pay benefits for any loss that is caused by a Pre-existing Condition, unless the Onset Date is more than six months after the Effective Date of coverage. Benefits are payable for only one covered loss at a time per Covered Person. Aflac will not pay benefits for any condition when diagnosis occurred prior to the Effective Date of coverage.
- Aflac will not pay benefits for any loss that is diagnosed or treated outside the territorial limits of the United States or its possessions.
- Aflac will not pay benefits whenever coverage provided by the rider is in violation of any U.S. economic or trade sanctions. If the coverage violates U.S. economic or trade sanctions, such coverage shall be null and void.
- For any benefit to be payable, the Onset Date of the loss must occur on or after the Effective Date of coverage and while coverage is in force. If more than one loss per Covered Person occurs on the same day, only the highest eligible benefit will be paid.
- Aflac will not pay benefits whenever fraud is committed in making a claim under the coverage or any prior claim under any other Aflac coverage for which benefits were received that were not lawfully due and that fraudulently induced payment.
- The rider does not cover loss caused by or resulting from:
- Intentionally self-inflicting a bodily injury or committing or attempting suicide, while sane or insane;
- Being involved in war or any act of war, declared or undeclared; or
- Actively serving in any of the armed forces or units auxiliary thereto, including the National Guard or Reserve. (We will return the premium paid during such service, and upon termination of military service, you have the right to renew coverage.)
PRE-EXISTING CONDITION LIMITATIONS
A “Pre-existing Condition” is any illness, disease, infection, disorder, or injury for which, within the six-month period before the Effective Date of coverage, prescription medication was taken or medical testing, medical advice, consultation, or treatment was recommended or received. Benefits for a loss that is caused by a Pre-existing Condition will not be covered unless the Onset Date is more than six months after the Effective Date of coverage.