(2) diseases caused by suicide. Just as life insurance stipulates that "suicide is not guaranteed" in the exclusion liability, health insurance generally clearly stipulates in the policy terms that "illness or disability caused by suicide" belongs to the insurer's exemption scope. Suicide is considered to be a deliberate action taken by the insured to end his life. No matter what motive the insured commits suicide, there are often cases of attempted suicide, and most of the suicides are fatal. Although they were lucky enough to save their lives after all-out rescue, they often left sequelae or disabilities. If only from the results, people who have insured both life insurance and sickness insurance but failed to commit suicide and left a disability can claim health insurance benefits based on illness or disability accidents, although they cannot claim life insurance benefits. However, from the insurer's point of view, although this disease or disability meets the underwriting conditions in the health insurance policy, it is the direct result of the intentional act of suicide, which should belong to the nature of moral hazard, and the insurer generally does not bear the liability for compensation or compensation, which is also one of the general principles of insurance contracts. Similarly, insurance companies can also list other behaviors that consciously harm health and lead to illness or disability, such as drug abuse and alcoholism. At the same time, from its external effect, this kind of regulation obviously has more advantages than disadvantages, and the insured will also be cautious about his behavior for economic reasons, which is conducive to safeguarding national health, public morality and good social customs. (3) Medical expenses incurred in war, military action, riot or armed rebellion. The occurrence of war, invasion, riots, etc. Often large-scale, it not only has a great destructive effect on the modern economy, but also seriously affects people's normal life and even poses a serious threat to people's life and health. The occurrence of these emergencies instantly changes the possibility of various dangers, and in most cases, many insurance accidents are concentrated, which brings great pressure to the insurer's operation. Therefore, in many insurance contracts, war is listed as an excluded liability, or as a special additional risk clause alone. For example, the cargo clauses of the London Insurance Association include war risks and special clauses on strikes, riots and civil commotions, while FPA includes war risks and clauses on strikes, riots and civil commotions. Of course, health insurance is no exception, because the extraordinary events of war have changed people's normal life order and habits, so very dangerous things happen frequently. There are countless casualties and infectious diseases in the war, which have a great impact on insurance management and should be included in the exclusion clause. From another point of view, health insurance covers diseases or disabilities caused by internal factors, while most of the injuries in wars and riots are caused by external factors. Accidental injuries caused by accidents, whether the result is illness, disability or death, should be included in the scope of accidental injury insurance, which is qualitatively different from health insurance. According to the principle of proximate cause, these diseases or injuries are caused by external accidents, which can be avoided by most people as long as they are reasonable and cautious under normal living conditions, so it is completely reasonable to include them in the exclusion range of health insurance. In addition, large-scale property losses and personal injuries caused by natural disasters such as earthquakes, floods, hurricanes and tsunamis have exceeded the underwriting capacity of commercial insurance companies and are generally borne by the state finance, so they belong to the category of social insurance. In terms of health insurance, "exclusion liability" is usually listed after "insurance liability", for example, "the illness caused by the insured due to the following reasons is not insurance liability: 1) the insured commits suicide or criminal acts; 2) The insured or its beneficiary intentionally cheats; 3) War or military action; 4) Congenital diseases and their operations; 5) Diseases or operations caused by accidental injuries; 6) Diseases or operations occurring during the observation period; 7) Any disease not included in the insurance liability. " Some insurance policies do not cover diseases, mental disorders, tuberculosis, etc. outside specific areas. , while others include illegal behavior, alcoholism, drug abuse, etc.
Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.