Page 8 - Customer-Booklet_Texas
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Also, no benefits will be payable under the Rider for:
a. loss that begins prior to the Rider Effective Date;
b. Treatment for which no charges are made by the provider of same;
c. services which are primarily for rest care, convalescent care, or for rehabilitation; or
d. any injury or Sickness paid for under any state or federal Workers’ Compensation, Employers’

Liability Law, or similar law.

PRE-EXISTING CONDITION(S) The benefits of the Rider will not be payable during the first twelve
(12) months that coverage is in force with respect to an Insured Person for any loss caused by Pre-
Existing Condition(s). This twelve (12) month period is measured from the Rider Effective Date for
each Insured Person.

We will pay the Hospital Indemnity Benefit Amount shown on the Policy Schedule Page for each
Day that an Insured Person is Hospital Confined. For benefits to be payable, the Hospital
Confinement must:
a. be due to an injury, Sickness, or Complication of Pregnancy;
b. begin while the Rider is in force for an Insured Person;
c. be for at least twenty-four (24) hours; and
d. be at the direction of and under the supervision of a Physician.

Benefits will not be payable beyond a Maximum Benefit Period of thirty (30) Days, as shown on the
Policy Schedule Page, for any one (1) Period of Confinement.

Upon attainment of Age sixty-five (65), coverage for each Insured Person will be reduced by fifty
percent (50%) as shown on the Policy Schedule Page.

EXCLUSIONS AND LIMITATIONS The Rider is subject to the following Exclusions and Limitations in
addition to those outlined in the policy.

In addition to any benefit-specific conditions, limitations, or exclusions, no benefits will be payable
under the Rider for Confinement or loss caused directly or indirectly by:
a. suicide (while sane or insane), attempted suicide, or intentionally self-inflicted injury;
b. war or act of war (whether declared or undeclared, excludes acts of terrorism);
c. commission or attempt to commit an illegal activity or a felony;
d. commission of or active participation in a riot, insurrection, rebellion, or police action;
e. voluntary self-administration 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;
f. operating any type of vehicle while under the influence of alcohol or any drug, narcotic, or other

intoxicant. “Under the influence of alcohol,” for purposes of this exclusion, means intoxicated, as
defined by the law of the state in which the injury occurred;
g. mental or emotional disorders, alcoholism, and drug addiction;
h. Treatment outside the United States except for emergency care for acute onset of Sickness or
accidental injury sustained while traveling for business or pleasure;
i. travel or activity outside the United States;
j. participation in any motorized race or contest of speed on sea, land, or air;
k. travel in or on any off-road motorized vehicle not requiring licensing as a motor vehicle;

LY-LSC-OC-B-FL 6 10/13
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