Exclusions from Benefits

No welfare benefits will be payable in the event of any one or more of the following circumstances: -

(i) If the claimant was employed by a firm not in full membership of the SJIB at the date of the event giving rise to the claim.
(ii) If the claimant would not have qualified under the rules applicable to payment of sickness or accident benefit.
(iii) If the Member Firm was in breach of its obligations to purchase welfare credits.
(iv) If an Apprentice or Adult Trainee was not registered with the SJIB.
(v) During any period of paid benefit.
(vi) If the claimant has a chronic illness from which excessive and regular claims to benefit have arisen.
(vii) Contravention of the current SJIB National Working Rules.

In addition, no benefit will be payable in respect of Accidental Dismemberment and Permanent and Total Disability where the bodily injury or disablement which results from or is caused, directly or indirectly, by any of the following causes: -

(1) Suicide or self-inflicted injury, while sane or insane.
(2) Injury incurred to which a contributing cause is the insured person’s commission of, or attempt to commit an assault or criminal offence.
(3) Insurrection or war, whether war be declared or not, or any act incident thereto, or participation in any riot.
(4) Travel or flight in any aircraft if the insured person is a pilot, officer, or other member of the crew of the aircraft, or if such flight is made for instructional, testing or training purposes.
(5) Bodily or mental infirmity, or medical or surgical treatment thereof.
(6) Accident, injury or other loss caused wholly or partly by disease, by medical or surgical treatment thereof, or by hernia or infection other than septic infection caused through a visible wound accidentally sustained.