Certification / Diagnosis Clause Samples

The Certification / Diagnosis clause establishes the requirement for a formal statement or confirmation regarding a particular condition, status, or fact, often related to health or compliance. In practice, this clause may require a party to provide a medical certificate from a licensed physician to verify illness or a professional diagnosis to confirm eligibility for certain benefits or actions. Its core function is to ensure that claims or requests are substantiated by credible, third-party evidence, thereby reducing the risk of false or unsupported assertions and promoting transparency between the parties.
Certification / Diagnosis. Treatment by a family member, or a person who stays with the Insured Person, or from persons not registered as Medical Practitioners under the respective Medical Councils, or from a Medical Practitioner who is practicing outside the discipline that he is licensed for, or any diagnosis or treatment that is not scientifically recognized or experimental or unproven, or any form of clinical trials or any kind of self-medication and its complications.
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Certification / Diagnosis. Treatment by a family member, or a person who stays with the Insured Person, or from persons not registered as Medical Practitioners under the respective Medical Councils, or from a 1. Any claim relating to events occurring before the Coverage Commencement Date or otherwise outside of the Period of Insurance. 2. Any Pre-Existing Disease or condition and/or any complications arising from it. This Policy is not designed to provide an indemnity with respect to any medical services, the need for which arises out of a Pre- Existing Disease or condition as defined herein, in normal course of treatment. 3. Any treatment undergone abroad, if that is the sole reason or one of the reasons for the Insured Person's Trip or any temporary stay abroad. 4. Any claim if the Insured Person – a. Is travelling against the advice of a Medical Practitioner; b. Is receiving, or is on any waiting list to receive, specified medical treatment declared in a Medical Practitioner's report or certificate; c. Has received terminal prognosis for a medical condition; Medical Practitioner who is practicing outside the discipline that he is licensed for, or any diagnosis or Treatment that is not scientifically recognised or Unproven/Experimental treatment, or any form of clinical trials or any kind of self-medication and its complications.
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