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DocuSign Envelope ID: EE765B38-37EF-4402-B4E9-8B82F98E2EE8 <br /> GENERAL EXCLUSIONS PROVISIONS <br /> The Company will not reimburse the Policyholder for any of the following: <br /> (a) Any payment which does not strictly comply with the terms and conditions of the Plan Document; <br /> (b) Any payment or expense caused by or resulting from war,whether or not declared, any act or hazard <br /> of war,while a Covered Person is a member of any kind of military force or auxiliary unit engaged in <br /> that war; <br /> (c) Any payment for litigation costs and expenses, extra-contractual damages, compensatory damages, <br /> interest, exemplary and punitive damages or liabilities, including but not limited to those resulting <br /> from negligence,intentional wrongs,fraud,bad faith or strict liability on the part of the Policyholder, <br /> Plan,Administrator or any agent or representative of the Policyholder,Plan or Administrator; <br /> (d) Services or supplies for the treatment of an Occupational Injury or Sickness which are paid under the <br /> North Carolina Worker's Compensation Act only to the extent such services or supplies are the <br /> liability of the employee, employer or workers' compensation insurance carrier according to a final <br /> adjudication under the North Carolina Worker's Compensation Act or an order of the North Carolina <br /> Industrial Commission approving a settlement agreement under the North Carolina Workers' <br /> Compensation Act. <br /> UHIELIP-NC(07/06) 10 EXCL <br />