5.18.24 post

Exclusions in Your Insurance Policy When You Go to Make a Claim!

What are exclusions within an insurance policy and how do they work?

An exclusion is a contractual provision in your insurance policy that states what the insurance company Will Not cover on a claim for damages. Often it seems there are more of these clauses in an insurance policy telling you what your company Won’t cover than there are saying what they will pay for on a claim.

Prior to buying a policy of insurance, or renewing one for your car, motorcycle, home, or health to name a few, make sure you consult with an agent to find out what your policy Will Not cover.

We often assume that the insurance we are purchasing will cover us on any claim for the type of coverage we bought, but this is not true.

If your claim falls under an exclusion, it means that the insurance company Will Not pay that claim and you are now personally exposed to the payment of those damages.

A common exclusion in an auto policy is for business use of a personal vehicle, such as driving for Uber or Lyft, delivering pizza, food, or flowers, etc. Personal use of a commercial vehicle could be excluded as well. Motorcycles, golf carts, or ATV’s can be excluded from a standard auto policy requiring the insured to purchase a separate policy for those vehicles.

Auto policies also have exclusions for “Acts of God”, which can include unforeseen medical events which cause a driver to have an accident, such as a heart attack or stroke.

Unnamed, or unknown drivers (ones the insurance company is not aware of living in the household) can be denied coverage under an auto policy exclusion. Vehicles not listed under the policy can be excluded too.

Homeowners’ policies often have clauses excluding damages caused by flooding, water leakage for a long period, or mold.

Damage caused by settling or shifting of the soil can be denied under the policy as well. A claim arising out of faulty or poor construction of a home or addition could be excluded also.

Dogs, specific types of breeds, or certain types of pets are often excluded from insurance coverage leaving the owner of those animals exposed to personal liability.

Of course, with health insurance, a common exclusion can be for pre-existing conditions.

 

Prevent yourself from being denied coverage under an exclusion by asking your agent if there are any riders or supplements to the policy that you can purchase to cover you if there is an exclusion for a particular situation or event under your main policy of insurance.

Always read your policy and be familiar with what it covers, as well as what it Doesn’t!

We have fought and litigated many of these exclusion issues, so if you should have any questions concerning this topic or any other legal matters, contact us. We are always here for YOU!

Chuck and Sarah