Insurance Authority - General exclusion (2024)

FAQs

What is the general exclusion of insurance? ›

Loss, destruction or damage that existed before the policyholder applied for home insurance is excluded from coverage. For example, a home insurance policy may not cover any losses caused by water leakage that existed in a newly build property when the owner moved in.

For example, many insurance policies exclude “hostile acts” such as war. In fact, catastrophic exclusions are sometimes simply referred to as “war exclusions,” and protect insurers from having to pay for losses caused by low-probability, high-cost widespread events.

In workers compensation insurance, general exclusions are operations (e.g., aircraft operations) that are specifically excluded from the basic classifications and are always separately classified unless specifically included in the basic classification wording.

The burden is on the insurer to show an exclusion applies. In ERISA cases, the principle is well settled that the plan has the burden to show the applicability of an exclusion once the claimant has presented a prima facie case that she is covered and thus entitled to benefits under the plan terms.

Exclusion Clauses are generally written into the policy at inception and are designed to protect the insurer against certain losses. They are typically very broad in scope and may be used to exclude a wide range of risks, for example those related to intentional acts, fraud, or illegal activities.

An exclusion is a provision within an insurance policy that eliminates coverage for certain acts, property, types of damage or locations.

Risky activity: Any death due to risky activities, such as skydiving or rock climbing, are usually counted as an exclusion. Substance abuse: If a policyholder's death is the result of drug or alcohol abuse, it may be excluded from their policy.

An excluded driver is a person in your household who has been explicitly excluded from coverage under your car insurance policy. Their name will show as "excluded" on your policy, and they won't be insured to drive any vehicles on your policy.

General liability policies typically exclude coverage for intentional acts. This means that if a business owner intentionally causes harm to another person or property, the general liability policy will not provide coverage.

What does CGL not cover? ›

In summary, while CGL policies provide broad coverage for general business liabilities, policyholders should be aware of common exclusions like expected harm, contractual obligations, pollution, aircraft/watercraft, and professional services.

Typical examples of excluded perils under a homeowners policy are flood, earthquake, and nuclear radiation. A typical example of an excluded loss under an automobile policy is damage due to wear and tear.

The most common key person insurance exclusions are fraud, misrepresentation, and suicide. A claim can be denied in case of a proven instance of intentional dishonesty. During the first two years of every life insurance policy, there is a contractual clause known as the contestability period.

The burden of proof is usually on the person who brings a claim in a dispute. It is often associated with the Latin maxim semper necessitas probandi incumbit ei qui agit, a translation of which is: "the necessity of proof always lies with the person who lays charges."

In an insurance claim, the plaintiff has the burden of proof and is required to prove their right to compensation based on the insurance policy and submitted claim. Insurance companies will often use the courts to determine which company is responsible for providing coverage when more than one insurer is involved.

An insurance exclusion specifies which events your policy won't cover, essentially narrowing the scope of coverage. These exclusions help insurers avoid risks they find too high or unpredictable. Sometimes, your policy only lists the perils it covers, meaning everything else is automatically excluded.

Some common excluded services include: Alternative medicine (e.g., acupressure, yoga, acupuncture, massage, biofeedback) Dental services. Vision care.