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Is there a trick to understanding an insurance policy? p3

Mon Jan 19th, 2015 on     Insurance Law,    

Anyone who has tried to put something together — a bookcase, a model airplane, a tool shed — knows the special frustration that comes from bad technical writing. Sometimes, the problem is a sloppy translation from the original language: “Helping is on the Internet website.” (True story.)

Our favorite is the one that tells you to use the Super Glue (included) to attach the tiny choking-hazard pieces of the model of the Battle of Agincourt to other tiny pieces, which you do at considerable cost to your eyesight, only to see the first words of the next step. “But first,” it reads, and only dogs can hear your screams.

This is a fair analogy for reading an insurance policy. First, the insurance company tells you what it will do for you in the insuring agreement. You are relieved, but the feeling fades quickly with the next step: The part where the insurance company explains what it will not do.

Review the list of exclusions. Exclusions are the perils, losses and property that the insurance company does not, with this particular policy, cover. In Florida, this is where you learn that your homeowners policy does not cover floods or sinkholes. In an auto policy, an exclusion could be normal wear and tear. Your car rusts out? Don’t come whining to us.

The insurance company is just making it clear that when it says it will cover damage resulting from an Act of God, it is not talking about a sinkhole or an earthquake. If nothing else, this is the part of the policy where you learn what other kind of coverage you need.

Turn to the exceptions. It is entirely possible for an exclusion to have an exception. The exception restores coverage.

For example, a commercial general liability policy covers injuries suffered by visitors — slips and falls, etc. The policy will not cover injuries, however, if they were related to a discharge of pollutants. You are doused with radioactive waste on the company’s property; the policy will not cover it.

The pollution exclusion, however, includes an exception. If the discharge of pollutants were “sudden and accidental,” the coverage is not excluded — that is, your injuries are covered under those specific circumstances.

This can be confusing, but when you look at your policy it will make more sense. 

We have just a few more steps to review, and we will try to take care of those all in our next post.

Sources:

Insurance Journal, “How to Read Any Insurance Policy: 12 Rules,” Christopher J. Boggs, Jan. 5, 2015

Schilberg Integrated Metals Corp. v. Cont’l Cas. Co., 263 Conn. 245, 819 A.2d 773, 778 (2003), via WestlawNext

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