According to the Health Insurance Glossary, an exclusion is a provision within a health insurance policy that eliminates coverage for certain acts, property, types of damage or locations. In the past, individual health insurance policies frequently contained exclusions for pre-existing medical conditions. Insurers add exclusions to policies in order to avoid covering severely high-risk claims.
You can usually locate any exclusions incorporated into your policy under a section titled “exclusions.” These exclusions may be included for a number of reasons. Just a few of these include:
Insurers are often unwilling to cover catastrophes that affect a large number of people. War would be an example of this.
Some things are excluded from certain policies because they are covered
elsewhere. For example, liability insurance does not cover auto liability because
it is included in commercial auto insurance.
Insurance policies cover events that are out of the policy holder’s control.
Therefore, losses intentionally inflicted by the holder are excluded. This would
include bodily harm inflicted by the holder on other individual.
Many policies exclude harm that could have been easily avoided by the policy holder. For example, if the holder forgets to park his car in the garage and subsequently suffers damage from sleet or snow, the insurance company will not cover the harm inflicted.
Most insurance companies will not cover loss that results from engagement in
Regardless of why your policy has exclusions, it’s important to know what those exclusions are. Take time today to read through your policy or contact an agent for assistance.