Ordinance or Law:
Means losses from legal stuff relating to construction, repair, or any tearing down or debris removal.
Earth Movement:
Refers to damages/losses from things like landslides, mudslides, sinkholes, earthquakes (there’s a separate policy for this if you want), and any other earth movement including earth sinking, rising or shifting.
Water:
We’re talking flooding from the outside-in: natural stuff like groundwater, tidal water, tsunamis, etc. as well as flooding caused by sewer blockages or broken sump pumps.
Caveat? For the natural stuff, you have flood insurance. Look into it when you’re getting a policy.
Power Failure:
This one’s pretty specific… if a power failure causes loss to stuff that isn’t on your property (even if it was a result of a named peril), it’s not covered.
Neglect and Intentional Loss:
Like most things that aren’t covered in your insurance policy, neglect and intentional loss fall under the category of stuff you can prevent. Once a loss happens, if you don’t do everything in your power to make things right, then it’ll be considered neglect – if you did it on purpose, it’s intentional loss.
War and Nuclear Hazard:
Quite simply, losses from war and nuclear hazard are excluded from your coverage.
Governmental Action:
This exclusion deals with good ‘ole Uncle Sam… if for some reason the government decides to do something that causes a loss, it’ll be excluded from your insurance coverage, unless the governmental action happened because of a named peril.
Note: in terms of personal liability, most of the exclusions have to do with vehicles and other things with engines if you’re the one in control/driving.
FAQs
An exclusion is a provision within an insurance policy that eliminates coverage for certain acts, property, types of damage or locations. Things that are excluded are not covered by the plan, and excluded costs don't count towards the plan's total out-of-pocket maximum.
What is the exclusion clause in an insurance policy? ›
Similarly, exclusions are a type of clause that dictate what is not covered by the contract. For example, the policyholder's spouse will not be covered if the policy buyer opts for an individual life insurance contract. The non-coverage of a spouse comes under insurance exclusions.
What is a common exclusion to property insurance coverage? ›
Earthquakes, landslides and sinkholes generally aren't covered under home insurance. Exceptions include Florida and Tennessee, where insurers must offer optional sinkhole protection. Aside from that, you'll need separate coverage for these disasters, which your insurer can help you find.
What is the exclusion of insurance risk? ›
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.
Why is exclusion important in insurance? ›
Exclusions are things not covered by an insurance policy, like perils, types of property, or actions by the insured. Insurers use exclusions to manage their risk and keep premiums affordable.
Who has the burden of proof for insurance exclusions? ›
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.
What is an exclusion clause in simple words? ›
Abstract. An exclusion clause may be defined as a 'clause in a contract or a term in a notice which appears to exclude or restrict a liability or a legal duty which would otherwise arise' (Yates, 1982, p. 1). Exclusion clauses are a common feature of contracts today and may take a number of different forms.
What is the difference between exclusion and exception in insurance? ›
Exclusions are specific situations or circ*mstances which are not covered by a particular policy, while exceptions are specific situations which are covered by a policy, even if they would normally be excluded.
What are the terms and conditions of exclusion clause? ›
An "exclusion of liability" clause does just what it sounds like: it excludes all of your liability for certain events or consequences. It anticipates that there will be a breach of contract, and then excludes all liability for that breach. These clauses are often very hard to read, and very dense.
What are the major exclusions in a typical homeowners policy? ›
Common exclusions in even the most comprehensive homeowners policies include: earth movement, such as earthquakes; sinkholes or landslides that damage your home; water damage, such as floods or sewer back-ups that leak through a pipe or seep through the foundation causing damage to your home; damage resulting from ...
Termites and insect damage, bird or rodent damage, rust, rot, mold, and general wear and tear are not covered. Damage caused by smog or smoke from industrial or agricultural operations is also not covered. If something is poorly made or has a hidden defect, this is generally excluded and won't be covered.
Where are exclusions found in an insurance policy? ›
While most exclusions can be found after the main coverage sections in your policy (named perils, personal property, personal liability, additional coverage, and medical payments to others), you'll also notice exclusions in the definitions, conditions, and endorsem*nts sections.
How long can an insurer exclude? ›
The time period during which a health plan won't pay for care relating to a pre-existing condition. Under a job-based plan, this cannot exceed 12 months for a regular enrollee or 18 months for a late-enrollee.
What does it mean when exclusions apply? ›
The department store that advertises a big sale often states at the bottom of the ad that "some exclusions apply," meaning the discounts don't apply to all items.
How to avoid pre-existing condition exclusion? ›
If your health plan is fully compliant with the ACA and obtained in either the individual/family market or the employer-sponsored market, you no longer need to worry about pre-existing condition exclusion periods.
