Exclusions

Definition

• A provision, or a number of provisions, outlined in an insurance policy that allows the insurer to eliminate their liability for insurance coverage in certain specific circumstances. For instance, property insurance companies generally exclude coverage of flood damage on properties built in flood zones, and some health insurance policies exclude coverage for pre-existing conditions.

Synonyms
bar, preclude, proviso, exempt, invalidate, stipulation

Related Terms and Acronyms

• Clean Sheeting — Definition,
  • A type of insurance fraud where an individual deliberately fails to disclose a pre-existing condition in order to receive coverage, sometimes with the help of an insurance broker.
• Flood Insurance — Definition,
  • An insurance policy that provides coverage for the damages resulting from flooding. Canadian homeowners are currently unable to purchase flood insurance.
• Flood Plain (flpl) — Abbreviation,
  • Land that is prone to inundation.
• Insurance Fraud — Definition,
  • An illegal attempt by an individual or entity to receive insurance benefits that they would otherwise not be entitled to or for an insurance company to deny a legitimate insurance claim.
• Insurance Policy — Definition,
  • A legal contract between an insurer and entity that specifies what the insurer is required to cover and any benefits the insured entity is entitled to.
• Least Expensive Alternative Treatment (LEAT) — Acronym,
  • When multiple treatment options exist for the same illness, insurers are only obligated to provide the most cost effective treatment.
• Policy Declarations — Definition,
  • The section of the insurance policy that declares the specifics of the insurance policy including premiums, named perils, and policy limits, amongst others.
• Pre-existing Condition (PRE-X) — Acronym,
  • A medical condition that's occurrence precedes the writing of an insurance policy.
• Stop Loss Insurance — Definition,
  • A low premium, high deductible insurance policy with an upper limit on coverage.
• Water Exclusion Clause — Definition,
  • A provision that gives an insurer the option to deny coverage for certain kinds of water damage.