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Exclusions

In insurance, exclusions are specific conditions, situations, or types of damage or loss that are not covered by the insurance policy. They're essentially the fine print that outlines what the insurer won’t pay for.

 

Why exclusions exist:

  • To limit risk exposure for the insurer.
  • To avoid duplicate coverage (e.g., things better covered under a different type of policy).
  • To encourage responsible behavior from the policyholder (e.g., no coverage for intentional acts).

Common Types of Exclusions (depending on the product):

 

1. Health Insurance

  • Pre-existing conditions (though this is changing in some countries)
  • Cosmetic surgery (unless medically necessary)
  • Injuries from self-harm or risky behavior
  • Experimental treatments

2. Life Insurance

  • Death due to suicide (within the first 1–2 years of the policy)
  • Death due to risky activities (e.g., skydiving, unless covered with a rider)
  • War or acts of terrorism

3. Auto Insurance

  • Damage when driving under the influence (DUI)
  • Racing or illegal activities
  • Wear and tear or mechanical breakdown
  • Using the vehicle for commercial purposes (unless disclosed)

4. Home Insurance

  • Floods or earthquakes (often need separate policies)
  • Mold, termites, or poor maintenance
  • Intentional damage by the homeowner
  • Business use of the property

Important Tip:

Always read the policy wording or Product Disclosure Statement (PDS) carefully. The exclusions are usually listed clearly, and understanding them can prevent nasty surprises at claim time.