Be aware of exclusion clauses in your policy…..

Your life assurance policy protects you in the event of death, disability and dreaded diseases. It is a cost-effective way of making provisions if you do not have the capital to provide for any of these life-changing events. However, T&Cs apply…

Why are exclusion clauses applied?

Exclusion clauses are normally legitimately included in life assurance policies to stop policyholders from making fraudulent claims, such as deliberately shooting themselves in the foot so they can receive a disability benefit. So they protect the financial well-being of the company as it relies on claims paid out to be covered by premiums collected.

Underwriting evaluates risk

Life Assurance Companies consider your lifestyle habits when underwriting your application. They essentially evaluate the risk that they are taking relative to the benefits being applied for. For example, a news correspondent in a war zone poses a much more serious risk to the assurer than a receptionist in a beauty salon..

The assurer will also consider habits such as smoking and drinking in conjunction with your medical history. 

Changes in your life may obligate you

Now, what you need to be aware of is the fine print in some policies which may obligate you to inform the assurer of any changes to your job or lifestyle habits. For example, if you take up sky diving or any other hazardous pursuits you should check with your assurer that you are covered. 

Pre-existing conditions 

Be very aware of policies which do not require any medicals. They probably exclude any pre-existing medical conditions. If you are not aware of this you may think you have cover which is not actually there.

The suicide clause

A common exclusion clause in the assurance industry is for suicide which most companies apply for a period of two years. However, be aware of the definitions in your policy as some exclusions clauses use wider terminology such as ‘self-inflicted injury’ which could have far more reaching interpretations to a claim.

Intentionally breaking the law

Another example is, say, you go out and drink too much, drive home too fast on worn tyres and are seriously injured in an accident. Your life assurance company may repudiate a disability claim on the contravention of an exclusion clause stating you may not intentionally break the law. Drinking and driving is a criminal offence and so is breaking the speed limit as well as driving a vehicle which is not road worthy.

Changing policies needs careful attention 

So be aware of the exclusion clauses imposed upon you in your policy. This also speaks to the importance of comparing the differences in definitions when changing policies. Older policies may have fewer restricting clauses than newer ones. The law leans in favour of the assurer at the end of the day so you need to understand the conditions of your cover as much as you can,

1,760 thoughts on “Be aware of exclusion clauses in your policy…..

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