Insurance policies cover risks of loss arising from daily life


War Exclusions

Insurance policies are intended to cover risks of loss arising from the normal incidents of life. The nuclear war, civil war, insurrection, rebellion, or revolution exclusions have long been held to be essentially uninsurable.

Governmental Coverage Exclusion

This exclusion appears in the ISO personal auto policy sold in some, but not all, states. This exclusion precludes automobile medical payments coverage for bodily injury to an insured who normally receives services or benefits for bodily injury from any agency, hospital, or other facility operated by any military or government. There is an exception if the person is legally required to pay for such services.

An exclusion of this nature has some pretty obvious purposes. The most apparent one is that of avoiding a double recovery by an insured who is entitled to free medical care as part of the conditions of his or her employment.

A second, less obvious, purpose relates back to the reasonable expenses term used in the auto medical payments insuring agreement. Aside from what may or may not constitute reasonable expenses from the standpoint of a health maintenance organization or a managed care plan, what may or may not be a reasonable expense incurred in a military or governmental hospital or healthcare facility may be so afflicted with proof problems that determining whether the cost, care, or services provided are reasonable can be impossible.

Finally, when services are provided to an insured by a government entity as part of that individual's employment, it is simply improper for other policyholders of that insurer to foot the bill through their insurance premiums when they are already footing the bill for those medical services as taxpayers.

Racing Competition Exclusion

The ISO personal auto policy auto medical payments coverage excludes bodily injury losses while an insured is occupying any vehicle located in a facility designed for racing.

This exclusion, when read fairly, is pretty limited. It applies only to bodily injury incurred within facilities designed for racing. It should come as a surprise to no one that racing and practicing for competition, would be excluded from coverage under an ordinary personal automobile policy. What needs to be understood, however, is that auto medical payments coverage terminates for anyone occupying the vehicle while it is located within a facility designed for racing.

An insured drives into the facility in a covered personal vehicle towing the trailer holding the racing vehicle and collides with another similar vehicle. An insured occupying the insured's personal vehicle injured in that collision would not be entitled to auto medical expense coverage. That does not mean, however, that the policy's auto liability coverage would not apply.

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Note: This article was sent to us by: Walt Bielfield at 10072010

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