The worst kind of insurance dispute is the one that could have been avoided – with a careful quarter of an hour before signing. Exclusions and waiting periods are public, knowable rules: here's the overview, no beating around the bush, so that when you request quotes you know exactly what's worth comparing.
- A waiting period limits the benefit during the period right after signing – typically for events that aren't accident-related.
- Exclusions are situations listed item by item in the policy terms – they vary between insurers, which is why they should be compared.
- Release from the obligation to pay is a different matter: it's tied to a breach of the duty of disclosure – and it's preventable.
Waiting period: what is it for, and how long does it last?
The waiting period protects the insurer against policies taken out abusively, for a "problem that's already known": during the period fixed in the policy terms right after signing, the benefit may be limited or excluded – typically for illness-related events; cover for accident-related events typically applies from day one. Its length and scope vary by product – we compare them item by item in the quote comparison table. Suicide is treated separately in the policy terms: the benefit typically doesn't extend to it within a period set by law and by the policy terms, counted from the start of the policy – this is stated factually in the terms.
Exclusions: the typical categories
- Events linked to war or acts of terrorism – with detailed rules that vary by product.
- Certain hazardous activities and extreme sports – unless specifically included by individual agreement: sport and occupation.
- Events caused while severely intoxicated or under the influence, or while driving without a valid license, typically appear in the policy terms not as exclusions but as grounds for exemption – it is the insurer that must prove the conduct and its causal link with the event.
- In some products, events linked to conditions that already existed before signing – this is where exclusions overlap with the world of the duty of disclosure.
Grounds for exemption: the third category
Grounds for exemption are not an extension of the exclusion list, but a separate legal category. The dividing lines: Exclusion – a situation listed in advance in the policy terms and carved out of the cover. Breach of the duty of disclosure – the insurer's obligation to pay does not arise, unless the policyholder proves that the insurer already knew of the circumstance, or that it did not contribute to the event (for life insurance, the insurer may exercise this right within the first five years of the policy). – Grounds for exemption: these apply where the insured event was caused intentionally or through gross negligence, or in the life-insurance-specific cases set out by law (intentional conduct by the beneficiary, suicide within two years). This category is entirely preventable: with an accurate declaration. Telling these three concepts apart is the basis of reading policy terms: a quick primer.
How do we handle this when comparing offers?
In the quote comparison table, the length and scope of waiting periods, along with differences in the exclusion lists, get their own row – because this is often where the explanation for premium differences lies. A cheaper quote with narrower cover isn't necessarily cheaper. It's worth going through this before you sign – feel free to ask: book a consultation.
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