What do you mean that you might refuse my home claim due to the operation of a condition or exclusion clause?

Insurance contracts often contain conditions and exclusion clauses.  The Insurance Company may refuse your claim if you have failed to comply with a condition. However, we cannot refuse to pay a claim because of some act or omission by you unless our interests have been prejudiced. For example, if you have failed to have keyed locks on all windows and a thief enters your premises by smashing a window, or knocking down the front door, you may be able to argue that your failure to install or maintain the window locks has not prejudiced us because it did not contribute to the loss or damage suffered as a result of the break in.

 

To rely on an exclusion clause the insurer has to prove on the balance of probabilities that the exclusion clause applies. In some cases we may also have an obligation to bring the exclusion clearly to your attention, although this does not need to be done in person. It would usually be sufficient to include this information in the documentation sent to you when you took out the policy.

Tags: condition, exclusion

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