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Exclusions and Insurance Bad Faith Claims

An “exclusion” is a provision in an insurance policy that specifically excludes a certain type of loss from coverage.

In the case of exclusions, the insurance company has the burden to show that an exclusion applies and that they wrote the exclusion into the policy in a manner that is reasonable and that their interpretation of the exclusion is reasonable. Basically, they need to interpret the policy in a way and that would be the interpretation the insured would also have – it can’t be ambiguous.

What we see a lot is where the insurer is asserting a new exclusion that has never been interpreted, and they are interpreting it in a skewed manner in order to assert it in a factual scenario that doesn’t really apply.