Conditions

Glossary

When it comes to insurance, conditions is a term used by insurance companies and their lawyers to describe the circumstances under which a specific activity or event will happen. A condition is a specific circumstances that dictates an allowable area surrounding a claim or part of a claim. Conversely, a condition may also specifically relate to when a claim or policy has left the bounds of acceptable circumstance, and therefore the claim will not be honored or the policy may become void.

Conditions Examples

One example of a significant condition is in health insurance terminology, as it relates to the term “pre-existing condition”. This always relates to an illness or diseases that predates the insurance contract between the insurance company and the insured. There are specific times, instances, or conditions, where pre-existing conditions will be covered by an insurance policy - usually after a waiting period of some sort, and there are times, instances or conditions where pre-existing conditions will not be covered by a health insurance policy no matter what the circumstances. Under those conditions, the insurance company may choose either to deny the policy outright, or investigate carefully any claims that are made by the insured to be sure that the pre-existing condition was not responsible for the circumstances surrounding the claim.

Another example where conditions may be used is in a homeowners or renters insurance policy. Usually these policies will cover flood or water damage only in the eventuality that the water damage is caused by a damaged pipe, or appliance that leaked the water. floods caused by overflowing rivers or storms of any kind are not covered. This is a condition of the policy that will be evaluated thoroughly any time a claim for water damage or destruction is reported to the insurance company.

Yet another condition prevalent in many life insurance policies is the conditional exception for suicide, which will usually negate any payment of benefit to the beneficiaries. Though recently challenged in many cases, usually life insurance policies will include a condition that in the eventuality that the insured takes their own life through certain behaviors, the insurance company will not provide coverage or protection or make payment after a claim. Suicide is one condition that nullifies the life insurance policy.

The various conditions present in all insurance policies can be very specific and exacting, you will want to check carefully the conditions in any policy before you sign it, specifically those that deal with the circumstances under which any policy claim may not receive payment from the insurance company. If you have any questions about a condition on your insurance policy, do not hesitate to ask your insurance agent or representative, or ask to show the policy to your attorney before agreeing to sign.