4. What are the usual "exclusion clauses" (insurance coverage or claims to be excluded) in an insurance policy?

There are usually some "exclusion" clauses in an insurance policy under which the insurance company would not be liable for the losses resulting from the specified events.

The exclusion clauses remove the insurance coverage for the specified events that the insurance company chooses not to insure. The relevant reasons might be: such coverage is available under another class of insurance, the risks are not suitable to be taken up, or some special conditions are required, etc.

There are different types of exclusions for different types of insurance. An exclusion clause may apply generally in respect of the whole insurance policy, or may only apply to specific sections of the policy. In certain circumstances, an exclusion clause may be limited or removed by paying an additional premium.

The following are some examples of exclusions in respect of certain types of insurance.

Life insurance : the insured person commits suicide within the first two years after the policy is issued of; certain activities considered to be dangerous such as flying other than with a regular scheduled airline, hang-gliding, motor-car racing , s cuba- diving or skydiving ; and war exclusions.

Medical and hospitalization insurance : self-inflicted injury or suicide; pregnancy and childbirth; existing illness or disease prior to the insurance being effected; AIDS or AIDS Related Complex; intoxication by alcohol, narcotics or drugs not prescribed by a registered medical practitioner; and injury, sickness or accident sustained or medical treatment received outside of Hong Kong.

Property insurance : war; acts of terrorism; flooding; pressure waves caused by aircraft or other aerial devices travelling at super-sonic speeds; radiation from nuclear fuel or combustion of nuclear fuel; asbestos and pollution or contamination; and fines, penalty, punitive or exemplary expense.

Motor vehicle insurance : modified vehicle; where reasonable care was not taken to protect the vehicle; operation of the vehicle not within the law; use of the vehicle other than for the declared or specified purpose; driving while under the influence of alcohol, narcotics or illegal drugs; unlicensed driver; excess load; unlawful purpose; and unsafe condition of the vehicle.

(Note: The above items are examples only. You should carefully check all the actual exclusion clauses written on your particular insurance policies.)

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