Making Sense of Insurance: Understanding Terms and Conditions

Hoffman Hanono
February 6, 2024

We pledged to do things differently when we founded our agency in 1959. This meant ensuring our customers felt heard, seen, and understood. It also meant providing a transparent experience—ensuring our customers understand the ins and outs of their policies before they ever need to use them.

This commitment is a part of our daily practice, but we also want to help you better understand the terms and conditions of your policy so you’re fully prepared in the event of a loss.

While every policy is unique, each shares a common framework and contains the following.

The Declaration Page

This is the grand opening of your policy. The declaration page identifies who is insured, what’s covered, the policy limits, and the policy duration (when it begins and ends).

If you have vehicle coverage the declaration page lists your vehicle make, model, and VIN, the policyholder's name, the premium amount, and the deductible.

The Insuring Agreement

This page includes information about what is covered under your policy and a summary of our promises. These include the various losses we cover and how we will defend you in the event of a lawsuit.

The insuring agreement typically outlines the following:

Named-Perils Coverage: This type of insurance policy covers only specific problems listed in the policy. This may include fire, theft, and vandalism. If the loss protection isn’t listed, the policy does not cover it.

All-Risk Coverage: This insurance policy covers all types of losses—except those expressly excluded in the policy. In other words, if a loss isn't explicitly excluded in the insuring agreement, expect it to be covered.

Exclusions

Exclusions are specific items that your policy doesn’t cover. These may include:

Excluded Perils or Causes of Loss: The causes of damage or loss and the reasons they are not covered in your policy. Say, for example, that you have a homeowners insurance policy. While your policy may cover theft and vandalism, it may exclude perils and causes of loss, like floods, earthquakes, or nuclear radiation.

Excluded Losses: The types of damage or loss the policy does not cover. In the case of auto insurance, for example, your coverage may protect you in the event of an accident. However, it will exclude losses like general wear and tear that happens over time.

Excluded Property: Specific items your policy may not cover. For example, a homeowner’s policy would not extend coverage to your vehicles, pets, or high-value items like jewelry.

Conditions

You must follow these “rules” to receive coverage or compensation from your policyholder. Otherwise, your insurance company has the right to refuse your insurance claim. Typical conditions found in your policy may include:

Proof of Loss: a formal statement detailing the property damage or items lost. The proof of loss statement typically must be filed within a specific timeframe.

Protection Plan Following the Loss: If you incur a loss, you must also take reasonable steps to prevent further loss. If, for example, a window breaks during a storm, your insurance company will expect you to avoid further damage inside your home by covering your window.

Cooperation: If someone files a lawsuit against you or the insurance company needs to investigate a claim, you must cooperate by providing additional information or allowing inspections.

Definitions

Policies typically include a definitions section outlining key terms used throughout the policy. These definitions offer clear explanations of words and phrases commonly used by our industry. We include these definitions to ensure clarity and consistency and avoid misunderstandings.

Endorsements & Riders

Your insurance provider may change some of the language or policy coverage at the time of renewal. Insurance companies must notify you and send a copy of these changes.

Need Help Understanding Your Insurance Policy?

Whether you need help understanding your current insurance policy or seek better coverage, we can help! Reach out today. We’re here to help!