In Insurance Policies the Insured is Not Legally Covered

In insurance policies, the insured is not legally covered in all situations.

The policyholder's rights are often limited, and the insured may not have the same level of protection as they expect.

The policy's terms and conditions can be complex, and the insured may not be aware of the limitations.

For example, if the policy excludes certain types of damages, the insured may not be covered for those losses.

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In court cases where insurance policy language is ambiguous, the courts have consistently ruled in favor of the insured.

The test is not what the insurer intended its words to mean, but what a reasonable person in the position of the insured would understand them to mean.

Insurance companies cannot rely on their own interpretation of policy language to deny claims, as seen in the Wolf v. American Cas. Co. of Reading, Pa. case.

The courts have decided that ambiguous policy language should be construed most strongly against the insurer and liberally in favor of the insured.

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In the Insurance Co. of Illinois v. Markogiannakis case, the court ruled that the ambiguity would be resolved against the insurer, not what the insurer intended.

Insurance policy language must be clear and concise to avoid ambiguity, as seen in the two court cases mentioned.

The courts' role is to protect the relatively unsophisticated insured against the savvy insurer by looking at insurance policies from the perspective of the average insurance consumer.

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Insurance policies can be notoriously tricky to understand, but the law is on your side. The courts have ruled that ambiguous policy language will be construed most strongly against the insurer and liberally in favor of the insured.

In fact, the court in Wolf v. American Cas. Co. of Reading, Pa. decided that ambiguous provisions will be resolved against the insurer. This means that if you're unsure about a policy term, the court will likely side with you.

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The test for determining ambiguity is not what the insurer intended its words to mean, but what a reasonable person in the position of the insured would understand them to mean. This was established in Insurance Co. of Illinois v. Markogiannakis.

This is a crucial distinction, as it puts the onus on the insurer to write clear and unambiguous policy language. If they fail to do so, you may be able to claim coverage even if they initially denied your claim.

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