When you take out insurance, you need to know exactly how your specific policy works. Otherwise, how can you really be sure you are protected? For instance, do you understand your insurance condition?

Insurance conditions are the conditions you need to meet for your policy to be valid.

Wait! You might ask. Isn’t that what I’m paying them to worry about?

Yes. It is. But at the same time, insurance is a two-way street. You have to meet your insurance company’s expectations when conducting business and filing claims. If you don’t hold up your part of the bargain, they can’t hold up theirs.

In this short guide, we’ll explain insurance conditions so that you’re fully prepared to use your policy when you need it most.

Why do insurance conditions exist?

As we’ve noted, insurance conditions outline the circumstances under which your policy is valid. Stick to these “rules”, and you’re protected.

While this might seem like another hoop to jump through, insurance policy conditions exist so that both the insurer and insuree are on the same page about:

  • Protocol for filing claims
  • Circumstances under which a policy might not pay a claim
  • Occasions when an insurer might cancel or refuse to renew your policy

If you’ve ever had car insurance, you probably know that you can’t file a claim for damage several months after an incident occurs. Likewise, there’s a good chance you already know that if you get a DUI, your insurer may not renew your insurance plan. These are examples of the wide range of insurance conditions.

And just like car insurance, there are policy conditions on your general liability insurance and commercial property insurance too. Insurance conditions don’t just benefit your insurer—they benefit the policyholder by outlining the procedure for filing claims.

Conditions vs. exclusions

Is an insurance condition the same as an exclusion? Not exactly.

  • An exclusion is a specific type of occurrence or claim that is not covered by your policy.
  • A condition is a guideline you must follow in order for you to be covered by your policy.

Say, for example, you get in a car accident with your business vehicle and damage someone’s property. Damage from automobile accidents is usually excluded from general liability insurance. But the fact that you got in an auto accident won’t impact your policy—it’s not breaking a condition. You’ll simply need to file a claim with your auto insurer instead.

Types of insurance conditions

Now, let’s take a look at some common kinds of insurance conditions.

Eligibility

Are you actually eligible for your insurance policy? For instance, here at Thimble, we ask customers to meet the following conditions:

  • Be over 18 and legally eligible to enter into an insurance agreement
  • Provide accurate information
  • Do not transfer the policy to someone else

Pretty simple, right? This gives the insurer the ability to void or otherwise take action with respect to fraudulent policies.

Notice of occurrences

Almost every policy includes conditions stating what to do in the event of a claim.1

General liability insurance usually asks you to notify your insurer as soon as possible if there’s an occurrence that may lead to an insurance claim. If you’ve damaged someone’s property or caused bodily injury, your insurer wants to immediately start assembling documentation so they’re prepared if a client or other third party files a claim against you.

Commercial property insurance If you wait too long to report a claim, or you don’t report it through proper channels, the claim may not be covered. Be sure to read the details when you sign up!

Concealment, misrepresentation, and fraud

Your insurer usually reserves the right to void or reserve the right not to make payment under your policy if you conceal the details around an occurrence that led to a claim.2

Say you’re a craft maker attending a state fair. You knock over the hand-blown glass in the booth next to you at 4 p.m., and the glassblower files a claim against you a few weeks later. You tell your insurer that you desired coverage for the event that lasted from 9 am to 3 p.m. However, during the discovery process, the glassblower shows time-stamped pictures of you packing up your booth right next to their shattered vases.

In a case like this, your insurer could not honor coverage under your policy because you weren’t honest with them.

Other common conditions

Beyond these three kinds of conditions, most insurance contains the following conditions:

  • You will not admit liability to a third party, but rather leave the investigation of the claim in the hands of the insurance company.
  • You won’t take legal action against your insurer unless you’ve fulfilled all conditions.
  • If you have other insurance, your insurer may share responsibility for losses with your other insurance plan.
  • There is no benefit to the bailee. No one else can take over your benefits just because they’ve acquired or are in temporary possession of property that is covered by your policy.

Understand your policy conditions

Insurance conditions aren’t established because your insurer wants to void your policy. In fact, it’s the opposite – they want to be able to properly (and legally) help you in a bind. Remember:

  • Insurance conditions are the insurance terms under which your policy is valid
  • For example, you must be eligible to take out insurance, and provide accurate information to your insurer
  • You should follow your insurer’s instructions when notifying them of claims and occurrences
  • Fraud and deception may void coverage under your policy

As long as you do your homework, your policy will be valid when you need it most.

Making insurance transparent

Are you puzzled by the conditions and exclusions in your current policy? At Thimble, our goal is to make insurance easy to get and easy to understand.

Taking out insurance with us is straightforward and simple. Click on “Get a Quote” or download the Thimble app, enter your ZIP code, desired insurance coverage limits and policy length, and we’ll generate an instant quote outlining your costs and terms. If everything looks good, purchase with a click. You can always make changes right from the Thimble mobile app.

Should you want to learn more about the different types of insurance coverage, we’ve compiled multiple resources for you on our blog.

Sources:

  1. IRMI. Notice of Occurrences.
  2. Investopedia. What is Concealment?

Our editorial content is intended for informational purposes only and is not written by a licensed insurance agent. Terms and conditions for rate and coverage may vary by class of business and state.