Always Check the Definitions Page
September 2, 2008
In each insurance policy you will find words that somehow stand out from other words in the policy. Those words might be in bold or italic type or even in "quotations". When you see such words, look for a "Definitions" portion of the policy. Those words should be defined in that section although sometimes that section is missing as it is in a $555,000 claim that is on my desk. However, assuming that the Definitions section is there, you will see simple words there like "you" or "we" or "us". Look those words over carefully when you consider what path an insurer will take.
I have seen a number of claims where insurers want to introduce you to a person who makes his or her living sucking up to insurance companies. The insurer will ask you to allow that person on the property to evaluate, scope, review the loss or whatever, only to report back to the insurer things that go a long way towards giving a big smile to the Corporate Titans who control those insurers. Are those persons "we" or "us"? I think not.
Even though words are defined in the policy, it is not uncommon that those words do not go far enough or there are words that are NOT defined. That is why there are other ways to define a word.
Many people do not know that a library of law books exist which are title "Words and Phrases". This multi-volume set of law books were first published in 1940 to list words that courts had to define before a case could go forward. This legal research and reference work usually finds its way to the Oak book cases of attorneys across the fruited plain. They involve the interpretation or meaning attributed to the word in any number of documents including, but not limited to insurance. Such words determine rights, defenses, duties, and obligations but the words don't just come out of a dictionary, they come from court decisions.
I was recently involved in a case in which an insurance company had denied coverage on a claim in which a balcony had fallen down. The claim rested on the definition of the word "decay", luckily defined to our liking in "Words and Phrases". That, and the fact that water is not an exclusion in a collapse claim, netted the insured a quarter of a million dollars. Chalk one up for the "Advocate", yours truly.
What is in a word? You better find out. While you might be thinking "Like, kind and quality", your insurer might be thinking "Comparable Construction".