The exclusions list is the least popular section of any policy terms – yet it's the most honest one: it states exactly where the cover ends. Anyone who gives it five minutes before signing won't be caught out at claim time. This map was built for exactly those five minutes.
- Exclusions fall into three families: conduct-based (intoxication, intent – in legal form these are typically grounds for exemption), activity-based (excluded sports, occupations) and origin-based (illness, gradual processes).
- The lists vary by product – your own policy terms always govern.
- Some excluded activities can be brought back in with an add-on – an exclusion isn't always final.
Conduct-based exclusions
The classic group: a deliberately caused accident, an event that happened while severely intoxicated or under the influence, driving without a licence, an injury sustained while committing a crime. Simple logic sits behind these: insurance takes on unexpected risk, not a knowingly committed breach of the rules. The exact wording (for example, the degree of intoxication) varies by product – in a disputed situation, these are the sentences that do the work. In legal form these are typically grounds for exemption: the insured event does occur, but the insurer is released only if it proves the ground set out in the policy terms.
Activity-based exclusions
The list of sports and activities classed as high-risk: motorsport, diving, mountaineering, air sports and the like – the scope varies by product. The most important thing to know here is a positive one: an activity on the list can often be brought in with an add-on or extra premium – the exclusion applies by default, but it's negotiable. The same is true for certain occupations: occupational risk classification settles this, for an extra premium.
Origin-based boundaries
Not a classic exclusion, but it has the same effect: personal accident insurance only pays for accident-related events. Illness, wear and tear, gradual processes – and typically events that arise from these – fall outside the cover: the article on the dividing line covers this in detail. This also includes special risks: acts of war, radioactive radiation – the standard scope found in every insurance policy.
How should you read the list?
Not alphabetically, but personally: look for the activities that feature in your family's life. Does someone ride a motorbike? Dive? Work at height? Does your child compete? Whatever appears on the list AND in your life is something to act on before signing: declare it, ask for an add-on, or choose a product where it isn't excluded. The sports-risk self-check and the needs assessment do exactly this filtering for you.
And what this looks like at claim time
A significant share of declined claims are exclusion cases: an excluded activity, an undeclared risk, intoxication. All of these are preventable – with honest disclosure when you sign up, and reporting any change afterwards. The full picture is in the article on declined claims – deliberately honest, because that's what trust rests on.
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