InsuranceFinancial Glossary
Exclusion
Definition
A condition, treatment, or expense specifically listed in an insurance policy as not covered. Common health insurance exclusions include cosmetic surgery, dental treatments (unless due to accident), self-inflicted injuries, war-related injuries, and treatments within the initial waiting period.
Why It Matters
Exclusions are where claims get denied. Every health insurance policy has a detailed exclusion list in the policy wording. Not reading this list is the most common cause of claim disappointment. Pay special attention to permanent exclusions (never covered) versus temporary exclusions (covered after a waiting period).