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Richard A Fogel, P.C
389 Cedar Ave. Islip, NY 516.721.7161

The Role of Policy Exclusions in New York Insurance Coverage Cases

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Insurance policies are lengthy and complex. Even attorneys who regularly draft and review contracts and other legal documents are often astounded at the depth of intricate legalese to be found in even a basic liability insurance policy. One of the trickier and yet most important provisions to understand deals with policy exclusions. Exclusions play a critical role in determining the extent of coverage provided by an insurance policy. Learn more below about the role of policy exclusions in NY insurance coverage cases. For help with insurance coverage litigation related to toxic torts, environmental law, or other coverage issues, contact the Law Offices of Richard A. Fogel, P.C., to speak with a knowledgeable and experienced New York insurance coverage litigation lawyer.

What Are Policy Exclusions?

Policy exclusions are specific conditions or circumstances that are not covered by an insurance policy. Exclusions limit the insurer’s liability and help define the scope of the coverage provided. They are explicitly stated in the policy document and can significantly impact the outcome of insurance claims.

Exclusions can be broadly categorized into three types:

  1. General Exclusions: Apply to all types of coverage within the policy.
  2. Specific Exclusions: Relate to particular coverages or situations.
  3. Conditional Exclusions: Apply only under certain conditions or circumstances.

Common Types of Policy Exclusions in New York

Several common exclusions frequently appear in New York insurance policies. Understanding these can help policyholders recognize potential coverage gaps and avoid unexpected denials of claims.

1. Intentional Acts

Insurance policies typically exclude coverage for losses resulting from intentional acts committed by the insured. This exclusion is based on the principle that insurance is meant to cover unforeseen and accidental events, not deliberate actions.

2. Environmental and Pollution Exclusions

In New York, environmental and pollution exclusions are particularly relevant in environmental law and toxic tort cases. These exclusions limit coverage for damages arising from the release or escape of contaminants or pollutants. However, there can be exceptions, such as sudden and accidental pollution events, which may still be covered.

3. Lead Paint, Asbestos and Mold

Most homeowners, landlord, and commercial liability policies expressly exclude coverage for claims arising out of lead paint, mold or asbestos. That means building owners, landlords and homeowners are on their own if they get sued for claimed injury arising out of these common conditions in buildings built before 1970.

4. Wear and Tear

Property insurance policies generally exclude losses due to wear and tear, deterioration, or lack of maintenance. This exclusion underscores the importance of regular upkeep and preventive measures to avoid potential coverage disputes.

5. Contractual Liability

Exclusions for contractual liability prevent coverage for obligations assumed under a contract, except where the insured would have had liability absent the contract. This ensures that insurers are not covering risks that were voluntarily assumed by the policyholder beyond the policy’s intent.

Navigating Policy Exclusions in New York Insurance Coverage Cases

When facing a claim denial based on a policy exclusion, it is crucial for policyholders to understand their rights and the legal framework governing these exclusions in New York. New York courts generally interpret policy exclusions narrowly, resolving any ambiguity in favor of the insured. However, this does not mean that all exclusions are easily challenged. Clear and unambiguous exclusions are typically upheld, making it vital to thoroughly review and understand policy terms.

Additionally, New York case law is rich with precedents on policy exclusions, providing valuable insights into how courts interpret and enforce these provisions. Staying informed about relevant case law can help anticipate potential challenges and strengthen your position in a coverage dispute.

Navigating the complexities of insurance coverage and exclusions can be challenging without professional assistance. Engaging an experienced insurance coverage litigator is essential to effectively challenge a denial based on exclusions. A skilled attorney can analyze the policy language, investigate the facts of the case, and advocate on your behalf.

Contact The Law Offices Of Richard A. Fogel, P.C., for Help With Insurance Coverage Disputes in New York

Policy exclusions are a fundamental aspect of insurance coverage in New York, shaping the extent and limits of the protection provided. Whether dealing with toxic tort claims or other insurance disputes, understanding these exclusions is crucial for both policyholders and insurers. By comprehensively reviewing policy terms, seeking expert legal counsel, and staying informed about relevant case law, parties can navigate the complexities of insurance coverage with greater confidence and clarity.

For more information or assistance with insurance coverage disputes in New York, call the Law Offices of Richard A. Fogel, P.C. at 516-721-7161. Our firm is dedicated to providing effective legal representation and ensuring your rights are protected.

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