What is referred to as a service, item, or event not covered by an insurance policy?

The term that describes a service, item, or event that is not covered by an insurance policy is known as an exclusion. Exclusions are specific conditions or circumstances for which the insurance policy does not provide coverage. This can include various types of events or treatments that the insurer has deemed not eligible for benefits under the terms of the policy.

For example, many health insurance policies may exclude certain elective procedures or treatments for pre-existing conditions. Understanding exclusions is crucial when choosing an insurance policy, as it clarifies what is and isn’t covered, helping policyholders to make informed decisions about their insurance needs.

In contrast, co-payments are fixed amounts that a policyholder pays at the time of medical service, deductibles refer to the amount that must be paid out of pocket before the insurance company starts to pay its share, and coinsurance is the percentage of costs of a covered healthcare service that the insured must pay after the deductible has been met. Each of these terms addresses different aspects of insurance coverage and costs, but none describe the concept of items or services that the policy specifically does not cover, which is the essence of an exclusion.