/ INSURANCE NEWS / THE INSURED MUST BE ABLE TO UNDERSTAND FROM THE FIRST READING IN WHICH CASES IT WILL NOT BE INSURED

THE INSURED MUST BE ABLE TO UNDERSTAND FROM THE FIRST READING IN WHICH CASES IT WILL NOT BE INSURED

For example, the insurance contract does not contain a definition of the term “computer configuration” or provides that the service is not guaranteed if it is not performed “in the rules of the art” without further clarification.

This means that the insured is left in uncertainty and in complete ignorance of this so-called exclusion. The exclusion is therefore not valid. Legally speaking, it is unenforceable against the insured, i.e. unenforceable. The insurer will therefore have to settle the claim without being able to invoke this clause. The limited formality implies that an exclusion clause must be understood by the insured from the first reading. That is, the insured must know, carefully reading the insurance policy, in what cases and circumstances he is not guaranteed.

When a clause is not formal and limited, within the meaning of article L. 113-1 of the insurance code, the penalty incurred is the nullity (inapplicability) of the clause, thus obliging the insurer to guarantee the insured in case of loss.

The constant jurisprudence invalidates clauses that are too vague and too “spacious” that empty the insurance guarantee of all its substance or clauses that are ambiguous and lack clarity that leave the insured in ignorance and misunderstanding of what is precisely excluded from the insurance guarantee.

Specifically, exclusion clauses are thus prohibited when they refer to imprecise criteria and assumptions not limited to enumerated. Consistent jurisprudence penalizes overly vague clauses that would require interpretation, which would prevent the insured from knowing the exact extent of his coverage.