Phillip Morris | Claims Journal
Question: “Can you define the word ‘is’ in a homeowners policy? Do you think the meaning can change based on how it’s used in the policy?”
—Artie Allen, owner of The Allen Agency (Mount Pleasant, South Carolina)
Answer: In a homeowners policy, the word “is” generally functions as a linking verb that connects the subject with a state of being or condition. It helps define or describe what something entails within the policy. For example, “The insured property is covered against fire damage” means that the coverage extends to fire damage specifically.
The meaning of “is” itself doesn’t change, but the context in which it is used can affect the interpretation of the clause or provision. In both legal and insurance documents, precision in wording is critical, so even small words like “is” play a significant role in conveying the exact terms and conditions of the policy.
For example:
“The roof is covered under the policy.”
What this means is that if something bad happens to the roof, such as storm damage, the insurer will help pay for the repairs.
Another example could be:
“Flood damage is not included in this policy.”
A good explanation of “is” within this phrase is that if a house gets damaged by a flood, the insurance won’t help pay for the repairs. The policyholder would need a different kind of insurance for floods.
In both examples, the word “is” helps explain what the insurance will or won’t pay for if something happens to a home.
In simpler terms the word “is” can also describe important details about a policy, like costs, coverage and conditions.
Understanding the role of the word “is” in an insurance policy is crucial for claims professionals as it aids in interpreting the precise terms and conditions outlined in the document.
By paying close attention to how “is” connects subjects to their states or conditions, claims professionals can accurately determine the coverage scope, exclusions and the responsibilities of the policyholder and the insurer. This clarity helps in making fair and consistent decisions when assessing claims, ensuring that the policyholder receives the appropriate benefits without any misunderstanding or misinterpretation of the policy language.
Additionally, whether you are a green insurance newbie or a savvy insurance veteran, having a clear grasp of these subtle linguistic nuances can improve communication with policyholders—ultimately setting the stage for a better policy and/or claim experience.
These nuances aid in explaining the policy details or the reasons behind a claim decision. Being able to point to specific clauses and their interpretations can build trust and transparency and this approach not only helps in resolving disputes more effectively but also enhances the overall customer experience.
By focusing on the precise use of terms like “is,” claims professionals can ensure they are upholding the policy’s intent and providing accurate, reliable service to policyholders. And following this advice, claims professionals can enhance their ability to interpret policies accurately, communicate effectively with policyholders, and make fair and consistent claim decisions, which, in turn, improves customer satisfaction and upholds the integrity of the insurance process.
When one of your cases is in need of a construction expert, estimates, insurance appraisal or umpire services in defect or insurance disputes – please call Advise & Consult, Inc. at 888.684.8305, or email experts@adviseandconsult.net.