Who Decides What Confusing Or Vaguely Written Insurance Policies Mean?
Insurance companies make a profit by denying claims or delaying claim payments - the more claims they reject for the more reasons, the more money they make. One way that some insurance companies deny valid claims is by writing confusing, badly worded, or vaguely written insurance policies. When you then file a claim after agreeing to the policy, they may point to a confusing or vague clause in the contract and deny payment. These policies could have any number of confusing, misleading, vague, or even absurd statements - and in many cases, the judge will rule in your favor.
If you then file a lawsuit involving the wording of your insurance policy, your judge will follow the "rules of construction" in interpreting the document - these rules are the agreed-upon conventions of reading these types of contracts.
In the case of a vaguely worded policy, judges have a history of siding with the victim and against the insurance company - the insurance company will have to pay the claim. In other cases, in which the issue involves excluding coverage, the judge will also likely ask the insurance company to pay. In all instances, the judge will allow for very little outside interpretation or added meaning on this issue.
The most important thing that you can do to protect yourself from these issues is to read your insurance policy very carefully before agreeing to it, no matter how long or intimidating it is. Look for vague words or overly complex phrases - if you find the document to be too hard for you to easily understand, you may want to review it with a lawyer. If you think your claim has been denied due to obscure or ambiguous wording, contact a specialized lawyer. Your insurance company could be acting in bad faith, and your legitimate claim could be wrongfully denied.