Contract trap · Insurance

Buried policy exclusions

An 'all-risks' or «полное КАСКО/имущество» headline is hollowed out by an exclusions list in a separate wording (Policy Booklet / Правила страхования) removing the most common real losses — gradual leaks, rot, mould, wear and tear, faulty workmanship, vermin — and a lead-in sentence excludes any loss to which an excluded peril (flood, earth movement) contributed 'concurrently or in any sequence', even if a covered peril also caused it.

Severity
Serious
How often it turns up
Almost always
Holds up?
Depends where you are
Clause phrases
24

What it looks like in a contract

Redline matches these phrases against your document verbatim. Drafters rarely invent new wording — they copy it, which is why the same sentences turn up across unrelated contracts.

In English-language contracts

  • wear and tear
  • gradual deterioration
  • inherent vice
  • constant or repeated seepage or leakage of water
  • over a period of weeks, months or years
  • faulty workmanship, design or materials
  • mould, fungus, wet or dry rot
  • vermin, insects or rodents
  • subject to the full policy wording
  • regardless of any other cause or event contributing concurrently or in any sequence to the loss
  • directly or indirectly
  • earth movement

In Russian-language contracts

  • не является страховым случаем
  • не подлежат возмещению
  • естественный износ
  • постепенное разрушение
  • коррозия, гниение, плесень
  • длительное воздействие влаги
  • заводские (производственные) дефекты
  • грызуны, насекомые
  • исключения из страхового покрытия
  • Правила страхования являются неотъемлемой частью договора
  • с Правилами страхования ознакомлен и согласен
  • независимо от иных причин

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Why it bites

The sales summary lists what is covered while the exclusions sit 30 pages deeper in a document the buyer never receives; most household water and roof claims are denied as 'gradual' or 'maintenance', the insurer decides which label applies, and ACC wording turns a partly covered hurricane loss into a total denial.

Is it enforceable where you are

The same clause can be routine in one country and void in another. What follows is what the law says where you are — not advice on your particular contract.

In the UK, the Insurance Act 2015 and Consumer Insurance (Disclosure and Representations) Act 2012 restrict what an insurer may avoid; in the EU, the IDD and Directive 93/13 apply, and in the US, insurance is regulated state by state.

United States

Enforceable when clear (ISO HO-3 lists these exclusions); ambiguity is construed against the insurer and most courts enforce ACC wording (Leonard v. Nationwide, 5th Cir. 2007), but California refuses to enforce it against Ins. Code §530 (Howell v. State Farm 1990) and a few states limit it.

  • Cited
  • Howell v. State Farm
  • Leonard v. Nationwide

European Union

Terms defining the insured risk escape the unfairness test of Directive 93/13 (Art 4(2)) only if plain and intelligible — CJEU C-96/14 Van Hove; opaque exclusions struck under national transparency rules (German BGB §307); ACC wording rare.

  • Cited
  • BGB §307
  • C-96/14
  • Directive 93/13
  • Van Hove

United Kingdom

CRA 2015 s.64 exempts core terms only if transparent and prominent; FCA ICOBS 6 and Consumer Duty require clear pre-sale disclosure; FOS regularly overturns 'wear and tear'/'gradual' denials where the insurer cannot evidence a gradual cause; English concurrent-cause rule (Wayne Tank) already lets an excluded concurrent cause defeat cover.

  • Cited
  • CRA 2015 s.64
  • FCA

Russia

Parties may list exclusions if they do not ущемляют права потребителя (ст. 16 ЗоЗПП; п. 15 Пленума ВС № 19/2024); rules bind only if handed over or printed with the policy (п. 2 ст. 943 ГК, п. 9 Пленума); ambiguity is read in the consumer's favour (п. 16); gross negligence frees the insurer only where a federal law says so (ст. 963 ГК, п. 49); the insurer bears the burden of proving an exclusion applies (ст. 56 ГПК).

  • Cited
  • Пленума ВС № 19/2024
  • ст. 16 ЗоЗПП
  • ст. 56 ГПК
  • ст. 943 ГК
  • ст. 963 ГК

Where this has actually happened

Regulator actions, court rulings and the contracts they were fought over.

  • ISO HO-3 homeowners form (US) — 'constant or repeated seepage or leakage of water ... over a period of weeks, months or years' and 'wear and tear, marring, deterioration' exclusions
  • Leonard v. Nationwide Mutual Insurance Co., 499 F.3d 419 (5th Cir. 2007): Hurricane Katrina storm-surge loss excluded under the clause 'even if another peril or event contributed concurrently or in any sequence to cause the loss'
  • Пленум ВС РФ № 19 от 25.06.2024, п. 9-11, 16: не вручённые правила не обязательны для страхователя; неясные условия толкуются в пользу потребителя

What to do

In order, from the thing that takes a minute to the thing that takes a letter.

  1. Read 'Exclusions' / «Не является страховым случаем» before paying
  2. Ask in writing whether a concrete scenario is covered
  3. Keep maintenance receipts and document sudden onset with dated photos and a plumber's or engineer's report
  4. Buy separate flood/earthquake cover
  5. RU: check whether the Правила страхования were handed to you or printed on the policy — otherwise they do not bind you (п. 2 ст. 943 ГК, п. 9 Пленума ВС № 19/2024) and individually agreed terms prevail (п. 11).

Check your own document

Traps that travel with it

Drafters who use one of these usually use several.

79 traps · 1789 verbatim clause phrases