With so much paperwork given to you by insurance companies, most people tend to overlook exactly what their contracts are about.

It is part of insurance law that any ambiguity or uncertainty in the choice of wording in a contract will be resolved in favor of the policy holder, and not the insurance company. This often works in favor of the policyholder when it comes to pointing fingers in court, but not all the time.

Most policyholders tend to have their own interpretation of the contract. Unfortunately, the judge doesn't care about the policyholder's understanding of the wording. In court, “plain meaning” is what the judge looks at. “Plain meaning” is how an ordinary citizen or common reader understands the text, and not how the policyholder, insurance company, or lawyer interprets it.

While courts do not necessarily interpret a contract at the expense of the policyholder experiencing a loss, it does not give leeway for “misunderstandings” of plain text by the policyholder.

Which is why contracts must be free of any ambiguities for both the insurance company and the policyholder. Whenever exclusions or limitations are stated, they must be stated very clearly. Oftentimes, insurance companies fail to fully explain these limitations to their clients, resulting in them successfully denying certain coverage when there is a loss. It is the insurer's policy to explain the contract to the client, especially if he is not aware of his rights or if he does not know if he is getting what is due fully his. However, the insurer is not required to tell him the adequacy of the insurance amount he selected. Keep in mind that when a contract contains provisions that are in favor of the company, the court will deem this unconscionable, and may refuse to enforce such provision.

Keep substantial evidence at hand. In such cases where a client is led to believe an advertisement or promotion of an insurance company that turns out to be false, depending on the state, legal protection can be provided for you.

When you are able to successfully prove that your insurance company has breached a contract, you can recover damages for consequential losses, loss of use of the insurance proceeds, general damages, attorneys' fees, and, in cases of egregious and misconduct, punitive damages.

Whatever happens, be sure to act fast. Insurance companies are always a step ahead of you in the legal department. Depending on the state, the statute limitation for a case like this is 2 years. In California, you are only given 1 year.



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