Question: Can health insurance exclude coverage for injuries caused by “dangerous activities” like riding ATVs or sky diving?
Answer: Yes. Contracts of insurance are governed by the same rules of construction as other contracts. The goal of contract interpretation is to ascertain and enforce the parties’ intent as manifested in the contract. To that end, courts construe the insurance policy as a whole and consider all of the provisions of the contract, not just individual words, phrases, or paragraphs. Insurers are free to limit coverage; however, all exceptions, limitations, and exclusions must be plainly expressed. An exclusionary clause must clearly and unmistakably express the particular act or omission that will bring the exclusion into play.