The insurance company's restrictions on the amount of benefits paid out for in certain situations. These will be listed in the sales brochure and policy.
a restriction on the amount of benefits paid out for a particular covered expense.
The maximum amount of insurance coverage available under a policy or exclusion of certain described premises.
Any provision of the Certificate of Coverage, other than an Exclusion, which restricts coverage.
Restrictive conditions stated in a benefit contract, such as age, length of time covered, and waiting periods, which affect an individual's or group's coverage.
Stated exceptions to coverage as outlined in a policy.
A restriction on the publics' use of a highway that is recorded in the Definitive Statement or can be shown to have been in place when the route was dedicated to the public and which has remained there ever since, without a break of twenty years.
Conditions, such as age and period of time covered, that restrict a dental program's coverage for certain services. (For example, in most programs, a prophylaxis is a covered benefit twice in a 12-month period.)
There may be specific provisions included in group disability plans that limit coverage in certain situations. Often only limited benefits are payable for specific conditions or under specific circumstances (e.g., mental illness and pre-existing conditions). See also Mental Illness Limitations and Pre-Existing Limitations below.
Exceptions to coverage and limitations of coverage as contained in an insurance contract.
Restricting conditions - such as age, period of time covered, and waiting periods - under which a group or individual is insured.
Certain specified provisions in the insurance contract that limit the amount of coverage and or the exclusion of certain situations or premises.