united-states insurance
What if the travel insurance plan document has coverage &quot;editorial&quot; error?
<p>I've posted this question because I've never bought travel insurance and I'm interested in the consequences of editorial errors. To illustrate such an error, I've posted a specific example from a real company with a good reputation (a financial institution that sells but does not service the travel insurance).</p>

<p><strong>From the financial institution's website</strong> </p>

<p>You will be provided with a complete Plan Document upon purchase of the plan. If you would like to review the Plan Document, please click below.</p>

<p><em>Download Plan Document</em></p>

<p><strong>Selected text from the downloaded plan</strong></p>

<p>Benefits are not payable for any loss due to, arising or resulting from:</p>

<ol start="7">
<li>participating in bodily contact sports, skydiving or parachuting <strong>except</strong> parasailing, hang gliding, bungee cord jumping, extreme skiing, skiing outside marked trails or heli-skiing, spelunking or caving, or scuba diving if the depth exceeds 120 feet (40 meters) or if You are not certified to
dive and a dive master is not present during the dive;</li>
</ol>

<p><strong>----------</strong></p>

<p>This is how I interpret the text:</p>

<p>We do not pay benefits for any loss that is due to, arises from, or results from
  your participation in these sports: bodily contact sports, skydiving, or parachuting. </p>

<p>Except we do pay for parasailing, hang gliding, bungee cord jumping, extreme skiing, skiing outside marked trails or heli-skiing, spelunking or caving, or scuba diving if you do so at more than 120 feet or if you are not certified to dive and a dive master is not present.</p>

<p><strong>Assumptions and Question</strong></p>

<p>In the original text of the plan, I bolded the word "except" so that it would stand out to anyone reading this post. The word "except" is reading (to my eyes) as an exclusion to an exclusion, so the listed sports are ok as long as you do something extra risky. (Note: To catch the nuance, you might have to slowly read the original out loud or have someone read it to you.)</p>

<p>One could also assume that the purchased plan documentation will (a) supersede all other plans, and (b) will not have the same type of error. </p>

<p>But what if it (the purchased plan) <em>does</em> have the same error, and you engage in one of the "excluded except [for]" activities? For example, do purchased insurance plans tend to have clauses that give them an "out?"</p>

<p><em>Note</em>: There may be no real answer to this question. In which case, I hope readers at least find some dark humor here. It's also possible that I've misread the text and need to be guided on how to read (interpret) it in a different way. If so, then American English is the standard.</p>

<p>I think you're reading it incorrectly.  I would read it as saying that the following are not covered:</p>

<ul>
<li><p>participating in bodily contact sports,</p></li>
<li><p>skydiving or parachuting except parasailing</p></li>
<li><p>hang gliding</p></li>
<li><p>bungee cord jumping</p></li>
<li><p>etc.</p></li>
</ul>

<p>So parasailing <em>is</em> covered.  All other types of skydiving and parachuting are not.  Hang gliding is not covered, bungee cord jumping is not covered, etc.</p>

<p>In other words, the scope of the "except" is only "parasailing" and is terminated at the comma.</p>

<p>In this case, my hunch is that this is intended to exclude all of the listed sports "except parasailing," as in 'parachuting is not covered, but parasailing still is,' while everything else listed is not covered. </p>

<p>There are a variety of rules of contract interpretation, including the <a href="https://www.law.cornell.edu/wex/last_antecedent_rule" rel="noreferrer">last antecedent rule</a> (which, fun fact, <a href="https://lawnlinguistics.com/2016/09/25/the-rule-of-the-last-antecedent-is-really-old/" rel="noreferrer">dates back to at least the 1400s</a>):</p>

<blockquote>
  <p>A doctrine of interpretation by which a court finds that qualifying words or phrases refer to the language immediately preceding the qualifier, unless common sense shows that it was meant to apply to something more distant or less obvious. For example, in the phrase "the commercial vehicular license shall not apply to boats, tractors, and trucks under three tons, " the qualifier "under three tons" applies only to trucks and not to boats or tractors.</p>
</blockquote>

<p>Indeed, millions of dollars have come down to <a href="https://www.nytimes.com/2017/03/16/us/oxford-comma-lawsuit.html" rel="noreferrer">interpreting the significance of a missing comma</a>.</p>

<p>In this case, it seems logical that this excludes coverage for "parachuting except parasailing." If the list of everything after "except" is considered covered, as you interpret it, that would produce an illogical result: scuba diving below 120' would be covered, while a 6' pool dive is excluded. Worse, uncertified unsupervised diving would be covered, while safe, responsible diving would be excluded. A rational insurance company would not write such a policy. I don't think it can reasonably be interpreted that way; whether you can convince a judge of that is ultimately not something you want to find out. This isn't legal advice, and if you are planning on performing any of these activities, you should get legal advice before relying on the policy. <a href="https://law.stackexchange.com/">Law.StackExchange</a> is also available for more general questions on contract interpretation principles. </p>

<p>Insurance companies will generally seek to enforce the exclusions written into their policies, and travel insurance is known for having a lot of exclusions. Ultimately, if they fail to pay a claim you believe you're entitled to, you may be able to complain to a government regulator who oversees insurance companies or file a lawsuit. The appropriate legal process (depending on the country and the dispute resolution process outlined in the policy) would interpret the agreement.</p>
