A restriction removing the consequences of a named condition from cover, leaving the premium untouched but the protection absent precisely where the risk is known.
A condition exclusion removes from cover the consequences of a named ailment, as opposed to a loading, which keeps cover whole and raises its price. It is common in borrower insurance and individual protection policies, where two families of exclusion recur systematically in group contracts: back conditions and psychiatric disorders, which are precisely the two leading causes of long term absence from work. An exclusion must be formal and limited, printed in conspicuous type, and it may not target a category so vague that it would empty the cover of substance, a control the courts exercise strictly. Its practical effect is asymmetric: it costs nothing so long as nothing happens, and it costs everything on the day the loss arrives through the excluded route. This is why comparing a cheap group contract carrying exclusions with a dearer but complete individual one is not a price comparison but a cover comparison, which the freedom to switch insurer opened by France's Lagarde Act of July 1, 2010 made possible.
The back and psychiatric exclusions appear in most French group borrower policies, while psychiatric conditions and musculoskeletal disorders top the list of work absences paid for by the health insurance system. Individual contracts usually buy them back against a loading, which shifts the question from price to what the cover actually contains.
exclusion d'affection nommée, exclusion dos et psy