What are the limitations and exclusions on coverage in a personal injury policy?

California, United States of America


The following excerpt is from Melton v. Industrial Indemnity Co., 103 Cal.Rptr.2d 222 (Cal. App. 2001):

Before considering any exclusions or limitations, we must first examine a policy's coverage provisions to determine whether a claim falls within its terms. (Waller v. Truck Ins. Exchange, Inc., supra, 11 Cal.4th at p. 16.) This is so for two reasons. First, where a claim clearly is not included within the insuring agreement, it need not be specifically excluded. Second, while limitations on coverage are narrowly construed and must be proved by the insurer, the burden is on the insured to bring the claim within the basic scope of coverage. (Ibid.)

4. "Compensation and Other Benefits"

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