What Do You Mean It's Not Covered: What Counts As an Injury

First, the phrase "accidental" will sometimes cause disputes between insurance companies and policyholders. On rare occasion, an insurance company will try to enforce an intentionality exclusion on medical coverage. This will usually involve issues of self-inflicted injuries or intentional physical abuse, which are separate exclusions. This definition of "accident" supports those exclusions. Second, the phrase "in force" is more likely to cause disputes. Insurance companies will sometimes claim -- in situations involving major injuries -- that some of the problems happened either before or after the policy's time limits.

Insured person: Any person covered under this policy.

Any person covered by the policy is an "insured person." Compare this passage with those in the homeowners or auto chapters for more details.

Loss: An insured expense or event for which this policy provides payment.

"Loss" is a more general version of the term "accident" that appears in the definition of "injury." Simply said, this means anything that happens that triggers some form of coverage under the policy. This word has such general meaning that it's not often the center of disputes.