contested coverage
[kən'testəd 'kʌvərɪdʒ]
nounpl: contested coverages
cobertura contestada
1. Insurance coverage or claim that is disputed or challenged by the insurer, often regarding whether the claim falls within the policy's terms and conditions
The insurance company denied the claim, citing contested coverage due to a pre-existing condition exclusion.
A companhia de seguros negou a indenização, citando cobertura contestada devido à exclusão de condições pré-existentes.
2. A dispute between an insured party and an insurance provider about whether a specific incident or damage is covered under the existing policy
After the flood, there was contested coverage regarding whether water damage was included in their homeowners policy.
Após a enchente, houve cobertura contestada sobre se os danos causados pela água estavam inclusos na apólice de seguro residencial.
3. A legal or administrative situation where insurance claim coverage is subject to disagreement or litigation
The medical procedures resulted in contested coverage, requiring arbitration between the patient and the insurance provider.
Os procedimentos médicos resultaram em cobertura contestada, exigindo arbitragem entre o paciente e a operadora de seguros.
This term is primarily used in insurance, legal, and business contexts in both the US and Brazil. In Brazilian insurance law, contested coverage often leads to formal disputes requiring intervention from insurance regulatory agencies (SUSEP - Superintendência de Seguros Privados). Understanding this concept is important for consumers navigating insurance claims in both countries, where policy language can be complex and subject to interpretation.
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