What is the term used for conditions or circumstances that are not covered by a health or disability policy?

The term used for conditions or circumstances that are not covered by a health or disability policy is "exclusions." Exclusions are specific clauses in insurance policies that clarify activities, situations, or types of treatment that the insurer will not provide coverage for. This is critical in understanding an insurance policy, as it directly impacts the policyholder’s financial responsibility and what medical services or situations require out-of-pocket payments.

In insurance contexts, exclusions are important for managing risk and clarifying the scope of coverage. They help the insurer define what is and isn’t covered, thus protecting the company from claims related to high-risk activities or pre-existing conditions, among other things. A thorough understanding of exclusions helps policyholders make informed decisions about their health care and financial planning.