Rather than separating claims into "covered" and "not covered", I recommend a third bucket "might be covered". I think this goes into that third bucket. Whether or not this particular claim should be paid doesn't mean it's not in the third bucket.

When buying insurance, you shouldn't rely on payments for claims in the third bucket, especially not without a legal fight.

Many consumers don't understand any of this. But I expect (hope) that most large businesses are sophisticated enough to understand this.

I don't think this will hurt Zurich's business, because most of their customers probably understand this.