Understanding Denied AD&D Life Insurance Claims
Nothing is more painful than the unexpected loss of a loved one, particularly if that person was the main breadwinner in your home. Hopefully, that person who has passed away purchased an accidental death policy to provide the funds to keep your family together and functioning without fear of overdue bills, the loss of your home or other financial disasters. Most of today’s accident policies are referred to as “AD&D,” which stands for “Accidental Death and Dismemberment.”
Sometimes this is purchased in addition to a regular life insurance policy, sometimes it is a completely separate policy. Some companies refer to these as Double Indemnity Policies, particularly if the policy states that it pays out more if the death is accidental rather than from an illness or health issue. AD&D claim denial
What the Second “D” Means in AD&D
The dismemberment portion of an Accidental Death & Dismemberment policy refers to the part of the coverage that may pay out if your loved one doesn’t die but loses a limb(s) or is disfigured or injured in such a catastrophic way that they can no longer support the family without financial help. Most of these policies have a specific dollar figure they will pay out based on what the injuries are. Common coverages are for the loss of a limb(s), loss of hearing or loss of vision. If the insured has lost a limb or lost use of one or more of his senses, be sure to speak to an attorney if the claim is denied.
Why Are Denied AD&D Life Insurance Claims So Common?
Denied AD&D life insurance claims aren’t uncommon, even when a standard policy is paid to the beneficiary. Why does this happen? AD&D policies have different criteria for paying an AD&D policy and in most cases these exclusions are more detailed and complex than those in a standard coverage policy.
Some common exclusions that are used to deny an AD&D life insurance claim include:
- Death by suicide
- Specific illnesses outlined in the policy
- Misuse of illegal substances or death from intoxication
- Use of unreported (on the policy) prescription medications
- Death as a result of committing a crime
- Failure to file a timely claim
- Self-injury to fulfill the “dismemberment” requirement
Many denied AD&D life insurance claims are based on an illness that the deceased or injured had that may have contributed to the death or injuries. Because most adults have some kind of health issue, it’s easy for a policy provider to claim that there is a connection between an illness and the death, rather than the death being strictly an accident. Usually this is simply an excuse so that the beneficiary doesn’t have to be paid. If you choose to go to court to fight the denial, the insurance company will have to prove that there is a direct connection between the illness and the death. Claims may also be denied because the person who has passed was drinking alcohol or using some type of medication. Neither of these is an automatic exclusion, but they can be powerful weapons for an insurance provider wanting to deny the claim.
Hiring an attorney who is familiar with denied AD&D life insurance claims can be your best protection. They can investigate the circumstances surrounding the death or injuries, work with medical experts and put together a solid defense for the beneficiaries and their families.
We Don’t Get Paid Unless Your Claim is Successfully Paid
The thought of consulting a lawyer about a denied AD&D life insurance claim can be intimidating, particularly if you’re either grieving or caring for someone who has suffered a catastrophic loss such as losing an arm or leg or no longer being able to see or hear. At our firm, the initial consultation is free, and we don’t get paid unless and until your claim is paid by the insurance company. Let our experience in handling denied AD&D life insurance claims take one problem off your shoulders so that you and your loved ones can recover with one less thing to worry about.