Wrongfully Denied an Accidental Death and Dismemberment (AD&D) Claim? Here's What You Need to Know
Each year, thousands of individuals purchase life insurance policies to ensure their loved ones are financially protected in the event of a tragedy. For many policyholders, especially young professionals, adding an Accidental Death and Dismemberment (AD&D) rider seems like a smart, proactive step. These riders increase the payout significantly—often three or four times the base amount—if the policyholder dies as the result of an accident. Unfortunately, while these riders offer peace of mind, life insurance companies are far from eager to pay out on AD&D claims. In fact, they often actively resist doing so. One of the most common tactics insurers use is to claim that the policyholder’s death wasn’t really accidental. Even when police reports, autopsies, and eyewitnesses clearly indicate otherwise, insurers may still twist the facts to justify a denial. As attorneys who regularly challenge wrongful denials of life insurance and AD&D claims, we’ve seen these tactics firsthand. Below are three cases that highlight how insurance companies wrongly deny claims and how beneficiaries fought back—and won.
Case #1: The Car Crash Called Suicide
Charlie, a 35-year-old accountant, was driving home after a long day at work when a chain-reaction accident unfolded. A semi-truck crossed the median and struck multiple vehicles. To avoid the wreckage, Charlie swerved—causing his car to veer off the freeway and fall down a 20-foot embankment. He died instantly.
Authorities investigated thoroughly. The incident was captured on surveillance footage, and police concluded it was a tragic accident. Yet when Charlie’s wife filed a claim under his life insurance policy and AD&D rider, the insurer paid the base benefit but denied the AD&D payout.
Their reasoning? They alleged Charlie drove off the road intentionally, claiming it was a suicide. There was no history of mental illness, no suicide note, no indication of self-harm—just the insurer trying to avoid a higher payout.
Charlie’s wife retained an attorney who had successfully handled AD&D denials in the past. Once the insurer was presented with legal pressure and the irrefutable facts, they reversed the denial and paid the full AD&D benefit.
Case #2: A Ski Collision Rewritten as Assault
Karen was an experienced skier who had spent her whole life on the slopes. While skiing at a local resort, another skier lost control and collided with her at full speed. Karen was rushed to the hospital, spoke briefly to authorities, and later fell into a coma she never woke from.
The police concluded it was an accidental collision. Witnesses confirmed the other skier had lost control. But when Karen’s husband, Bill, filed for AD&D benefits, the insurer took a different position.
They denied the claim based on their “finding” that the other skier intentionally ran into Karen—despite no such conclusion from police or evidence to support it.
Bill filed a lawsuit with the help of a life insurance attorney. Key facts were brought to court:
The police report supported that the crash was accidental
The other skier testified, denying any intent
Eyewitnesses backed up the accidental nature of the incident
The court ruled in Bill’s favor, awarding him the full AD&D payout plus interest.
Case #3: Home Repairs Turned Into False Suicide Claims
Jack and Lucy were new homeowners working hard to renovate their fixer-upper. Jack began doing small home repairs himself, learning from online tutorials. During one project, Jack attempted to replace an electrical outlet without shutting off the power. He was tragically electrocuted and died on the spot.
Lucy filed a claim and received the base life insurance payout. But when she submitted for AD&D benefits, the insurer denied it, claiming Jack’s death was likely intentional. Their argument? That Jack knowingly handled live wires and must have done so to harm himself.
Lucy hired an attorney who promptly appealed the denial. To counter the baseless suicide theory, the lawyer provided:
Proof of Jack and Lucy’s upcoming vacation plans
Texts and emails showing excitement about home renovations
No history of mental illness or suicidal ideation
Eventually, the insurer relented and paid the full AD&D benefit, realizing their position wouldn’t survive scrutiny.
Why AD&D Riders Are Frequently Denied
AD&D benefits are higher than standard payouts, which is why insurers often try to avoid honoring them. Their go-to tactic is reinterpreting accidents as intentional acts, even when there’s no evidence to support that view. Here are common tactics we’ve seen insurers use:
Reclassifying accidental deaths as suicides or reckless behavior
Ignoring official police and coroner reports
Using ambiguous policy language to justify denials
Hoping grief-stricken families won’t push back
Insurers know many beneficiaries won’t have the time, energy, or resources to fight. That’s why hiring a lawyer with experience in denied life insurance and AD&D claims can make all the difference.
What You Can Do If Your AD&D Claim Was Denied
If your loved one had an AD&D rider and you received a denial letter, don’t assume the insurer is right. Their interpretations are often self-serving and legally flawed.
Here's how to take action:
Review the denial letter carefully—note what exclusion or reasoning the insurer cites
Gather documents—autopsy reports, police records, medical notes, and eyewitness statements
Contact an attorney who specializes in denied life insurance and AD&D claims
Don’t delay—most policies have short timelines for appeal, and legal help is often free unless you win
Our firm has helped many families overturn wrongful denials. We’re familiar with insurer tactics and know how to challenge them effectively.
Call Us Today—Let Us Help You Get What You’re Owed
If your AD&D claim was denied under questionable circumstances, don’t walk away from the money your loved one intended for you. We offer free consultations, and if we take your case, you don’t pay us unless and until we recover benefits for you.
You have options. And with the right legal team, you can fight back—and win.