Why Your AD&D Life Insurance Claim May Be Denied and How to Fight Back
Accidental Death and Dismemberment (AD&D) insurance is a popular choice for many because it’s affordable and easy to obtain. It’s often purchased either as a stand-alone policy or as an add-on to other life insurance coverage. AD&D policies can even be offered through unconventional channels, like credit card issuers, making them accessible to a wide audience. However, when a beneficiary files a claim under an AD&D policy, the result is often a denial of benefits.
Why Insurance Companies Have an Incentive to Deny AD&D Claims
One reason AD&D policies are so inexpensive is that accidental deaths are relatively rare. The low-risk nature of accidents means that insurance companies receive premiums for many years without having to pay out on claims, which is highly profitable for them. But when an insured person dies in an accident, the insurance company may face a significant payout — sometimes upwards of $100,000.
This financial risk can create an incentive for the insurance company to deny legitimate claims. Even though premiums are often minimal, the company may resist paying out the claim in hopes that the beneficiary will not challenge the decision. But remember, life insurance is a contract, and the company cannot arbitrarily decide not to pay a valid claim just because it’s financially inconvenient.
Common Reasons for Denial of AD&D Claims
AD&D policies typically cover only accidents, so insurance companies may try to avoid payment by asserting that the cause of death was not an accident. Here are some common tactics used by insurers to deny AD&D claims:
Suicide Claims: Some insurance companies will attempt to classify the cause of death as suicide rather than an accident, even in ambiguous situations such as single-car accidents or falls. In cases where the cause of death is uncertain, the insurance company may decide to classify the incident as a suicide, which is excluded from coverage. However, the burden of proof is on the insurance company to establish that the death was intentional, and the beneficiary should not accept this classification without further investigation.
Intoxication and Drug Exclusions: Many AD&D policies contain exclusions for accidents that occur while the insured is intoxicated by alcohol or drugs. If the insured was impaired at the time of the accident, the insurance company may argue that the policy doesn’t cover the death. Similarly, accidents triggered by pre-existing medical conditions (e.g., a seizure leading to a fatal crash) may also be excluded under some policies. Again, the insurance company has to prove that the exclusion applies. Even in these cases, the company might attempt to interpret the facts in a way that saves them money.
Fighting an AD&D Claim Denial
The denial of an AD&D claim can feel like an overwhelming setback, but it’s important to know your rights. The insurance company doesn’t have the final say. If your claim has been denied, don’t accept their decision without a fight. Insurance companies often have a financial incentive to reject claims, but you have the law on your side, and with professional legal guidance, you can challenge the denial and increase your chances of securing the benefits you deserve.
How a Life Insurance Claim Denial Attorney Can Help
When an insurance company denies a valid AD&D claim, it’s counting on your resignation. However, with the help of an experienced life insurance claim denial attorney, you can fight back and challenge the insurance company’s decision.
Our attorneys specialize in denied AD&D claims and have the knowledge and experience needed to push back against wrongful denials. If you believe your AD&D claim was unfairly denied, schedule a free consultation with us today. We’ll review your case, assess whether the denial was valid, and help you explore your options for pursuing the benefits you’re entitled to.