Accidental death insurance is intended to support beneficiaries financially in the event that the insured passes away in an accident. Unfortunately, claims for accidental death are routinely delayed or rejected, just like with many life insurance policies. This occurs as a result of the numerous exclusions that insurance companies routinely use that bar accidental deaths from coverage. We cover everything about accidental death claim denials in this blog.
Examples of What AD&D Insurance Covers
AD&D (Accidental Death & Dismemberment) insurance only covers accident-related deaths. For the insurance company to provide benefits, the death or injury must be a result of an accident covered by the policy. Let's say, for instance, that the insured had a tragic accident because of a heart attack while skydiving. Due to the fact that the death was caused by a heart attack (a natural death cause) the life insurance company may decline to pay the accidental death benefit in that situation. It's because natural death causes are covered by typical life insurance contracts.
Here are a few instances of what an insurance company considers an accidental death to be:
- A collision involving a car or any other kind of vehicle, including a bus or other type of public transportation;
- Deaths brought on by fire, such as those caused by asphyxiation, falling objects, or burns;
- Drowning;
- Falls;
- Poisoning;
- When someone is shot or stabbed by another person, whether intentionally or not, it is called murder;
- Industrial mishaps, explosions, equipment failures, mining accidents, and other workplace mishaps;
- industrial mishaps, explosions, mining mishaps, equipment failures, and further workplace mishaps; Pedestrian accidents;
- Water, train, or air transport accidents.
Beneficiaries only receive a policy reimbursement if the death is deemed to be the result of an accident and took place shortly after the accident. Most insurance plans will pay for deaths that take place within 365 days of the accident. If not, the insurer will contend that since there was a delay between the accident and the insured's death, the claim is ineligible because the accident did not cause the death.
Types of Injuries or Deaths that AD&D Insurance May Not Cover
There are accidental death "life insurance exclusions" in every accidental death policy. An exclusion is a clause in a contract that specifies a circumstance in which accidental death benefits won't be paid.
- Death because of suicide, attempted suicide, or self-inflicted injury, whether insane or sane;
- Deaths brought on or aggravated by ailments, including mental disorders;
- Taking part in an act of war, whether it is proclaimed or not, or a riot;
- Deaths that occur while being a part of any nation or international organization's armed forces;
- Fatalities incurred while traveling on any aircraft: a) in the capacity of a pilot, a member of the crew, or a student pilot; b) as a flying instructor or examiner;
- Deaths brought on by overdoses when using medicines that are illegal under federal law to dispense without a prescription, such as sedatives, opioids, barbiturates, amphetamines, or hallucinogens, unless they are taken as directed or supplied by a qualified doctor;
- Fatalities resulting from attempted or committed crime
- Deaths brought on by alcohol drinking that resulted in legal intoxication;
- Driving after consuming alcohol;
- Deaths that take place during a medical procedure, surgery, or rehabilitation after surgery;
- Deaths brought on by medical negligence;
- Deaths resulting from professional sports, racing in cars, or risky pastimes like bungee jumping, scuba diving, or skydiving;
- Deaths brought on by autoerotic asphyxiation.
In certain cases, however, insurers may be incorrect in rejecting the accidental death compensation even if the insured's death fits under one of the aforementioned categories. It would be best to speak with a life insurance attorney if you have received a denial letter to determine whether a claim denial is legitimate or not.