Six Hundred Thousand Denied Mutual of Omaha AD&D Life Insurance Claim Won

Policy exclusions: Accidental death and dismemberment (AD&D) policies typically have exclusions that outline the circumstances in which the policy will not provide coverage. For example, if the death or injury was a result of participating in certain high-risk activities, such as skydiving or bungee jumping, the claim may be denied.

Failure to disclose pre-existing medical conditions: If the policyholder failed to disclose a pre-existing medical condition when applying for the AD&D policy, the insurer may deny the claim on the basis of misrepresentation.

Intentional acts: If the policyholder's death or injury was a result of an intentional act, such as suicide or self-harm, the claim may be denied.

Alcohol or drug use: If the policyholder's death or injury was a result of being under the influence of drugs or alcohol, the claim may be denied.

Policy lapse: If the policyholder did not pay their premiums on time, their policy may have lapsed, and any subsequent claims may be denied.

Lack of documentation: The insurer may require certain documentation to process a claim, such as a death certificate or police report. If the necessary documentation is not provided, the claim may be denied.

Non-accidental death: AD&D policies only cover accidental deaths, not deaths that result from natural causes. If the policyholder died from a medical condition, the claim may be denied.

Exceeding benefit limits: AD&D policies typically have benefit limits, and if the claim exceeds these limits, the insurer may deny the excess portion of the claim.

Ineligible beneficiaries: If the beneficiary named in the policy is ineligible to receive benefits, such as if they are deceased or were not named in the policy, the claim may be denied.

Policyholder's age: Some AD&D policies have age restrictions, and if the policyholder is outside the age range covered by the policy, any subsequent claims may be denied.