Death resulting from a pre-existing medical condition: If the policyholder's death is caused by a pre-existing medical condition and not by an accidental event, the insurer may deny the claim.
Death caused by suicide: Most accidental death and dismemberment policies have exclusions for suicide, meaning that if the policyholder's death was a result of suicide, the claim will be denied.
Death caused by drug or alcohol use: If the policyholder's death was caused by the use of drugs or alcohol, the insurer may deny the claim.
Death caused by participating in high-risk activities: Many accidental death and dismemberment policies have exclusions for high-risk activities, such as skydiving or extreme sports. If the policyholder's death was caused by participating in one of these activities, the claim may be denied.
Death caused by criminal activity: If the policyholder's death was a result of criminal activity, the insurer may deny the claim.
Death caused by natural causes: Accidental death and dismemberment policies only cover accidental deaths, not deaths that result from natural causes such as heart attacks or strokes.
Death caused by medical malpractice: If the policyholder's death was caused by medical malpractice, the insurer may deny the claim.
Death caused by a work-related injury: If the policyholder's death was caused by a work-related injury, it may be covered by workers' compensation instead of the accidental death and dismemberment policy.
Death caused by self-harm: If the policyholder's death was a result of self-harm, such as intentionally injuring oneself, the claim may be denied.
Death caused by an act of war: Many accidental death and dismemberment
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Two Hundred Fifty Thousand Prudential AD&D Denied Life Claim Won
/ Life Insurance AttorneyWe recently recovered a $250k denied AD&D policy for a client.
Some examples of deaths denied deemed as not accidental on an accidental death and dismemberment life insurance claim are the following: