As with life insurance, purchasing accidental death and dismemberment (AD&D) coverage is a good way to plan for the unexpected. Unfortunately, accidental death and dismemberment claims are frequently declined by the insurance company. What many people endorse as an accident may not be considered an accident by the insurer.
When the insurance company wrongly denies AD&D claims, Marc Whitehead & Associates can provide skilled, reliable help. We represent claimants nationwide who have suffered dismemberment, and beneficiaries who have lost beloved family and relatives as the result of an accident. We bring many strategies to the table to prove our client’s case.
Accidental Death and Dismemberment is Different than Life Insurance
AD&D insurance can be purchased as a stand-alone policy or as a rider to a life insurance policy. As a rider it is a supplemental section of the existing life insurance contract. AD&D provisions are purchased individually or included in group policies offered through the workplace. If your AD&D is sponsored or offered through your employer, coverage and claims will be regulated by ERISA. Otherwise, state insurance law will govern your claim.
Coverage and benefits are different in accidental death and dismemberment policies when compared to life insurance policies. AD&D benefits are paid only if death was the result of an accident, such as a car, truck or boating accident. A death resulting from natural causes is not covered in AD&D claims. This form of coverage also pays benefits on injuries that cause the policyholder loss of limb, speech, hearing or vision, when those injuries are proven, direct results of an accident.
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Tactics Used to Deny Accidental Death and Dismemberment Claims
Insurers may deny an AD&D claim by basing allegations on weak or nonexistent evidence, or that the death was not accidental.
An insurer may refuse to pay benefits when a death caused by an accident does not immediately follow the accident, but takes weeks or months to occur. We often see instances where insurers allege that the deceased acted negligently (e.g., driving a car while intoxicated) at the time of accidental death. Or, the deceased may have had a stroke while driving and then dies in a car crash. The insurer refuses to pay death benefits claiming that the stroke was the underlying cause of death and not the car accident.
Multiple Exclusions
AD&D claims are often written to have multiple exclusions. This gives insurance companies many interpretations of policy terms when assigning grounds for denial. Examples of exclusions include that the death involved or was the result of
- Intoxication
- Abuse of prescription or illegal drugs
- Criminal activity
- Suicide
- Pregnancy or sickness at the time of the accident
- Heart attack or stroke
- War injury
- Professional athletic injuries
And as with life insurance policies, denials for material misrepresentation are used by insurance companies to avoid paying accidental death claims.
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Contact Marc Whitehead & Associates for an Attorney Case Evaluation
Let us assist you in receiving the benefits you deserve. We help people throughout the United States in their fight to recover their rightful life insurance and AD&D benefits. Call us at 800-562-9830 to request a free case evaluation with a life insurance lawyer.
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