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Denied Accidental Death & Dismemberment Claim

Accidental Death & Dismemberment Claims

Accidental death policies are designed to provide financial support to beneficiaries when the insured dies due to accidental means. AD&D insurance may be purchased as a separate contract or it may be an option in a regular life insurance policy.

We’ve seen many cases where the insurance company pays out the basic life insurance claims but denies the AD&D claim. This is because the AD&D contracts have their own set of exclusions that, if applicable, can result in denials of benefits.

It is very common for people to buy accidental death and dismemberment (AD&D) coverage along with regular life insurance. AD&D coverage is available as a separate policy or as a rider to a life insurance policy. As a separate contract, an accidental death policy pays a benefit in the event that the insured dies in an accident or due to accidental means or loses one or more limbs, hearing or vision.

Accidental death and dismemberment payouts

Accidental Death and Dismemberment (AD&D) insurance is a type of insurance coverage that provides a payout in the event of accidental death or certain specified injuries, such as the loss of limbs, eyesight, or hearing. It is a supplemental insurance policy that is often offered as part of an employer-sponsored benefits package or can be purchased individually.

Here’s more information about AD&D insurance claims:

Coverage: AD&D insurance provides coverage for accidental events that result in death or specified injuries. The coverage typically applies to accidents that occur due to unexpected and unforeseen events, such as car accidents, falls, or other accidents.

Death Benefits: If the insured person dies due to an accident, the policy beneficiaries will receive a death benefit payout. This payout is a predetermined amount specified in the insurance policy and is usually a percentage of the policy’s total coverage amount.

Dismemberment Benefits: In cases of dismemberment or loss of certain body parts or functions, the policyholder may receive a percentage of the policy’s coverage amount. The specific body parts and the corresponding payout percentages are outlined in the policy. Common examples include the loss of a limb, eyesight, or hearing.

Exclusions: AD&D insurance policies typically have exclusions that define the circumstances under which claims will not be paid. These exclusions may include deaths or injuries resulting from drug or alcohol use, self-inflicted injuries, medical conditions, or participating in high-risk activities not covered by the policy.

Claim Process: In the unfortunate event of an accidental death or injury covered by the policy, the beneficiaries or the insured (if applicable) should contact the insurance company to initiate the claims process. This usually involves submitting a claim form along with supporting documentation, such as medical records, police reports, and other relevant information.

Claim Evaluation: The insurance company will review the submitted claim to determine if it meets the policy’s criteria for coverage. This may involve assessing the circumstances of the accident, verifying medical records, and ensuring that the claim falls within the scope of the policy’s coverage.

Payout: If the claim is approved, the insurance company will provide a payout based on the terms outlined in the policy. The beneficiaries or the insured (depending on the situation) will receive the specified benefit amount.

Policy Limits: AD&D insurance policies have coverage limits, meaning that there is a maximum amount the insurance company will pay out for a claim. It’s important to review and understand the policy’s terms, coverage limits, and payout percentages.

Premiums: Policyholders pay regular premiums to maintain AD&D insurance coverage. Premiums can vary based on factors such as the coverage amount, the insured person’s age, and the policy’s terms.

As with any insurance product, it’s essential to carefully read and understand the terms of the policy before purchasing or making a claim. If you have an AD&D insurance policy, it’s a good idea to keep the policy documents and contact information for the insurance company in a safe and easily accessible place, so that you or your beneficiaries can quickly access the necessary information in case of an emergency.

We Will Fight For You

You can trust The DiGeorge Life Insurance Law Firm to fight on your behalf and get you the best possible result. Feel free to call (800-210-5397) or email us now for a Free Case Evaluation. Our life insurance dispute lawyers work on a contingent fee basis. This means that we do not charge legal fees unless we collect proceeds for you.