Accidental Death And Dismemberment (AD&D)
Life Insurance Policies often have two components. There is usually a “basic life” component and an AD&D component. In many cases the life insurance company will pay the basic death benefit; but they will deny the accidental death and dismemberment payout. Usually the AD&D policy is larger so the life insurance company has a greater incentive to find a way to deny the claim or rescind the policy for misrepresentation on the policy application.
DiGeorge Life Insurance Law has great expertise in winning denied AD&D claims. We handle many cases where the cause of death is murder or homicide. Many times the police and coroner incorrectly label homicides as an accidental drug overdose. We see many cases where someone was intentionally given fentanyl to kill them. All denied accidental death and dismemberment claims should be closely examined by an experienced life insurance policy lawyer.
What is involved in an accidental death claim?
An accidental death claim typically refers to a process where beneficiaries or claimants seek compensation or benefits from an insurance policy due to the accidental death of the insured person. The exact process can vary depending on the insurance company, policy terms, and local regulations, but here’s a general overview of what’s typically involved in an accidental death claim:
Notification: The beneficiaries or legal representatives of the deceased must contact the insurance company to notify them about the accidental death. This should be done as soon as possible after the incident occurs.
Claim Form: The insurance company will provide the claimants with the necessary forms to initiate the claim. These forms will require details about the deceased, the circumstances of the accident, and the beneficiaries who are claiming the benefits.
Documentation: Claimants will need to gather and provide various documents to support the claim. This might include:
Death certificate: A certified copy of the death certificate is usually required as proof of the insured person’s passing.
Police report: If the accident involved any law enforcement response, a copy of the police report detailing the incident may be needed.
Proof of identity and relationship: Claimants might need to provide documents proving their identity and relationship to the deceased, such as birth certificates, marriage certificates, or legal documentation.
Accidental Death Coverage Verification: The insurance company will review the policy to verify that accidental death coverage is in place. They will assess whether the circumstances of the death match the policy’s definition of accidental death. Some policies might have exclusions or limitations that could affect the claim.
Investigation: The insurance company may conduct its own investigation into the circumstances of the accidental death to ensure that the claim is valid. This could involve reviewing medical records, police reports, and other relevant information.
Beneficiary Designations: The insurance company will verify the designated beneficiaries listed in the policy. If there are multiple beneficiaries or if the primary beneficiary is deceased, this could impact how the benefits are distributed.
Claim Evaluation and Payout: After all necessary documentation is submitted and reviewed, the insurance company will evaluate the claim. If the claim is approved, the beneficiaries will receive the payout according to the terms of the policy. The payout amount will depend on the coverage amount specified in the policy.
Appeals: If the claim is denied, claimants typically have the option to appeal the decision. This might involve providing additional evidence or information to support the claim.
It’s important to note that the specific steps and requirements can vary widely based on the insurance company, the type of policy, and local laws. If you’re involved in an accidental death claim, it’s recommended to closely follow the instructions provided by the insurance company and, if necessary, seek legal or professional assistance to navigate the process successfully.
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