Accidental Death & Dismemberment Claim Delays and Denials

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Navigating the complexities of accidental death insurance can be daunting, particularly when grappling with the loss of a loved one. At Boonswang Law, our seasoned attorneys specialize in accidental death and dismemberment (AD&D) claims.

We are committed to helping you understand the intricacies of how accidental death insurance functions, the circumstances life insurance companies acknowledge as accidental death, and the process for securing accidental death benefits on top of regular life insurance benefits.

If you’re a life insurance beneficiary facing challenges in receiving your rightful accidental death benefits, we’re here to help. Our mission is to ensure that justice is served and you receive the benefits you are entitled to.

Contact our accidental death and dismemberment lawyers for a no-obligation free consultation about your case.

Remember, we operate on a contingency fee basis, meaning we only succeed when you do.

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Understanding Accidental Death and Dismemberment Insurance

Also known as an accidental death and dismemberment insurance policy, accidental death insurance typically serves as an optional rider added to a standard life insurance policy. This additional layer of protection incurs an extra cost for the policyholder but can provide invaluable financial security in the wake of unforeseen tragedies. 

Accidental death and dismemberment insurance is designed to cover unexpected fatalities or serious injuries resulting from accidents, supplementing the benefits of a basic life insurance policy.

Diverse Types of Accidental Death Riders

Accidental death and dismemberment insurance coverage is versatile and can be obtained through various avenues. Employers might offer this insurance as an employee benefit, safeguarding against potential workplace accidents. 

Alternatively, employees may have the option to personally invest in this coverage at their own expense. Accidental death coverage can also be added as an optional rider to an individual life insurance policy, enhancing the accidental death and dismemberment insurance policy’s protective net. 

Moreover, accidental death and dismemberment insurance can be procured temporarily, especially beneficial for those undertaking travel for a specific period, thus providing an additional safety net against potential accidents during their journey.

Scope of Accidental Death Policies

Accidental death policies cast a wide coverage net, encompassing an array of accident-caused fatalities.

These can range from:

  • Vehicle accidents
  • Drowning incidents
  • Slip and fall accidents
  • Burns, severe or minor, leading to fatality
  • Choking
  • Accidents involving machinery
  • Lightning strikes
  • Heat strokes
  • Death due to freezing
  • Homicide

Some accidental death and dismemberment insurance policies extend their coverage to include dismemberment, as well as total or partial loss of essential faculties such as hearing, vision, or speech. They also cover partial paralysis and other permanent impairments directly resulting from an accident. 

The insurer disburses the insured benefits by following a schedule, determining what percentage of the accidental death benefit corresponds to the insured’s specific injury.

Deciding on Accidental Death Coverage

Investing in accidental death and dismemberment insurance coverage and determining its extent is influenced by various factors. This can include the nature of one’s profession, particularly for those working with hazardous substances or heavy machinery, where risks of accidents are statistically higher. 

Regular travelers or individuals commuting long distances may also consider opting for accidental death coverage, given the increased chances of potential mishaps on the road. The key is to evaluate personal circumstances and potential exposure to risk, ensuring a suitable safety net is in place.

Exclusions in Accidental Death Policies

Accidental death and dismemberment insurance policies typically come with a set of exclusions that fall outside their coverage purview. If the insured voluntarily partakes in hazardous activities or hobbies such as extreme mountain climbing, bungee jumping, race car driving, or motocross, the insurer will not cover the claim or provide payout for any resulting injuries or death.

Furthermore, fatalities resulting from acts of war or terrorism, illness, alcohol poisoning, drug overdose, or those that occur while performing an illegal act are generally excluded from coverage. It’s essential to thoroughly understand these exclusions when purchasing a policy to avoid potential coverage gaps.

Life Insurance Companies’ Criteria for Classifying an Accidental Death

For a death to be classified as ‘accidental’ by a life insurance company, certain criteria need to be met. Essentially, the death should not be a result of illness, natural causes, or any exclusion stipulated in the policy. 

Additionally, the fatality must occur within a specific time frame following the accident, as detailed in the policy conditions.

Why a Life Insurance Company Might Deny Accidental Death Claims

Life insurance companies, like all businesses, operate to generate profit. This leads to denied life insurance claims.

This profit comes from collecting premiums and, in some instances, limiting payouts on beneficiaries’ claims. Consequently, an insurer may hesitate or refuse to disburse accidental death benefits, asserting that the death doesn’t fall under the ‘accidental’ category.

This issue frequently surfaces when an accident precipitates what is deemed a ‘natural’ cause of death. For instance, consider a scenario where an individual involved in a car accident experiences a heart attack. The death certificate may attribute the cause of death to the heart attack, despite the heart attack being a direct result of the car accident.

Additionally, life insurance companies might argue that the death was not a direct consequence of the accident, particularly if the death occurred a significant amount of time post-accident or if the duration between the accident and the insured’s death surpasses the policy’s specified time limit.

Speak With Our Knowledgeable Life Insurance Attorneys About Your Denied Claim

At Boonswang Law, we passionately advocate for beneficiaries’ rights to claim the AD&D insurance benefits they are justly entitled to. Your loved one invested in this additional coverage to protect you — you have every right to be treated fairly and receive these benefits. 

We encourage you to reach out to a Boonswang Law accidental death and dismemberment insurance lawyer. 

We take no attorney fees until you win! 

Our firm pledges to thoroughly investigate your AD&D insurance claim and strive tirelessly to secure your accidental death benefits.

See how much your case is worth, and contact Boonswang Law today.

Accidental Death Claims FAQs

Do standard life insurance policies include coverage for accidental death?

Yes, most standard life insurance policies inherently cover accidental death. 

However, adding an accidental death rider to your life insurance policy can further increase the death benefit payout in the event of accidental death, providing additional financial security against fatalities not caused by natural causes, illnesses, or any other policy exclusions.

Accidental death, as defined by insurance companies, refers to a death resulting from unexpected and unintentional incidents. 

Unexpected death could include but is not limited to automobile accidents, unintentional poisoning, falls, or drowning. Only accidental deaths count. Deaths from natural causes, illnesses, or intentional self-harm are generally not classified as accidental deaths.

Yes, there typically are. 

Most insurance companies limit the offering of accidental death benefits, usually ceasing coverage when the insured reaches a certain age (often 70), but this can vary from one policy to another. It’s crucial to review the terms of your specific policy for precise information.

Accidental death policies generally exclude deaths resulting from certain activities or circumstances. 

These can include extreme sports, war or acts of terrorism, drug or alcohol use, certain types of dangerous hobbies, and deaths occurring while committing an illegal act. The specifics of these exclusions can vary, so always refer to your policy for details.

Yes, an insurance company can deny coverage of an accidental death claim under certain circumstances, such as if the cause of death falls under a policy exclusion or if the death occurs outside the policy’s defined time limit following an accident. 

The risk of claim denial underscores the importance of understanding your policy terms and working with experienced accidental death dismemberment insurance lawyers.