Losing a loved one is never easy. Along with the emotional pain comes the financial burdens associated with end-of-life expenses. Covering the costs of these expenses becomes even more difficult when insurance companies deny claims. Read on to learn what to do if an AD&D insurance company chose to deny your claims after the death of a loved one.
Understanding AD&D Insurance
Along with traditional life insurance policies, individuals can purchase Accidental Death & Dismemberment (AD&D) insurance too. AD&D insurance is not the same as conventional life insurance. It is a form of supplemental coverage that can be purchased in addition to traditional life insurance policies. Some individuals choose to use AD&D insurance as a standalone coverage as well.
Unlike traditional life insurance, AD&D coverage only covers accidental deaths. AD&D insurance is intended to cover traumatic deaths such as those that occur due to a vehicle accident. A death that occurs by natural cause is excluded from receiving AD&D insurance coverage. Along with natural death, there are a number of other reasons why AD&D insurance claims can be denied.
Reason Why AD&D Insurance Claims are Denied
AD&D insurance only compensates an individual’s beneficiaries if their death was a result of an accident. This means the insurance company may deny the claim if the individual’s death was a result of the following:
- Death was a result of suicide
- Death was a result of a pre-existing medical condition
- Death was a result of participation in criminal activity
- Death was a result of misusing alcohol or drugs
- Death was a result of intoxicated driving
- Death was a result of physical illness
- Death was a result of mental illness
- Death was a result of military combat
- Death occurred while the insured was driving a vehicle for compensation or hire
- Death occurred while the insured was flying a plane or working as a flight crew member
- Death was a result of an incident that does not qualify as an accident
While there are valid reasons for an AD&D insurance claim to be denied, many insurance companies attempt to undervalue AD&D claims or deny claims for invalid reasons. Oftentimes, AD&D claims are denied without merit but don’t be discouraged. There are steps you can take if your AD&D insurance claim was denied without merit.
What Should I Do If the Life Insurance Company Denies My AD&D Insurance Claim?
Before you make an AD&D claim, be sure to read over the insurance policy carefully. This will give you a clear insight into whether your claim has any merit. If your loved one did die as a result of an accident, you would need to gather all documentation related to the accident and have it ready to submit to the insurance company. This includes all medical records, witness statements, and accident reports surrounding the death. Once you have gathered all the necessary documentation, you should go ahead and file the AD&D insurance claim.
Once the insurance company responds, be sure to keep detailed notes of every conversation and correspondence you have with the company. Write down the name of the person you talk to, the date you spoke to them, and the details of your conversation. If the insurance company decides to deny the claim, this information will come in handy when fighting back against the insurance company’s decision.
If the insurance company does deny your AD&D insurance claim, you must act quickly. There is only a small window of time that you are allowed to fight back against their decision. Most AD&D policies are governed by the federal law known as ERISA. In most cases, ERISA gives an unfair advantage to the insurance company and sets out specific rules and timelines for filing appeals of a denial. If you fail to submit an appeal that meets all ERISA requirements prior to the deadline, you are usually barred from moving forward with a lawsuit against the insurance company.
When AD&D insurance deny claims, appeals and lawsuits can become complicated and overwhelming quickly. Therefore, as soon as you have been notified that your AD&D insurance claim has been denied, you should reach out to an ERISA lawyer immediately. An experienced attorney will be able to help you navigate this difficult situation and help you obtain the compensation you and your family deserve.
Consult with an ERISA Lawyer Today
Dealing with the death of a loved one should not be made more difficult by having to deal with denied insurance claims. You and your family deserve proper representation and compensation. If AD&D insurance deny claims after the death of a loved one, reach out to an experienced ERISA lawyer immediately.
Contact us today to schedule a consultation. We look forward to working with you and helping you obtain the compensation that is rightfully yours.