The Do’s And Don’ts Of Denied AD&D Claims

If you attempted to file a claim for accidental death and dismemberment insurance only to have it denied by your insurance company, you may feel at a loss with what to do next. Not to worry, there are still things you can do to get the payout you want. That being said, you may also feel the need to take steps that may be harmful to your case in the long run. With that in mind, below are the do’s and don’ts of rejected accidental death claims.

Do

  • Understand that it is in the insurance companies best interest to deny claims as opposed to paying them out. Don’t be surprised if they do what they can to deny your claim
  • Immediately gather any and all insurance policy documentation
  • Get any medical, hospital, or autopsy records that pertain to your case
  • If applicable, get an independent alcohol test done at your earliest convenience

Do not

  • Get the contact information or directly contact any witnesses
  • Assume that just because the death certificate lists the reason for death as accidental that the insurance company will approve your accidental death claim
  • Talk to or provide any information to your insurance company without first speaking to an attorney
  • Hesitate to hire your own pathologist to perform an autopsy separate from the insurance company
  • Attempt to fight the denial on your own. Talk to an experienced lawyer who can guide you.

Common Reasons That Accidental Death And Dismemberment Claims Are Denied

There are several reasons your insurance company may deny your AD&D claim, but the most common two reasons are either that the death or injury was not caused by an accident, or that the injury or death occurred within a policy exclusion. Your claim may also be denied for things like failing to pay premiums or because the death happened too long after the accident which would cause it to be covered by AD&D insurance.

When Death Or Dismemberment Was Not Caused By An Accident

Because AD&D policies are only designed for accidental death and injury, anything else will not be covered. However, it is not always obvious the exact cause of death, so there is some uncertainty that allows insurance companies to deny claims they should be honoring.

When Death Or Dismemberment Occurred Within A Policy Exclusion

Policy exclusions are things laid out within your AD&D policy that it does not cover. Some typical exclusions would be deaths caused by illegal drug overdose taken without a prescription or death or injury that was caused by driving under the influence of drugs or alcohol. Policy exclusions will vary depending on the particular company you use and the policy you pick. To avoid rejection of your claim on these grounds, you should ensure you read and fully understand what your policy covers and what it does not

How Can A Lawyer Help Me If My Accidental Death And Dismemberment Claim Is Denied?

If your claim was rejected, know that it is not the end of the line. Especially if you believe that your insurance company denied your payout unfairly, you can appeal their decision. Take note, however, that you will only have a certain amount of time to file your appeal, with the particular timeline being dependent on what state you live in. If you decide to pursue an appeal case, you should start by contacting a lawyer. They will be able to help you understand why your initial claim was denied and ensure you have the best chance of receiving your payout.

At McKennon law group, we offer free consultations so you can get your insurance questions answered free of charge. And if you choose to pursue legal action, we have a team of attorneys experienced at getting their clients the money they are owed.

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