Has Your Accidental Death Claim Been Denied?

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Accidental Death and Dismemberment Insurance Attorney

Accidental Death and Dismemberment Insurance Claim Lawyers

Losing a loved one is already difficult, but facing a denial for the accidental death and dismemberment insurance you relied on makes it worse. Insurance companies often deny AD&D claims citing various exclusions, like intoxication or natural causes, even when they’re wrong. This happens frequently, and insurers hope you either give up or submit an insufficient appeal, missing your chance to build a strong case.

Your appeal is your only opportunity to present the evidence needed to win your case if it goes to trial. It’s crucial to provide substantial evidence, including witness testimony and expert opinions, rather than just arguments. At DiGeorge Life Insurance Law Firm, our accidental death and dismemberment insurance attorney understands the importance of this process. We offer resources and expert guidance to help you build a solid case. Reach out to us for support and to ensure you get the compensation you deserve.

What is Accidental Death and Dismemberment Insurance?

Accidental Death and Dismemberment (AD&D) insurance provides financial benefits if the insured person dies or suffers severe injuries due to an accident. It covers incidents that are sudden, unexpected, and result from an external cause, unlike standard life insurance, which does not cover death, injuries, or disability from illness or natural causes.

Accidental Death and Dismemberment Coverage Details

Accidental Death and Dismemberment policies typically cover accidental death, and serious injuries such as loss of limbs, paralysis, and loss of sensory functions like sight, speech, or hearing. The insurance benefits are paid based on the severity of the injury, often as a percentage of the total coverage amount. Some insurance policies may also cover conditions such as a coma, disability, or brain damage resulting from an accident.

Importance of AD&D Insurance Policies

Accidental death and dismemberment insurance benefits provide financial security after unexpected accidents, helping beneficiaries manage expenses such as medical bills, rehabilitation costs, and lost income. It ensures the insured person’s family can maintain financial stability during challenging times, offering peace of mind and economic support when needed most.

What to Do if Denied

If your accidental death and dismemberment insurance claim is denied, act quickly. Carefully read the AD&D denial letter to understand the reasons and contact the insurer for a detailed explanation. Gather all relevant documents, including your policy, denial letter, medical records, accident reports, and correspondence with the insurance company.

Importance of Not Accepting the Initial Denial Without Further Investigation

Do not accept the initial denial without further investigation. Insurance companies may deny claims based on misinterpretations or incomplete information. Challenge the decision by collecting detailed evidence to support your claim, ensuring you are fully informed about your rights and options to recover your benefits.

Gather Necessary Documents and Information for Further Action

Organize and review all insurance documentation related to your AD&D insurance policy and the accident. It is recommended to seek legal help if necessary to ensure all relevant information is gathered and presented effectively. This will strengthen your case when disputing the denial under ERISA law or fighting to reach an alternative settlement in or our of court.

How to Challenge a Denial of AD&D Benefits

Challenging a denied accidental death and dismemberment claim involves reviewing the denial letter, gathering supporting documents, and formally appealing the decision.

Steps Involved in Filing an Appeal with the Insurance Company

  • Review the Denial Letter: Understand the specific reasons for the AD&D denial.
  • Gather Supporting Documents: Collect all relevant documents, such as medical records, accident reports, and witness statements.
  • Prepare a Written Appeal: Write a detailed appeal letter addressing the reasons for denial and providing evidence to support your claim.
  • Submit the Appeal: Send the appeal letter and supporting documents to the insurance company, following their specified procedures.
  • Follow Up: Maintain communication with the insurer and track the progress of your appeal.

Importance of Meeting Deadlines and Providing Thorough Evidence

Meeting deadlines is crucial when appealing a denied accidental death and dismemberment claim. Missing a deadline can forfeit your right to appeal. Submit all documents on time and ensure your appeal is comprehensive and well-documented with thorough evidence to strengthen your case.

Practical Tips on What to Do When Dealing with a Denied Claim

  • Do Act Quickly: Start the appeals process as soon as you receive the AD&D denial letter.
  • Do Gather Evidence: Collect all relevant documents and evidence that support your claim.
  • Do Seek Professional Help: Consider consulting with an experienced AD&D attorney to guide you through the process.

Common Mistakes to Avoid During the Appeals Process

  • Don’t Miss Deadlines: Ensure all paperwork is submitted within the required time frames.
  • Don’t Provide Incomplete Information: Make sure your appeal includes all necessary documents and evidence.
  • Don’t Rely on Verbal Agreements: Get all communications and agreements in writing.

Why Insurance Companies Deny Accidental Death Insurance Claims

Insurance companies may deny AD&D and accidental death insurance claims for various reasons, often citing policy exclusions, misinterpretations of the policy terms, or insufficient evidence of the accidental nature of the incident.

Financial Motives and Common Tactics Used by Insurers

Insurance companies have financial motives to minimize payouts. Common tactics include:

  • Claiming the death or injury was not accidental.
  • Arguing that the death falls under policy exclusions.
  • Requesting excessive documentation or evidence to delay the process.
  • Misinterpreting policy terms to justify denial.

Common Reasons Why Claims Are Denied

Insurance companies may reject AD&D claims based on specific policy criteria or their interpretation of the incident. This awareness helps you prepare for potential insurance disputes and strengthens your position when challenging a denial.

  • Not Caused by Accident: Insurers may deny claims by arguing that the incident was not an accident. For example, if an insured person has a heart attack while driving, causing an accident, the insurer might classify the heart attack as a natural cause rather than an accidental injury.
  • Coverage Exclusion: Accidental death and dismemberment policies often have exclusions that limit coverage. Common exclusions include incidents related to substance abuse, illegal activities, or high-risk sports. For instance, if an insured person dies while skydiving, the insurer may deny the claim based on a high-risk activity exclusion.

Understanding these exclusions is crucial for assessing the validity of a denied claim and planning an appeal.

How an AD& D Attorney Can Help Recover Benefits and Protect Your Rights

An insurance attorney is essential in handling accidental death and dismemberment insurance disputes, giving you the best chance to recover your benefits. They analyze AD&D policies, gather evidence, build a strong case, and communicate with the insurance company on your behalf.

At DiGeorge Life Insurance Law Firm, our experienced accidental death and dismemberment insurance lawyers understand AD&D policies and have a proven track record of overturning denials. We provide expert guidance throughout the appeals process, meticulously review denial letters, identify errors, and compile comprehensive evidence to support your claim, ensuring all deadlines are met.

We are dedicated to navigating legal complexities, advocating for your rights, and securing the benefits you deserve. Our results speak for themselves. We have recovered millions in AD&D denied benefits claims and can do the same for you. Complete the form on our contact page to request a free case evaluation with our life insurance lawyers.

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How Much Does it Cost to Hire a Life Insurance Lawyer

At DiGeorge Life Insurance Law Firm, we understand the financial and emotional strain of a denied life insurance claim. That’s why we offer our legal services on a contingency fee basis, meaning you won’t pay any legal fees unless we successfully recover a settlement for you.

There are no upfront costs to start your case, and you will never receive a bill from us. If we don’t win your case, you don’t owe us anything.

To get started, simply fill out our secure online form for a complimentary case review with a life insurance lawyer, or call our office at (800) 391-9692 to schedule your free consultation.

What Is the Payout for Accidental Dismemberment?

The payout for accidental dismemberment varies depending on the specific life insurance policy and the extent of the injury. Typically, policies with an accidental death and dismemberment (AD&D) rider will pay a percentage of the death benefit for the loss of limbs, fingers, toes, or eyesight due to a covered accident. For example, the policy might pay 50% of the death benefit for the loss of one limb or sight in one eye, and 100% for the loss of two limbs or sight in both eyes. However, the exact terms and percentages can differ among policies, so it’s essential to review the specific provisions of your life insurance contract.

Does Insurance Pay Out for Accidental Death?

Yes, life insurance policies generally pay out for accidental death. In fact, many policies include an accidental death benefit (ADB) or accidental death and dismemberment (AD&D) rider, which provides additional coverage if the insured dies due to a covered accident. The beneficiary will typically receive the standard death benefit, plus the additional amount specified in the ADB or AD&D rider. However, there may be some exclusions, such as death caused by engaging in dangerous activities or while under the influence of drugs or alcohol. It’s important to review the specific terms and conditions of the life insurance policy to understand the coverage and any limitations related to accidental death.

Is Dying During Surgery Considered Accidental Death?

When determining if a death during surgery is considered accidental, insurers will examine the specific circumstances surrounding the case. If the death was caused by an unexpected complication or medical error that occurred during the surgical procedure itself, it may be deemed an accidental death, even if the surgery was performed to treat an underlying illness or disease. However, if the death was primarily due to the pre-existing condition or a known risk associated with the surgery, it would likely not be classified as an accidental death under the policy terms.

What Does a Accidental Death and Dismemberment Insurance Attorney Do?

AD&D insurance attorneys help beneficiaries file claims and navigate the process when an insured person dies or is dismembered in an accident. They represent clients in appealing denied or delayed claims, pursuing legal action if needed. These attorneys also advise clients on their rights and obligations under AD&D policies and help resolve disputes between beneficiaries or with the insurance company.

The DiGeorge Law Firm Advantage

DiGeorge Life Insurance Law Firm excels in representing clients whose life insurance claims have been denied due to policy lapses. Our attorneys possess a deep understanding of the complexities involved in these cases and are committed to conducting thorough investigations and advocating fiercely on behalf of our clients.


No Recovery, No Fee

Our contingent fee structure means we are as invested in your success as you are; we only succeed when you do.


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Our team has recovered millions of dollars for our clients after receiving life insurance benefits denied or delayed.

Has Your AD&D Claim Been Denied?

Our life insurance lawyers help you receive the life insurance benefits owed to you, despite what the insurance company may say.

There is never any risk or out-of-pocket cost to you.