Getting Denied AD&D Insurance Claim Decisions Reversed
Beware Of Exclusions In AD&D Policies
AD&D benefits are paid in one, lump-sum payment to beneficiaries if an accidental death occurred. AD&D benefits are separate from life insurance so if a policy holder has both AD&D and life insurance coverage is killed accidentally, both policies will provide benefits to surviving beneficiaries. If the insured suffers loss of a limb or other part covered under the policy, the insured will receive the benefits.
If your insurance company has denied your accidental death and dismemberment (AD&D) insurance benefits without giving your claim proper consideration, it can be said that it was acting in bad faith.
In some cases, even when the medical examiner’s report and the death certificate will state “accidental death” insurers will find ways to deny a claim based on an exclusion.
A few common exclusions written into AD&D insurance policies include if the death was caused by, or involved:
- Prescription or illegal drug misuse or intoxication;
- During a commission of a crime;
- Suicide;
- Homicide;
- Pregnancy-related death;
- If the cause of death was not independent of other causes; or
- Death was the result of an accident, but the victim lived one or more years after the accident.
AD&D policies are filled with loopholes and ambiguous exclusions that insurance companies will try to use to avoid paying claims. We truly understand the methods of “the other side,” because our law firm features former insurance defense lawyers. We have seen firsthand the loopholes they will try to use and we know how to aggressively challenge them.
Insurers may deny an AD&D insurance claim on the basis that the event does not meet the policy’s definition of an accidental death. They may go so far as to claim that the victim was the cause of the accident and is not eligible for benefits. Our experience means we know how to close the loopholes, overcome the insurance company’s objections and help you.
About AD&D Insurance Benefits
Accidental death and dismemberment (AD&D) is a unique type of insurance. If you have lost a loved one and you are trying to collect on this type of insurance policy, it is important to understand that it does not work the same as life insurance. Benefits will not be paid if your loved one died of natural causes. They will only be paid if the death was caused by a car accident, truck accident, motorcycle accident or any other type of accident. This type of insurance is also beneficial because it may cover accidents that cause dismemberment or loss of speech, hearing or vision.
AD&D benefits are paid in one, lump-sum payment to beneficiaries if an accidental death occurred. AD&D benefits are separate from life insurance so if a policy holder has both AD&D and life insurance coverage is killed accidentally, both policies will provide benefits to surviving beneficiaries. If the insured suffers loss of a limb or other part covered under the policy, the insured will receive the benefits.
Insurance Bad Faith Lawyer in Santa Ana
The implied contract of good faith and fair dealing means that an insurance company must be honest when considering your benefits claim. There are several duties that must be performed, including to:
- Objectively evaluate the insured’s claim and to give at least as much consideration to the insured’s interests as it does its own;
- Refrain from construing an insurance policy term in a more restrictive manner from the accepted legal definition;
- Refrain from imposing additional preconditions to coverage beyond those in the insurance policy;
- Respond to the insured’s inquiries in a timely manner.
Contact a Santa Ana Insurance Bad Faith Attorney Today
At Donahue & Horrow, L.L.P., our attorneys have more than 50 combined years of experience representing clients against insurance carriers. We understand the stress and confusion that follows having your benefits claim denied. It is our goal to ensure the insurance company is held responsible for its actions. Our experienced insurance bad faith attorneys can explain your options for reversing the insurer’s decision and to help you get the benefits that are owed to you.
To learn more about how our attorneys can help you, schedule a free consultation today. We represent clients in Santa Ana, Los Angeles and other communities throughout Southern California. Call us at 877-664-5407 or contact us online to schedule an appointment.