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Accidental Death & Dismemberment Insurance Claim Denied?


Insurance companies deny you insurance benefits after the loss of a loved one, just when your family needs help the most

Losing a loved one in an accident is one of the hardest things any family can experience.  The situation can be even more difficult when the death results in financial hardship.  For example, if the person killed was the primary breadwinner, the family may not know where to turn for financial help.  Accidental Death & Dismemberment (AD&D) insurance is meant to supplement life insurance payouts to provide financial security after a loved one is killed in an accident.  Unfortunately, insurance companies are known to add insult to injury by looking for reasons to deny insurance coverage after an accident-related death.

If you have experienced a traumatic loss in your family and your insurer refuses to pay out, you have the right to challenge their decision and seek the coverage you are owed.  At Gianelli & Morris, our lawyers know California insurance law and life insurance policies.  We know when you’re being treated fairly and when you’re not.  We’ve devoted decades to representing families seeking the benefits of insurance that they rightfully purchased, breaking down the roadblocks thrown in their path by bad faith insurance denials.

If your California AD&D policy claim has been denied and you don’t know what to do, call Gianelli & Morris for a no-cost, confidential consultation.  We will investigate the circumstances of your claim and determine how we can best help your family recover after a loss.  If your insurance company is mistreating you, we’ll do what it takes to make sure they treat you right.

What is Accidental Death & Dismemberment Insurance?

AD&D insurance is not the same as life insurance.  It is a bit more unique.  AD&D is a form of supplemental coverage that can be purchased separately from life insurance or as an option in a regular life insurance policy.  AD&D will not kick in whenever the covered party passes away.  Instead, AD&D is triggered only when a death is caused by accident.  AD&D is meant to cover traumatic deaths such as car accidents, truck accidents, defective product injuries, slip and fall accidents, etc. Death by natural causes, for example, would be excluded. AD&D policies will typically have a list of exclusions that determine which causes of death will and will not be covered.

What Qualifies for AD&D Coverage?  What is Excluded?

AD&D covers more than just death.  AD&D insurance may cover dismemberment and loss of a limb as well as the loss of other bodily functions, including speech, hearing, or vision.  If your insurer claims you are not covered because there was no “dismemberment,” it is worth revisiting your policy to see if other forms of disability are covered.

Key to AD&D coverage is understanding what the policy means by “accident.”  Your AD&D insurer will try to claim that anything that cannot be classified as an accident–like a traffic crash or dangerous premises incident–does not qualify for coverage under the AD&D policy.  Your insurer may be making this argument in bad faith.  The insurance bad faith denial lawyers at Gianelli & Morris have years of experience parsing the language in your policy and dealing with the tricks that insurers try to pull in order to deny coverage.

Some of the more common reasons claimed by insurance providers for denying AD&D coverage include the following:

  • Denial due to suicide
  • Denial because the incident does not qualify as an “accident”
  • Denial due to participation in a crime
  • Denial due to illness
  • Denial because the type of accident is specifically excluded
  • Denial due to use of alcohol or drugs, legal or prescription
  • Denial due to failure to separate out accidental death from other causes
  • Denial due to failure to file the claim within the time limit set by the policy

Many of these reasons may be claimed in bad faith.  If a triggering event is not explicitly excluded under AD&D policies, your insurer may be manufacturing a reason to deny your claims.  Speak with a dedicated California health insurance lawyer to review your policy and your claims and determine whether your claim was denied in bad faith.

Call Gianelli & Morris for Advice and Representation to Resolve Your California Accidental Death & Dismemberment Policy Dispute

For help with an accidental death & dismemberment denial or other problem with your insurance policy, call the California AD&D attorneys Gianelli & Morris for a complimentary, confidential consultation at 866-361-0719.

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