What If an Accidental Death Insurance Claim Is Denied?
In the aftermath of losing a loved one, dealing with insurance payouts is understandably overwhelming. For those who’ve received a denial for their loved one’s Accidental Death & Dismemberment insurance claim, it can be almost too much to bear.
If your Accidental Death insurance claim has been denied, understand that you don’t have to fight the decision on your own. There are steps you can take to secure the insurance payout you deserve.
Let Share Lawyers protect you. We’ve been through this process many times over the past 35 years, and we know how to hold the insurance company accountable.
Accidental Death & Dismemberment insurance claim denied? Reach out to Share Lawyers to explore your options.
8 Reasons Why AD&D Claims Are Denied
Here are the most common reasons why AD&D claims in Canada are denied:
- Cause of Death or Injury Not Covered
AD&D policies typically cover deaths or injuries that are deemed accidental. If the cause of death or injury is considered to be natural or non-accidental, insurance companies may deny the claim.
- Policy Exclusions
Many policies have specific exclusions, such as deaths caused by illegal activities, suicide, substance abuse, etc.
- Failure to Pay Premiums
If you have not maintained your premium payments, the policy may lapse, resulting in a denial.
- Timing of Death or Injury
Some policies have time limits within which the death injury must occur following the accident. If the death or injury happens outside of this period, the claim may be denied.
- Insufficient Documentation
Incomplete or incorrect information in documents such as medical records, death certificates, or police reports may lead to a claim being denied due to a lack of evidence.
- Misinterpretation of Policy Terms
Policy terms for AD&D policies are often complex and subject to interpretation. Insurance companies may interpret terms to favour denying the claim.
- Pre-existing Conditions
If the deceased had a pre-existing condition that contributed to the death or injury, the insurance company may argue that the cause was not accidental and deny the claim.
- Legal & Technical Issues
Legal disputes over the interpretation of policy language or technical issues with how the claim was filed can lead to denial.
What To Avoid After Filing an Accidental Death Insurance Claim
As with any situation, there are also certain things you should avoid.
What To Avoid After Your Accidental Death Insurance Claim | |
1. Assuming Approval Based on Death Certificate | Do not assume that your claim will be approved just because the death certificate lists the cause as accidental. Insurance companies often look for any reason to deny a claim. |
2. Communicate with the Insurance Company Without Legal Guidance | Avoid providing any information to the insurance company without first consulting a lawyer. Anything you say can potentially be used against your claim. |
3. Fight the Denial Alone | Do not attempt to challenge the denial on your own. Engaging with an experienced AD&D insurance lawyer like Share Lawyers is crucial to navigating the complex appeals process and improving your chances of success. |