What to Do When You Experience a Denied AD&D Claim

When you submit an Accidental Death & Dismemberment (AD&D) claim, you’re counting on those benefits to cover crucial expenses. Whether it’s from the passing of a loved one or a lost limb or appendage, it can be incredibly frustrating and disheartening when your insurance company denies your AD&D claim, leaving you feeling unsure of what to do next.

However, a denied AD&D claim doesn't mean the end of the road. There are essential steps you can take to challenge the decision and still obtain the benefits you need.

At Share Lawyers, we are dedicated to helping you explore all your options and guiding you toward securing the benefits you depend on. We're here to provide support and a clear path forward.

Did you experience a denied AD&D claim? Reach out to Share Lawyers to explore your options.

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Why Are AD&D Claims Denied?

AD&D claims can be denied for a variety of reasons, which should be outlined clearly in a denial letter.

• Policy Exclusions: AD&D policies often have specific exclusions that outline circumstances under which benefits will not be paid, such as but not limited to:
• Illness or disease
• Self-inflicted injuries
• Drug or alcohol use
• Participation in dangerous activities or extreme sports
• Acts of war or terrorism
  
  
• Failure to Meet the Definition of “Accident”: For an AD&D claim to be valid, the death or injury must result from an accident. If the insurance company determines that the incident was not accidental or resulted from natural causes, they may deny the claim.
  
  
• Insufficient Documentation: Claims can be denied if there is not enough evidence to support the occurrence of an accidental death or dismemberment. Lack of proper documentation, such as medical records, accident reports, or death certificates, can result in denial.
  
  
• Delayed Reporting: Claims must be reported within a specific timeframe. Missing this deadline can result in a denial.
  
  
• Non-Covered Injuries: AD&D policies cover specific injuries. If the injury or loss isn't covered, the claim may be denied.
  
  
• Pre-Existing Conditions: The claim might be denied as not purely accidental if the death or injury is linked to a pre-existing condition.
  
  
• Policy Lapses: The claim will be denied if the policy was inactive during the incident due to non-payment or other reasons.
  
  
• Discrepancies or Inconsistencies: Inconsistent information or signs of potential fraud can result in a denial.
  
  
• Incorrect Filing: Errors or incomplete forms during the claim submission can cause a denial. Accurate and complete paperwork is crucial.
  
  
• Non-Accidental Clauses: Claims resulting from intentional acts, such as suicide or criminal activity, will be denied.
  
  
• Employment-Related Exclusions: Some policies exclude incidents during work-related duties, especially if not employer-provided.

Knowing these reasons can help you prepare a more substantial claim. Regardless of the reason behind your denied AD&D claim, contacting Share Lawyers will help you understand if our experienced insurance lawyers are able to support you in fighting back against your denied claim.

What to Do When You Experience a Denied AD&D Claim

When you face a denied AD&D claim, it’s crucial to remember not to lose hope. Understanding that you still have options is key. Unfortunately, insurance companies sometimes deny valid AD&D claims to avoid paying out benefits, often using technicalities in the policy as a reason.

But don’t be discouraged. There are steps you can take to challenge the denial and pursue the benefits you deserve. There are also some pitfalls that you want to avoid.

Here’s what you need to know.