We offer a free consultation and no fees unless you win.
Non-payment of accidental death and dismemberment (AD&D) claims are upsetting and often confusing. When claims are denied it may relate to issues regarding underwriting or interpretation of policy terms.
Before accepting a refusal by your insurance company to pay out on your accidental death and dismemberment policy, we encourage you to consult with one of our AD&D lawyers to determine whether we can assist you in recovering all or part of what rightly belongs to you or your family.
How we can support you
After receiving a denial of your accidental death and dismemberment insurance, you might not know where to turn next. You may feel hopeless, but rest assured you are not alone. When you call Share Lawyers, you will speak with someone who knows what you are going through and can offer you the best possible advice at no cost to you.
Why you should contact us:
- It’s free to talk to us
- There are no fees unless you win
- We specialize in AD&D claims and can go through your options
- We make arrangements for a free consultation with one of our AD&D lawyers to see how we can help you get your critical illness benefits
- We're there to answer all of your questions
Our lawyers can help with AD&D insurance claim denials
AD&D insurance is designed to pay out a lump sum in the event that you suffered a significant accident causing death, loss of a limb (or total loss of use), complete loss of vision, and several orhwe serious injuries.
Claims are often denied for two reasons. Insurance companies will contest whether or not the injury was caused by an accident (this can be more complicated than it seems) or whether or not the injury has caused total loss of use.
Why Was My AD&D Claim Denied?
The two biggest reasons for an AD&D claim to be denied are related to whether the injury was accidental and/or whether the nature and severity of the injury meets the listed losses outlined in the AD&D coverage. Clients often worry that it’s because of something they did wrong when applying for their pay out or in the way they kept track of medical history or medical records, and while that is possible, it is also the insurance companies job to look hard for even the smallest way to get out of paying a claim. You are not the first person who has not received this payout.
Was your Injury Accidental?
What is considered an accident? This may seem obvious but there have been conflicting legal decisions regarding what constitutes accidental injury that triggers entitlement under an Accidental Death and Dismemberment insurance policy. As an example, in past court decisions Canadian courts have found that death suffered as a complication of a medical procedure is not an accident, while contracting West Nile Virus resulting in paralysis is an accident. If your insurance company is denying your AD&D claim stating it was not an accident, it would be best to contact our team of accidental death and dismemberment lawyers to see how we can assist. When we book our free consultation call, be prepared with your medical records and as much information as you can about the insurance policy.
Does the Injury Meet the Definitions Under the AD&D Policy?
AD&D coverage lists various injuries that would qualify for a lump sum payout. Any injury listed will include a definition of the specifics of the injury required in order for you to be eligible for the payment. When claiming for an AD&D benefit, the insurance company will look over all medical information to see if you meet the definitions based on their interpretations. For instance, in one case a claim was made for paraplegia based on the following definition of paraplegia, “…the loss of use of both lower limbs”, and loss of use was defined as “… the entire and irrecoverable loss of use beyond remedy by surgical or other means”. The accidental death and dismemberment claim was denied because the injured person’s condition did not meet these definitions, while the evidence showed that he had lost all practical and functional use of his legs, even though he still had some partial use of his legs. In this case, he was successful, although a court could have ruled otherwise.
These cases are focused both on the policy wording and the specific facts of each case, but an initial denial by the insurance company should not be taken at face value, without being further reviewed. If your insurance company is stating that you do not meet the definitions of the AD&D benefit policy, contact one of our AD&D lawyers to see how we can fight their decision to not pay. If you or your loved one has been through something as tragic as losing a limb or losing their life, you deserve to have the best disability and life insurance lawyers.
We Can Help
Before accepting a refusal by an insurance company to pay out on yours or a loved one’s accidental death and dismemberment policy, our lawyers for AD&D claims encourage you to consult further with us to determine whether we can assist you in recovering all or part of what rightly belongs to you or your family. Remember that to the insurance company, you are a number on a list, but for Share Lawyers, you are a surviving spouse or family member who deserves support.
How much time do I have?
There are time limits to all disability claims and any delay in proceeding may be subject to a deadline so you should not delay in proceeding with your disability claim or obtaining legal advice to clarify these deadlines. We understand how important these timelines are and will respond to any call or email as soon as we can.
Disability Lawyers in Toronto, proudly serving clients in Ontario and across Canada
Are you looking for a disability lawyer to fight for your rights? Our law firm has unmatched experience in disability law and we don't let provincial borders stop us from helping you in your time of need. Your insurance company has a presence throughout Canada and it makes sense to hire a disability law firm that has a true expertise in disability law and has a national presence too. Your insurance company knows who we are and knows that we won’t back down.
Regardless of whether you have just applied for your insurance benefits or have been denied your benefits by your insurance company and need support, we will talk you through all of your options — free of charge. It’s important to be informed about the insurance claim process and to know your rights.
No fees unless you win your case
We understand your situation and that paying for an insurance lawyer can feel out of reach. We are here to help you no matter where you are in the process. That is why we offer a free consultation, why there are no upfront costs to you, and why there are no fees unless you win your case. You’re not alone. We believe in your case, which is why we only get paid when you do.
When you work with us, you get guidance and tools to help you along the way. You will become a member of a privileged group of clients that have access to our hub, called Life reBUILDER™, exclusively from Share Lawyers. It offers six unique services to help rebuild your life and get you back on track, beginning with the expertise of a full legal team all working for you.