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Has Your Insurance Company Denied
Your Disability Claim?

Whether an insurance company, employer, union or other ERISA governed
plan has denied your insurance claim, we can help.

Understanding the Definition of Accidental Death, Claims, and Causes

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gavel and books Definition of Accidental Death

If you are unfamiliar with the definition of accidental death, an attorney may be able to help provide the explanation you need. Accidental death and dismemberment insurance is intended to supplement a standard life insurance policy. Such policies require proof that the deceased was involved in an accident that led to his or her death. While this process is often straightforward, the circumstances of death may sometimes call into question whether the death was accidental. In such cases, it can be difficult for beneficiaries to receive their payments.

Causes of Action for AD&D Claims

Causes of action for all AD&D claims place the burden of proof on the beneficiaries. An attorney may be able to help eligible beneficiaries receive the benefits to which they are entitled. It is important for beneficiaries to remember that official reports are valuable evidence in showing the cause of an accidental death. Some claims can be resolved by simply providing the insurer with a copy of the autopsy report, police report, medical examiner’s report or a death certificate. In some cases, insurance companies have been known to ignore official reports of deaths in an attempt to avoid paying benefits. Beneficiaries should be prepared to challenge questions or a false denial of a qualified claim. Proving that an illness or other impairment was not the cause of an accidental death is often necessary if the deceased had an underlying condition. Accidental deaths affecting those with existing conditions or serious injuries are often cause for insurance claims denial as the insurer may try to insist that the condition was the cause of the death rather than the accident. Deaths that involve alcohol intoxication are particularly difficult when it comes to making an AD&D policy claim. Many policies specifically exclude deaths that resulted from or were related to alcohol intoxication. In such cases, the burden of proof is on the insurance company to show that the exclusion applies to that particular death. Most insurance companies are expected to prove that the alcohol use was the sole cause of death, or the exemption may not be considered valid. It is still common for insurers to claim that a death was not accidental but rather foreseeable due to the intoxication. After an AD&D claim has been denied, contacting a lawyer is the best way to proceed for many beneficiaries. A lawyer can provide representation and deal with the insurer so the beneficiary does not feel intimidated or discouraged. It is important not to let delays or denials of a valid claim deter you from pursuing the benefits to which you are entitled. Insurance companies often attempt to stall a claim in hopes that the beneficiaries will give up on pursuing benefits.

Working with a Lawyer

Insurance companies can often be aggressive when it comes to denying a claim, even if the claim falls within their AD&D policy guidelines. Many insurers hope that beneficiaries will simply accept a claims denial without moving forward to appeal their decision. An experienced lawyer is familiar with all the tricks and tactics insurance companies use to unjustly deny claims and intimidate beneficiaries to prevent them from pursuing benefits. It is important to have representation and guidance when it comes to gathering the appropriate documentation that can support your AD&D benefits claim. A single medical report or testimony could mean the difference between a successful appeal for benefits and a denied claim.

Contact a Lawyer to Understand the Definition of Accidental Death

Contact Jonathan M. Feigenbaum, Esquire today at (617) 357-9700 for more information on the definition of accidental death and representation for your claim.


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