In the aftermath of a tragedy, the last thing you’ll want to deal with is red tape. An Arlington insurance claims lawyer can handle the insurance company and help you obtain the benefits you’re owed.
Accidental death and dismemberment (AD&D) insurance is supposed to provide financial protection after a terrible accident, such as the unexpected loss of a loved one or a catastrophic injury. Unfortunately, insurance companies often deny or delay valid AD&D claims.
ERISA Insurance Claim Attorneys has been advocating for clients like you for over 30 years. If the insurance company has delayed or denied your AD&D claim, an accidental death and dismemberment lawyer in Arlington can help you secure the benefits you deserve.
How Can an Accidental Death and Dismemberment Attorney in Arlington Help Me?
If you need help with an accidental death and dismemberment claim, a lawyer can:
- Review your policy:Â Interpret complex insurance language and explain the benefits you’re entitled to.
- Gather evidence: Collect medical records, accident reports, and expert testimony to strengthen your claim.
- Negotiate fair compensation: Protect you from insurers’ manipulative tactics and fight for fair compensation on your behalf.
- Provide representation: Argue your case in court, if needed.
- Challenge denials: Appeal a potential denial and, if necessary, file a lawsuit.
An Arlington accidental death and dismemberment lawyer can significantly improve your odds of a favorable outcome.
For a free legal consultation with an accidental death and dismemberment lawyer serving Arlington, call (225) 201-8311
How Much Is My AD&D Claim Worth?
Accidental death and dismemberment settlements can range from tens of thousands to millions of dollars. The specific value of your AD&D claim will depend on the terms of the policy and the type of loss you’ve suffered. Policies typically pay out:
- The full benefit amount for accidental death or the loss of two major body parts (such as both arms or legs)
- Partial benefits for losing one limb, vision in one eye, or partial dismemberment
- Additional coverage if the accident occurred under specific circumstances, such as in a common carrier (plane, bus, or train)
An accidental death and dismemberment attorney in Arlington can make sure the insurance company doesn’t undervalue your claim.
Arlington Accidental Death And Dismemberment Lawyer Near Me (225) 201-8311
Types of Available Compensation for an Accidental Death and Dismemberment Claim
If you intend to file an accidental death and dismemberment (AD&D) claim under an ERISA policy in Arlington, Texas, it’s important to understand the types of benefits you can pursue.
For an AD&D claim, the compensation generally falls into two main categories: death benefits and dismemberment benefits.
Death Benefits
If a policyholder dies due to an accident, the beneficiaries are entitled to death benefits. The policy typically predetermines this amount, which can be a fixed sum or a multiple of the policyholder’s salary.
This compensation provides financial support to the family members left behind, helping them cover expenses such as funeral costs, outstanding debts, and ongoing living expenses.
Dismemberment Benefits
If the policyholder suffers a dismemberment (which usually means the loss of a limb, eyesight, hearing, or other critical bodily functions due to an accident), the AD&D policy may provide compensation. However, the specific amount will depend on the severity and type of dismemberment.
This compensation is intended to cover medical bills, rehabilitation costs, and adjustments necessary for a new lifestyle, such as home modifications or specialized equipment.
Additional Benefits and Riders
Some AD&D policies include additional benefits or riders that can provide extra compensation. For example, policies may have a double indemnity clause, which pays double the benefit amount if the accident occurred under specific circumstances, like while traveling on public transportation.
Other policies can offer educational benefits for the policyholder’s children or spouse, ensuring they can continue their education despite the financial strain the accident has caused.
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What Do Accidental Death and Dismemberment Policies Cover?
Accidental death and dismemberment insurance typically covers:
- Death caused by accidents such as car crashes, falls, or workplace injuries
- Loss of limbs, fingers, toes, eyesight, hearing, or speech due to an accident
- Paralysis caused by accidental injury
In addition, some accidental death and dismemberment insurance policies provide extra benefits if the accident involves public transportation or occurs while traveling.
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How Long Do I Have to File an AD&D Claim in Texas?
Most insurance policies set strict deadlines for filing AD&D claims in Texas. Generally, you should:
- Notify the insurance company as soon as possible after the accident or death.
- Submit proof of loss (such as medical or death records) within the time frame outlined in your policy (often 20 to 90 days).
- File a lawsuit (if necessary) for breach of contract or bad faith before the deadline in Texas, which is usually four years after a breach or two years after bad faith actions from the insurer.
If you miss these deadlines, you may lose your ability to recover benefits, which is why it’s important to hire an attorney as soon as possible.
What Qualifies as Accidental Death and Dismemberment?
To qualify for AD&D coverage, the death or injury must be:
- Accidental: The incident must be sudden, unexpected, and not caused by illness or natural disease.
- Directly linked to the accident: The injury or death must result from the accident itself, not from unrelated health conditions.
- Within the policy’s timeframe: Many policies require the death or dismemberment to occur within 90 to 365 days of the accident.
What Is Not Covered Under AD&D?
AD&D policies come with exclusions that insurance companies frequently use to deny claims. Common exclusions include:
- Deaths caused by illness, stroke, or heart attack
- Injuries from suicide or self-inflicted harm
- Death or dismemberment while under the influence of drugs or alcohol
- Accidents that occur while committing a crime
- Deaths related to high-risk activities, like skydiving or racing (unless specifically included in the policy)
Who Can File an AD&D Claim?
Typically, these individuals can file an AD&D claim:
- Beneficiaries listed in the policy, such as a spouse or children
- The insured person, if the claim involves dismemberment or paralysis
- The estate if no specific beneficiary is named
How Does the AD&D Claims Process Work?
The AD&D claims process generally involves these steps:
- Filing a notice of claim with the insurance provider
- Submitting documentation, including accident reports, medical records, or death certificates
- Insurance review, during which the insurer investigates whether the death or injury meets policy requirements
- Approval, denial, or request for more information from the insurance company
- Appeal or litigation if the insurer refuses to pay fairly
What Evidence Is Needed to Prove Accidental Death or Dismemberment?
Insurance companies demand extensive proof before paying out an AD&D claim. Types of evidence they may ask for include:
- Police reports and accident investigations
- Medical records showing the direct cause of injury or death
- An autopsy or coroner’s report
- Witness statements
- Expert opinions to rule out exclusions such as pre-existing conditions
The stronger your documentation, the harder it will be for the insurer to deny your claim. An Arlington accidental death and dismemberment attorney can help gather evidence that supports your case.
How Long Does It Take to Settle an AD&D Claim?
Every AD&D case is different. Simple claims may settle in a few months, but more complex or disputed claims can take a year or longer.
Factors that can affect the timeline include:
- How quickly you submit the required paperwork
- Whether the insurer disputes the cause of death or injury
- If an appeal or lawsuit becomes necessary
An accidental death and dismemberment lawyer in Arlington can push for a faster resolution and ensure delays don’t hurt your claim.
What Is AD&D Insurance?
Accidental death and dismemberment insurance is a specialized type of coverage that pays out benefits if the insured dies or suffers a qualifying dismemberment due to an accident. Unlike traditional life insurance, AD&D does not apply to natural causes such as illness or old age.
These policies often supplement life insurance coverage to provide additional financial protection when the unexpected happens.
What Is the Definition of Accidental Death in Texas?
In Texas, accidental death is generally defined as a death caused by an unexpected, sudden, and external event. Examples include:
- Motor vehicle collisions
- Falls from heights
- Fires or explosions
- Work-related accidents
To qualify under an AD&D policy, the death must be accidental rather than the result of illness, suicide, or intentional harm.
What Is the Definition of Accidental Dismemberment in Texas?
Accidental dismemberment usually refers to the loss of a limb, digit, or a vital sense as the direct result of an accident. Policies often specify which losses qualify, such as:
- Loss of one or more limbs
- Loss of eyesight in one or both eyes
- Loss of speech or hearing
- Paralysis
Each type of dismemberment may entitle the insured to a different percentage of their policy’s total payout.
ERISA vs. Non-ERISA AD&D Claims
Non–ERISA policies, which are typically purchased directly from an insurer, are governed by state law and allow policyholders to recover a wide range of damages. In contrast, ERISA policies are provided through employment and fall under the federal Employee Retirement Income Security Act (ERISA).Â
ERISA rules require claimants to follow a strict administrative appeal process before going to court, and they limit the types of damages that can be recovered. For these reasons, it’s critical to work with attorneys who have experience with ERISA claims.
Common Reasons AD&D Claims Are Denied
Insurance companies often look for ways to minimize or deny AD&D claims. Common reasons for denial include:
- Exclusions in the policy: Your policy may not allow you to pursue compensation for accidents involving intoxication, drug use, or hazardous activities.
- Disputes over cause of death or injury: Insurers may argue the loss was caused by illness or preexisting conditions rather than an accident.
- Insufficient documentation: A lack of supporting documentation can give insurers grounds to reject your claim.
- Late filing: Missing deadlines for notifying your insurer or submitting paperwork can result in a denial.
What Happens if My AD&D Claim Gets Denied?
If your AD&D claim gets denied, you still have options. Start by:
- Reviewing the denial letter to understand the insurer’s reasoning
- Collecting additional evidence, such as medical records, accident reports, or expert opinions
- Consulting an attorney who can challenge the insurer’s interpretation of the policy and help you file an appeal
Why Choose Our Arlington Accidental Death and Dismemberment Attorneys?
When it comes to recovering benefits under an accidental death and dismemberment policy, you want experienced legal counsel on your side advocating for you.
At ERISA Insurance Claim Attorneys, we have a strong track record of success settling and litigating these cases. We understand the pain of losing a loved one and are not afraid to appeal an insurance company’s decision (or litigate it in the court system) to pursue the full benefits you deserve.
What to Do After an Accidental Death or Dismemberment
If your family has suffered an accidental death or dismemberment, these steps will be crucial to a successful claim:
- Notify the insurance company promptly so you don’t miss any filing deadlines.
- Gather documentation, including death certificates, medical records, and accident reports.
- Avoid signing insurance forms without a lawyer, as they may limit your rights.
- Consult a lawyer to discuss your case and go over the next steps.
Speak to an Arlington Accidental Death and Dismember Lawyer
Dealing with the aftermath of an accident that causes death or serious injury can be overwhelming. Insurance companies often delay, deny, or underpay claims, which can leave families struggling to cover expenses at the worst possible time.
If you find yourself in this situation, an experienced Arlington accidental death and dismemberment attorney from ERISA Insurance Claim Attorneys can step in to negotiate a fair settlement and, if necessary, help you file an appeal.
Schedule a free consultation to find out how you can secure the benefits you and your family are entitled to.
Call or text (225) 201-8311 or complete a Free Case Evaluation form