Losing a loved one or suffering a serious injury can feel overwhelming—especially when your insurance company denies or delays the benefits you’re entitled to.
At ERISA Insurance Claim Attorneys, our Houston accidental death and dismemberment lawyer brings over 30 years of experience fighting for clients under employer-sponsored insurance policies governed by ERISA.
We provide compassionate, one-on-one support at every stage, from filing claims to appeals and federal court litigation. Our Houston insurance claims lawyer offers personalized legal services. Contact us today for a free initial consultation.
What is Accidental Death and Dismemberment Insurance?
Accidental death and dismemberment (AD&D) is a type of rider added to either a health insurance or life insurance policy that can cover the costs of unintentional death or dismemberment. Insurance companies define dismemberment as the loss or loss of use of a body part.Â
Under this type of insurance coverage, beneficiaries can receive particular terms and percentages under exceptional circumstances. These policies are governed by the Employee Retirement Income Security Act (ERISA) of 1974.Â
For a free legal consultation with an accidental death and dismemberment lawyer serving Houston, call (225) 201-8311
Examples of Accidental Death
If the policyholder dies accidentally, the assigned beneficiaries are allowed to receive benefits through an employer-provided AD&D insurance plan.
Some fatal incidents covered through this type of rider include:
- Traffic accidents
- Exposure to the elements
- Homicide
- FallsÂ
- Drowning
- Accidents that involve heavy equipment
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Examples of Dismemberment
An AD&D rider provides a percentage of benefits to the policyholder for the loss of a limb or body function after severe injuries. The types of dismemberment and the extent of injuries covered can be defined by and included in each policy.
Some examples of dismemberment that a policyholder can have covered through their policy include:
- Temporary or permanent paralysis
- Loss of a body part
- Loss of use of specific body parts
- Loss of sight
- Hearing loss
- Loss of speech
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Are there Other Types of Accidental Death and Dismemberment Policies?
There is a voluntary accidental death and dismemberment insurance policy that is a limited form of life insurance. AD&D is an optional insurance plan that can provide a policyholder’s beneficiaries with cash when the policyholder accidentally dies or loses specific body parts.
The premiums depend on the amount of insurance. Workers whose occupations place them at risk of severe physical injury often purchase these policies, which are renewed periodically.
How Much Do Voluntary AD&D Insurance Policies Pay?
A voluntary AD&D insurance policy pays based on the amount of coverage purchased and the type of claim filed. The policy may pay 100% if the policyholder is killed or becomes paralyzed and 50% to a policyholder who suffered from the loss of a hand or permanent loss of hearing in one ear.
What Types of Deaths Does an Accidental Death and Dismemberment Rider Not Cover?
Every insurance policy has special considerations, and accidental death and dismemberment are no exception. Some exclusions to an accidental death and dismemberment rider include deaths from suicide, wartime civilian injuries, and natural causes.
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How Accidental Death and Dismemberment Insurance Policies Help Beneficiaries
An accidental death and dismemberment rider is also called a double indemnity rider. That means it can mirror the actual value of a policyholder’s original life insurance policy. These riders can provide a policyholder’s beneficiaries twice the face value of a life insurance policy if the policyholder dies in an accident.
The loss of a loved one or the loss of a limb is traumatic and full of grief. While nothing can emotionally make up for this loss, accidental death and dismemberment riders can help lessen the financial burden it causes.
Affordable Premiums
Another benefit of accidental death and dismemberment riders is that the premiums are often inexpensive. This low price is because the coverage is limited to only particular events that can cause fatalities or the loss of a limb.
Individuals can purchase these riders through their employer-offered insurance policies or privately through their life insurance policies. How they buy them will affect the claims process. Regardless, the costs are still considerably lower than premiums for life insurance policies that offer the same value.
How to Determine Accidental Death and Dismemberment Coverage
Another benefit to accidental death and dismemberment riders is that the policyholder determines the coverage limits for the riders. In some policies, the policyholder can set up a benefit reduction schedule based on the policyholder’s age.Â
For example, a policyholder or their beneficiaries can receive 35% of coverage when the policyholder reaches 65. The coverage can then increase to 60% when the policyholder reaches 70, 75% when the policyholder reaches 75, and 85% when the policyholder reaches 80.
Should Policyholders Pay for Accidental Death and Dismemberment Riders Without a Life Insurance Policy?
Even though these benefits are great for policyholders, individuals should still purchase life insurance policies and avoid treating these riders as replacements for life insurance.
If a policyholder dies from a natural cause without a life insurance policy, the beneficiaries may receive few benefits. The same is true for disability benefits; these riders should not be used as replacements for disability benefits.
How Insurance Companies Deny Accidental Death and Dismemberment Claims
Insurance companies challenge or deny a policyholder’s AD&D claims by making allegations based on weak or nonexistent evidence. Because there are several exclusions to a policy, insurance companies will try to insinuate that your loved one’s death resulted from one or several exclusions.
Another common tactic that insurance companies will use to deny your AD&D claim is to insinuate that your loved one’s death was not accidental. The insurance company may challenge that they died from a natural cause like a stroke or a drug overdose.
Even though there are differences between life insurance policies and AD&D riders, insurers may use the same tactics during the life insurance claims process for beneficiaries.
How a Houston, Texas, Accidental Death and Dismemberment Insurance Lawyer Can Help
You or your loved one have put specific policies in place to help your beneficiaries in a fatal accident. When that deadly accident happens, your beneficiaries deserve to receive just financial compensation. They should not have to jump through hoops with the insurance companies for the benefits they’re legally entitled to.
With a Houston accidental death and dismemberment insurance lawyer on your side, your beneficiaries will have a sympathetic legal advantage against the insurance companies. Even though a range of insurance disputes can arise, our Houston AD&D insurance lawyer helps clients in insurance litigation.
Devise Strategies Against the Insurance Company’s Tactics
An accidental death and dismemberment insurance lawyer brings creative strategies to combat the insurance company’s tactics. AD&D lawyers know the reasons insurance companies will use to deny claims and how to challenge each one.
Our Houston AD&D attorney will also understand what evidence to use to argue against the insurance company’s weak allegations.
Review Your Accidental Death and Dismemberment Rider
Another benefit that an experienced accidental death and dismemberment lawyer brings to the table is the ability to reevaluate your rider. Insurance companies will try to deny your AD&D claim by insinuating that your rider does not cover the type of accidental death that resulted in your loved one’s untimely demise.
Our experienced accidental death and dismemberment lawyer can review your rider and determine whether an exclusion applies to your claim.
Increase the Chances of Receiving Benefits Despite Exclusions
Even in cases where exclusions may apply, an experienced accidental death and dismemberment lawyer can increase your beneficiaries’ chances of recovering their benefits for their claim. Insurance companies may expect you to be confused by the legal jargon and technical language and believe their assertions are the supposed exclusions to your rider.
An experienced accidental death and dismemberment lawyer can add clarity to the legal jargon. They’ll explain how you or your beneficiaries can still receive benefits in light of any exclusion to the rider.
File an Appeal in Response to the Denial of Your Claim
Seasoned accidental death and dismemberment lawyers can also help your beneficiaries if they want to appeal their claim.Â
The Houston accidental death and dismemberment lawyer from ERISA Insurance Claim Attorneys can assist with the life insurance claim process. We’ll gather the necessary documentation for your appeal.
Represent Your Beneficiaries in a Potential Lawsuit
Your accidental death and dismemberment lawyer also offers crucial legal representation in case your claim proceeds to a jury trial. Our attorney can help with a lawsuit by:Â
- Gathering the necessary evidence
- Ensuring that the compensation you request fully covers your benefits
- Preparing challenges to any arguments that the insurance companies may make
An experienced accidental death and dismemberment lawyer can increase your beneficiaries’ chances of receiving their desired verdict.
Get Help from Our Houston Accidental Death and Dismemberment Lawyer Today
It can be devastating when you or your beneficiaries receive a denial for your accidental death and dismemberment claim. However, you still have options.Â
At ERISA Insurance Claim Attorneys, our Houston accidental death and dismemberment lawyer is ready to assist you with protecting your legal rights. Our team is here to help you pursue the financial compensation you need to move forward.
Contact us for your free initial consultation.
Call or text (225) 201-8311 or complete a Free Case Evaluation form