While some people have mixed emotions regarding death, it is better to prepare for the worst-case scenario. If you die from an unfortunate accident or suffer the loss of a limb, what type of coverage do your beneficiaries have? For many people, an insurance policy coverage known as accidental death and dismemberment provides benefits for these exact situations.
When you or a loved one have suffered an accidental death or the loss of a limb, accidental death and dismemberment insurance might refuse to pay the benefits your family deserves.
An experienced Houston accidental death and dismemberment lawyer from J. Price McNamara ERISA Insurance Claim Attorney can help advocate for the benefits that you and your loved ones deserve.
Our law firm has had a dedication to representing clients with disabilities, injuries, and other losses since 1995, and we are ready to evaluate your situation. We have obtained many successful results for our clients, and we can assist you or your family in seeking the benefits you deserve.
Do not hesitate to contact us for a Free Denial Review to discuss your circumstances and how we can help.
Table of Contents
- What are accidental death and dismemberment?
- Examples of accidental death
- Examples of dismemberment
- Are there other types of accidental death and dismemberment policies?
- How an accidental death and dismemberment insurance lawyer can help
- Talk to a Houston accidental death and dismemberment lawyer today
What are accidental death and dismemberment?
Accidental death and dismemberment is a type of rider added to either health insurance or life insurance policy. In other words, this rider can cover the costs of unintentional death or dismemberment. Insurance companies define dismemberment as the loss or loss of use of a body part. Through this type of insurance coverage, there are particular terms and percentages that beneficiaries can receive under exceptional circumstances.
Examples of accidental death
Through an accidental death and dismemberment rider, the assigned beneficiaries are allowed to receive benefits if the policyholder dies accidentally.
Some of the accidental deaths covered through this type of rider include:
- Traffic accidents
- Exposure to the elements
- Homicide
- Falls drowning
- Accidents that involve heavy equipment
Examples of dismemberment
In addition to accidental death, the AD&D rider provides a percentage of benefits to the policyholder for the loss of a limb or body function. The types of dismemberment and the extent of injuries covered can be defined and included by each policyholder and 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
Are there other types of accidental death and dismemberment policies?
In addition to accidental death and dismemberment, 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 who perform in occupations that place them at risk of severe physical injury often purchase this insurance. These policies renew 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 percent if the policyholder is killed or becomes paralyzed and 50 percent 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 injuries, and deaths from natural causes.
Other exclusions include deaths from an overdose of toxic substances, deaths due to the influence of nonprescription drugs, and the death of a professional athlete during a sporting event. Most policies also exclude deaths resulting from a felonious act on the policyholder’s part from the policy.
How accidental death and dismemberment insurance policies help beneficiaries
An accidental death and dismemberment rider is also called a double indemnity rider. That means the rider can mirror the actual value of a policyholder's original life insurance policy. These riders can provide a policyholder's beneficiaries twice the amount of a life insurance policy's face value if the policyholder dies in an accident. Although the loss of a loved one or the loss of a limb is traumatic and full of grief, accidental death and dismemberment riders can help lessen the financial burden of the loss.
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 accidental death or loss of a limb.
Individuals can purchase these riders through their employer-offered insurance policies or buy them privately through their life insurance policy. How they buy them will affect the claims process.
In any case, the costs are still considerably less 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. For example, a policyholder or their beneficiaries can receive 35 percent of coverage when the policyholder reaches 65. The coverage can then increase to 60 percent when the policyholder reaches 70. The coverage can then increase to 75 percent of coverage when the policyholder reaches 75 and 85 percent when the policyholder reaches 80 years of age.
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 not treat these riders as a replacement for life insurance. Accidental death and dismemberment riders are great for deaths that occur from unforeseen accidents but do not offer coverage for deaths that result from natural causes, which are still the primary causes of death for individuals in the United States.
If a policyholder dies from a natural cause without a life insurance policy, the beneficiaries may receive few benefits. It is the same for disability benefits; these riders should not be used as replacements for disability benefits as well.
How insurance companies deny accidental death and dismemberment claims
When a policyholder suffers accidental death or dismemberment, the beneficiaries can receive a set amount of money. After the AD&D claim concludes, the insurance company will pay the coverage amount to the beneficiaries in one lump sum payment. The beneficiaries of the policyholder can receive financial compensation without having to wait.
Unfortunately, the insurance companies may stall the process by challenging or denying the policyholder’s AD&D claims.
Making allegations based on weak evidence
One of the methods that insurance companies will use to try to deny your AD&D claim is to make allegations based on weak or nonexistent evidence. Because there are several exclusions to an accidental death and dismemberment rider, insurance companies will try to insinuate that your loved one’s death resulted from one or several exclusions.
One of the typical situations where this happens is when the policyholder's death does not immediately follow the accident. For example, if a policyholder dies weeks or months after their accident, insurance companies will insinuate that other circumstances led to your loved one's death. Even more tasteless, the insurance companies may imply that your loved one's death resulted from their negligence.
Challenging your loved one’s accidental death
Another common tactic that insurance companies will use to deny your AD&D claim is to insinuate that your loved one’s accidental death was not accidental. The insurance company may challenge that your loved one’s death resulted from a natural cause like a stroke or a drug overdose. Even though there are differences between life insurance policies and AD&D riders, insurance companies use the same tactics to avoid paying claims out to policyholders and their beneficiaries.
How an 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 the financial compensation they deserve. They should not have to jump through hoops with the insurance companies for their just benefits.
With an experienced accidental death and dismemberment insurance lawyer on your side, your beneficiaries will have a sympathetic legal advantage against the insurance companies. Even though insurance companies will still resort to certain tactics, the success of those tactics will dwindle if an experienced AD&D insurance lawyer is in your corner.
Devise strategies against the insurance company’s tactics
A seasoned accidental death and dismemberment insurance lawyer bring creative strategies to combat the insurance company's tactics. Seasoned accidental death and dismemberment lawyers know the reasons insurance companies will use to deny claims and how to challenge each reason. Accidental death and dismemberment lawyers will also understand what evidence to use to challenge 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. Another way that insurance companies will try to deny your AD&D claim is to insinuate that your rider does not cover the type of accidental death that resulted in your loved one’s untimely demise.
An experienced accidental death and dismemberment lawyer can review your rider and ensure you receive the full coverage of the benefits you deserve. Experienced accidental death and dismemberment lawyers 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 and 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. Your Houston accidental death and dismemberment lawyer from J. Price McNamara ERISA Insurance Claim Attorney can assist with the claim process and gather the necessary documentation for your appeal.
Represent your beneficiaries in a potential lawsuit
Another benefit that your accidental death and dismemberment lawyer provides is your legal representation in case your claim proceeds to trial. Your seasoned attorney can help gather the necessary evidence, ensure that the compensation you request is full coverage of your benefits, and prepare 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.
Talk to a 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. Your best option is to contact an accidental death and dismemberment insurance lawyer at J. Price McNamara ERISA Insurance Claim Attorney. Our Houston accidental death and dismemberment lawyers are ready to assist you with protecting your legal rights and obtaining the compensation you deserve.
Contact us by calling our office at (713) 300-0462 or filling out our contact form for your free initial consultation with our Houston accidental death and dismemberment lawyer.
Houston Office
2000 Crawford St
Suite 1649
Houston, TX 77002
Phone: (713) 300-0462
Fax: (225) 201-8313 (By Appointment)
Our Testimonials
"Price is very professional, honest, and reliable. Whatever he says, he will follow through with the utmost integrity. He will turn over every stone and pays close attention to even the smallest detail."
A Testament of our Excellence
