You lose a family member in a tragic accident. Following this incident, you file an accidental death & dismemberment (AD&D) claim, and you anticipate immediate approval.
Unfortunately, the insurance company denies your claim. At this point, ask for help from an accidental death & dismemberment lawyer in North Carolina who will prioritize your claim.
J. Price McNamara: Disability, Life, AD&D Insurance Attorneys has a team in place with over 30 years of combined experience. We make it easy to connect with an insurance claims lawyer in North Carolina who will get to the root of your denial and appeal on your behalf promptly. To learn more, schedule a free case evaluation.
Why You Should Get Legal Help If Your Accidental Death & Dismemberment Claim in North Carolina Was Denied
You know that your family member was covered under an accidental death & dismemberment policy. Regardless, when you file a claim as you cope with your devastating loss, their insurer disputes your request. With an accidental death & dismemberment attorney in North Carolina, you are well-equipped to contest the insurance company’s case.
Expect your attorney to review your late family member’s AD&D policy and provide you with insights into what it entails. From here, your lawyer can start your appeal.
They may gather evidence to support your claim. Plus, they can make sure that your appeal is filed before the window in which you’re legally permitted to do so closes.
For a free legal consultation with an accidental death and dismemberment lawyer serving North Carolina, call (225) 201-8311
How to Appeal a Denied AD&D Claim
If you’re thinking about appealing a denied accidental death & dismemberment claim, remember, the things you do now could affect you for years to come.
Thus, it may be beneficial to get a North Carolina accidental death & dismemberment lawyer on your side. Your attorney can walk you through the appeals process, which consists of these steps:
- Read the Denial Letter with Your Lawyer: Together, you and your attorney can find out why your claim was denied and prepare your appeal accordingly.
- Ask for Your Claim File: Request all of the records that the insurance company used to evaluate your claim.
- Collect Evidence: Obtain coroner reports, autopsy results, witness statements, and medical records, as these can help you prove that your family member’s death was accidental.
- Adhere to Your Policy‘s Deadlines: Submit your appeal right away, or you could wind up missing the deadline for disputing the insurer’s denial.
You may be tempted to report insurance fraud if your AD&D claim is rejected. Ultimately, your lawyer may advise you to see your appeal through to the end, without having the North Carolina Department of Insurance investigate potential fraud.
With your attorney’s help, it may be difficult for the insurer to validate its decision. Therefore, your initial claim denial could be overturned.
North Carolina Accidental Death And Dismemberment Lawyer Near Me (225) 201-8311
Challenges That You Could Face if You Appeal a Denied AD&D Claim
Just because you appeal a denied accidental death & dismemberment claim doesn’t guarantee that the insurance company will reverse their denial.
Your insurance claims attorney knows the tactics that insurers will use to dispute and reject benefits requests. They can help you overcome various challenges that could come up during your appeal, such as:
Burden of Proof
You have no idea what is considered an accidental death and what evidence you’ll need to prove that your claim is legitimate. Thankfully, your attorney can retrieve proof based on the insurance company’s definition of an “accident.” By doing so, you may meet the burden of proof for getting your benefits request approved.
Medical Causation Dispute
The insurance company could argue that your family member’s death was the result of a preexisting medical condition, not an accident. In this situation, your lawyer will get medical records and other evidence to show that this condition had nothing to do with the loss of your loved one.
Policy Exclusions
Insurance companies may cite a policy’s exclusions as justification for denying AD&D claims. For instance, in your case, the insurer may say that alcohol voids accidental death coverage. If this happens, your lawyer can poke holes in the insurer’s argument to the point where it becomes tough for the business to continue to justify your claim denial.
The challenges that can arise during the appeals process may feel overwhelming, but you don’t have to deal with them alone. If you have insurance claims lawyers who’ve earned dozens of positive client testimonials at your disposal, you’re in a great position to get the results you want out of your appeal.
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How an Insurance Company Will Respond to the Appeal of Your Denied AD&D Claim
After you appeal, the insurance company will review your claim once again. Ideally, the business sees that your claim is warranted and that you have sufficient evidence to support it. When this occurs, the company may sign off on your claim.
Even if you appeal right away and provide the insurance company with a wide range of proof, the business may take measures to delay and dispute your claim. The business could acknowledge that it’s received your appeal but choose not to respond to it in a timely manner. Or, the company could continue to deny your benefits request.
Having an AD&D lawyer assist you with your appeal can make a world of difference. Your attorney is unafraid to stand up to insurance companies. They can keep you updated about the status of your appeal. If, for any reason, this appeal is unsuccessful, your attorney may encourage you to proceed with a lawsuit.
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We’re on a Mission to Restore Fairness to the Insurance Claims Process
Let a North Carolina accidental death & dismemberment attorney from J. Price McNamara: Disability, Life, AD&D Insurance Attorneys help you with appealing your denied claim. To get started, request a free case evaluation.
Call or text (225) 201-8311 or complete a Free Case Evaluation form
