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Accidental Death and Dismemberment Insurance Attorney

Accidental Death & Dismemberment (AD&D) insurance is a supplement life insurance policy that will pay benefits if the insured dies in an accident. The policy may also pay lesser amounts for the loss of sight, hearing, or a limb. AD&D is much cheaper than traditional life insurance, but it is only an add-on to whole or term life insurance, not a replacement for them.

Despite the allure of such policies, many individuals find they are unable to obtain the benefits they are entitled to. If this has happened to you or your family, it may be in your or their best interest to contact an accidental death and dismemberment insurance lawyer. A compassionate ERISA attorney could advocate for you or your loved ones.

The law firm of J. Price McNamara ERISA Insurance Claim Attorney handles only life insurance, accidental death and dismemberment insurance, and other insurance matters. Since this is our sole area of focus, you can rely on us for unmatched legal counsel and support, and we promise to do all we can to help you get the full amount of benefits you deserve.

Contact our law firm today at 225-201-8311 or fill out our contact form to request a free consultation.

Why Choose Us as Your Accidental Death and Dismemberment Insurance Lawyer

Experienced ERISA and insurance attorney J. Price McNamara founded our law firm in 1995 with a mission to deliver the highest level of representation possible to individuals and families struggling to get their rightful insurance benefits.

Attorney McNamara has lost immediate family members due to debilitating illnesses. He understands the importance of having disability and life insurance policies and how not having benefits–or not being able to get them–can severely impact the lives of everyone involved.

For more than 30 years, we have helped thousands of clients throughout Louisiana, Texas, and beyond with their complex accidental death and dismemberment insurance and ERISA claims. We have obtained a $1.3 million trial verdict award in an ERISA accidental death and dismemberment insurance case, and we have secured many other six- and seven-figure settlements and jury verdicts for our clients.

Attorney McNamara has received many top attorney rankings from prominent legal organizations and publications, and he has received superb 10.0 client ratings on Avvo. Our law firm also holds an A+ rating with the Better Business Bureau, and we have gained a reputation for excellence, integrity, and professionalism.

You can be confident knowing we have your and your family’s best interests at heart, and we will do all we can to hold the insurance companies accountable and help you get all you deserve.

Contact J. Price McNamara ERISA Insurance Claim Attorney at 225-201-8311 to speak with us about your case at no cost.

What Does AD&D Insurance Cover?

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No one likes to think about their own death or dismemberment, but since these unfortunate accidents do happen, it is best to plan ahead and ensure your loved ones are financially protected if the worst happens. To ensure financial stability in the event of accidental death, many people choose to purchase accidental death and dismemberment insurance governed by ERISA.

As its name suggests, this type of policy provides financial benefits to a beneficiary if a policyholder is killed or dismembered in an accident. If your policy is sponsored by your employer, it is likely reinforced by the Employee Retirement Income Security Act of 1974 (ERISA).

Accidental death and dismemberment (AD&D) insurance policies provide policyholders and their beneficiaries with a lump sum of money in the event the policyholder dies of an accident or loses their hearing, vision, or limbs. These types of insurance policies are usually purchased in addition to regular life insurance, and they are relatively low-cost when compared to other types of insurance.

Unlike regular life insurance, which provides coverage for all types of deaths, AD&D only provides coverage for certain types of death. AD&D insurance sometimes allows for a scenario known as “double indemnity,” meaning it often pays out up to twice or sometimes three times the amount of a normal life insurance policy.

AD&D Is Not The Same As Life Insurance

Life insurance is a contract between an insurance company and an insured. In return for the insured’s payment of premiums, the insurance company will pay benefits to a designated beneficiary upon the insured’s death. Life insurance policies can be either whole or term. A whole life insurance policy offers lifelong benefits and builds a cash value where premiums build over time. Term life insurance offers benefits for a specified period of time and does not have a cash value—beneficiaries will receive their benefits if the policyholder dies within the timeframe.

Term life insurance is typically cheaper because all the premiums go to the insurance cost. Still, the cash value policy may provide greater benefits over the long run by allowing you to access the cash value in various ways.

In either case, the deal is the policy owner pays premiums, and, upon the insured’s death from almost any cause, the insurance company pays the required benefits. Death by suicide close to the purchase date of the policy or by acts of war is generally excluded from benefits, as are some high-risk activities. But, in general, no matter how you die, standard life insurance pays the beneficiary.

By contrast, AD&D pays only in the event of accidental death or loss. If a truck T-bones you at an intersection, the AD&D policy should pay. However, if you have a massive heart attack, it may not. Since insurance companies are profit-making institutions seeking to take in more premium dollars than they pay out in benefit dollars, they prefer to deny your claim if they can. They will seek to find an intervening non-accident clause or at least try to argue that your injury did not result from an accident.

Do AD&D Policies Have Exclusions?

As limited insurance policies, AD&D policies often exclude several conditions or actions from coverage under the policy. Insurers often word these exclusions in a manner that gives them a lot of room to interpret the exclusions and deny coverage.

Some of these exclusions are:

  • Injury caused or exacerbated by a pre-existing medical condition
  • Inappropriate use of alcohol as a factor in the death
  • Abuse of prescription or recreational drugs as contributing to the accident
  • Medical treatment of the injury rather than the accident caused the death
  • The injury happened due to an act of war or terrorism
  • The injury happened while the insured engaged in a felony offense

The wording of the exclusions may favor the insurance company, but don’t trust the insurance company’s word if it claims the policy excludes you. You will want an experienced AD&D lawyer who can verify whether those exclusions apply to you and fight for the benefits you deserve if they do not.

Dealing With Claim Denials

It may be necessary to hire an ERISA accidental death and dismemberment insurance attorney if the insurance company attempts to claim a policyholder caused their own accident or death. This is a common practice meant to deter policyholders from taking legal action.

Insurance companies–even those overseeing plans governed by ERISA–may attempt to avoid paying by alleging the policyholder was killed in one of the following ways, any of which would preclude payment on an AD&D policy:

  • Suicide or attempted self-injury
  • Complications from an existing medical condition
  • Reckless or irresponsible behavior
  • Prescription or illicit drug abuse

Some insurance companies may also attempt to deny coverage by claiming the beneficiaries waited too long after the policyholder’s death to file a claim. Dealing with insurance companies can be frustrating, but it is possible to fight back against their deceptive practices.

A Lawyer May Prove Incontestability to Help You Get Benefits

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The ERISA insurance claims process can be very confusing, especially for individuals who have never had to deal with a major insurance company before. Often, insurers deny claims due to a lack of information or missing facts. Important documents can be misplaced or filled out incorrectly, and a single mistake can result in a denial from an insurer.

When an insurer denies a claim due to insufficient information or errors, an ERISA accidental death and dismemberment insurance lawyer may be able to claim incontestability, especially if the insurer continued to collect premiums even after the erroneous information was submitted and processed. This is also a common practice employed by insurers.

FAQs Accidental Death & Dismemberment Insurance

Q. Is accidental death & dismemberment insurance the same as term life insurance?

A. No. Term life insurance is a life insurance policy that covers any cause of death (except for a few limited exclusions like suicide close to the purchase or acts of war). It does not build cash value like whole life insurance, but if the insured dies, the policy should, in good faith, pay the designated beneficiary. On an AD&D policy, the death or dismemberment must result from an accident and not from any other cause. Most insurance companies seeking to deny a claim will begin will assert the cause of death was not an accident.

Q.: How will the beneficiary of an AD&D policy receive payment?

A.: Once the insurance adjuster has investigated and approved the claim, the insurance company will make a lump-sum payment to the beneficiaries. Whether the payment is tax-free or not depends on whether you bought your policy or obtained it through your employer.

Q.: Does an AD&D policy cover an unexpected catastrophic illness?

A.: No. An AD&D policy covers only accidental deaths or dismemberment. The insurance company will deny any claim based on any injury caused by something other than an accident.

Q.: What does the “dismemberment” part of an AD&D policy refer to?

A.: An AD&D policy provides coverage for accidental death or dismemberment. Your policy will define the conditions that constitute dismemberment and what benefits you will receive from them. Using a $10,000 policy as an example, typical provisions are:

Accidental Injury Benefit to Be Paid

  • Loss of life: $10,000
  • Loss of one arm at or above elbow: $7,500
  • Loss of one leg at or above knee: $7,500
  • Loss of one hand or one foot: $5,000
  • Loss of thumb and index finger one hand: $2,500
  • Loss of sight in one eye: $5,000
  • Loss of hearing in both ears for six months or more: $5,000
  • Loss of speech for at least six months or more: $10,000
  • Paralysis of one arm or leg: $2,500
  • Brain damage for at least 12 months: $10,000

If more than one of the above results from the same accident, the insurer will pay the lesser of $10,000 or the sum of benefits payable for each loss.

Q.: What are the pros and cons of AD&D coverage?


  • You don’t need a medical examination to get the policy. You don’t have to answer health questions, so if you have pre-existing conditions, this is one way to have some coverage that might not be otherwise available.
  • You won’t get a health-based denial of coverage. You only have to meet the policy’s age range, which is usually between 18 and 70, 80, or 90.
  • Coverage is usually available quickly, sometimes even immediately with an online purchase.
  • AD&D can be useful for younger people who are far more likely to die of an accident than an illness.


  • The coverage is limited. It only pays in the event of an accident.
  • The policy may seem cheap, but the limited coverage means that you’re not getting much for your money. You could probably get a cheap policy to pay benefits when a dinosaur eats you, but you could invest your money more wisely.
  • Although many advisors will tell you the policies aren’t worth the money, the benefits can help after the unexpected death of the family’s breadwinner.
  • If your policy comes through your employer, you may lose it if you change jobs.
If dealing with a denied claim from CIGNA long term disability, consult with a skilled Macon insurance benefits attorney.
Accidental Death and Dismemberment Insurance Lawyer, J. Price McNamara

Receiving a denial from an insurance company can be devastating, and many policyholders and beneficiaries feel helpless and confused. Such feelings are normal in the wake of a policy claim denial, but it is important to remember you may be able to take legal action against an insurer and obtain the benefits you need to survive. Call an accidental death and dismemberment insurance lawyer today to learn more.

If your insurance company is denying your claim or delaying negotiations on your claim, let J. Price McNamara ERISA Insurance Claim Attorney help you move them along. Contact us or call (713) 300-0462 for a no-cost initial consultation on your AD&D denial case.