Kansas City Townsend Law Firm

What To Do When Your AD&D Insurance Claim is Denied?

On Behalf of | Mar 9, 2021 | Bad Faith Insurance

When people get life insurance or other types of insurance coverage, they want to ensure they can have peace of mind that they, or their loved ones will be taken care of if anything happens. An additional type of insurance policy some people choose to get is called accidental death and dismemberment insurance (AD&D or AD&D Policy). These types of insurance policies are also available through employers, though they are governed by ERISA. The AD&D benefits the policyholder is entitled to will vary greatly, and while submitting an accidental death claim is already stressful enough, when there is a claim denial of insurance benefits it can sometimes feel like too much to bear.

There are times when insurance carriers refuse to pay a life insurance claim or settlement when an appropriate AD&D claim is made. At Townsend Law LLC, our Kansas City insurance bad faith attorneys are ready to help if you are struggling to secure compensation from an insurer for an AD&D claim denial.

What is AD&D Insurance?

Accidental death and dismemberment insurance (AD&D) is usually a rider attached to a health insurance or life insurance policy. As the name suggests, this rider will cover unintentional death or dismemberment costs that arise for the person who is insured under the AD&D benefits. Accidental death benefits are typically paid to surviving family members. Dismemberment benefits include compensation for:

  • the loss of body parts
  • the loss of use of body parts or functions

Accidental death insurance benefits are not designed for events that happen from natural causes or on-going medical conditions, like heart attacks or strokes, unless those happen or the cause of death is as a direct result of an accident. Your medical records need to match the circumstances around the accidental death or dismemberment, and the death certificate must match up as well. AD&D coverage is designed for events that happen beyond your control, and is truly an accident.

Filing an AD&D Claim

To properly file your AD&D Claim you will need copies of complete medical records, death certificate, autopsy report and any other relevant documentation to prove that what happened was a result of an accident and not due to natural causes or existing medical conditions.
Having the proper documentation will help when dealing with the insurance company, life insurance company, long term disability or other entities that are there to provide a payout. Having all of the documents up front will help avoid any misrepresentation, or what the insurance company may view as misrepresentation.

Bad Faith Insurance Claims For AD&D

Just like any other insurance policy, insurance companies have a duty to pay out a settlement when a legitimate claim is made by the insured person. However, there are times when an insurer wrongfully denies a claim to the policyholder, fails to properly investigate an incident or fails to defend the insured when a claim is made.

If you or a loved one make an AD&D claim that is denied by the insurance carrier, you may have to file a lawsuit in order to recover the compensation you are entitled to. The first step to take is to secure an attorney who can review your policy and ensure that you should indeed be covered for the claim.

Your attorney will examine your case and file a demand letter with the insurance carrier requesting prompt payment for the claim. If the insurance carrier still denies a claim, it may be necessary to file a complaint with the Missouri Department of Insurance. The claim will likely then move to mediation where both sides will work to come to a resolution.

However, if a claim is still not settled, it may be necessary to file a bad faith insurance lawsuit against the insurance carrier. Your attorney will have a thorough understanding of this process and handle your entire case for you.

We Are Here To Help You Through This

If you or someone you know has made a claim on their AD&D insurance, but that claim has been denied or delayed, seek legal assistance as soon as possible. At Townsend Law LLC, our qualified and experienced team thoroughly understands Missouri insurance laws.

Our law firm will investigate your case and work to ensure you receive the compensation you are entitled to. This can include the rightful coverage you should receive for your claim based on your policy. We will also pursue punitive damages against your insurance carrier. When you need legal advice from a Kansas City bad faith insurance attorney, or overall help learning how to file a personal injury lawsuit, you can contact us for a free consultation by clicking here or calling us at 816-408-6476.