Accidental Death Claim Denied? We Can Get it Paid.
Accidental Death claims are some of the most difficult claims to get an insurer to pay. We have decades of experience getting these claims paid to our clients. Contact us for help with your claim.
The Investigation Process of Accidental Death Claims
Accidental death benefit insurance provides a cash payment to the insured’s beneficiary when the insured dies from an accident. An accident can be anything from a car crash to falling down. Once a claim has been filed the insurance company’s Claims department opens an investigation. This is standard practice for all accidental death benefit claims. The Claims department will then go about their investigation as to the cause of death and whether anything else contributed to the death.
They will review the Certified death certificate, the Medical Examiner’s Report and the complete health records of the deceased. Logic would dictate that the insurer would investigate the insured before they offer the coverage and accept premium payments, but they don’t. Every accidental death claim is investigated. Every beneficiary should have their own AD&D expert handling their side of the claim.
Policy Exclusions
Accidental death policies have many exclusions (intoxication, pre-existing medical conditions, …) and always have the stipulation that the death must be the result of an accident. What surprises most beneficiaries of accidental death benefit policies is that even when the death certificate states the cause of death as “accidental”, the claim will likely be denied.
What accompanies the death certificate is the Medical Report. This identifies the cause of death in medical terms. While death from falling may be an accident on the Death Certificate, it may be defined as an aneurism on the Medical Report. The denial of most accidental death claims is due to a common link between the health history of the deceased and the Medical Examiner’s Report.
Once an accidental death claim is made the investigator immediately starts looking for ways to link the medical cause of death to a medical condition that existed while the insured was alive – even if the insured didn’t know one existed.
The unfairness of this post-death investigation is that it’s rarely conclusive but it’s used as the common reason for a claim denial. It is like the proverbial question of which came first, the chicken or the egg? The insurance companies take advantage of the fact that it’s impossible to prove whether a past event or the accident triggered a bodily reaction that ended in death. Their approach seems to be that if the beneficiary cannot disprove something, then how can they argue the matter? Thereby, most accidental death benefit claims are denied.
“The death certificate states the cause of death was Accidental, but the insurer denied my claim. Can the Center for Life Insurance Disputes help me?”
Yes! We’ve successfully appealed many accidental death claims that were initially denied due to exclusions in the policy.
Naturally, insurance companies will argue that they never intend to deny valid accidental death claims. But when they offer one million dollars of coverage for a premium of only eight dollars per month, they cannot afford to pay very many claims or they will be out of business.
The Center for Life Insurance Disputes represents beneficiaries of accidental death claims.
There are two ways you can benefit from our representation: 1) while your claim is being investigated, and 2) after your claim is denied.
If you have not yet submitted the claim, we’ll prepare the claim for submission to the insurer. In this way we can investigate the facts and address any reasons an insurer may use to deny a claim. Our success in getting accidental death benefit claims paid is due, in large part, to our ability to anticipate the likely reasons a claim will be denied and to substantiate why they cannot be used against the claim.
If your AD&D claim has been denied you need an expert to investigate the facts surrounding the claim, the death and how matters were handled that led to the denial. Insurers typically only investigate far enough to deny a claim, not to look for mistakes that could justify a payout. We do!
We know how to get accidental death claims paid. We’ve been doing this for 30 years with great success.
Many people think they have to have an attorney to fight an AD&D claim claim that’s been denied, but that isn’t true. If you have the right facts and evidence, an AD&D claim can be fought and won. We know exactly what the necessary “facts” and “evidence” are. That’s how we’ve recovered more than $250 million for our clients. If you’re not sure who to trust or what to do, call us. We’ll be happy to speak with you about your claim and answer your questions – at no charge. We have experience with almost every possible claim issue and we’re sure we can help you resolve yours.
Contact us now.
Also Read:
Accidental Death Claim Pays Out $150,000 Based on Our Investigation
Another Accidental Death Claim Successfully Paid Based on Our Report to Insurer
