If you suffer a serious injury, or a loved one dies because of a tragic accident, you may feel overwhelmed by what happened. At some point, you realize that long ago, you or your loved one signed up for accidental death and dismemberment (AD&D) coverage at work. So, now you want to file a claim because you lost vision in one eye or you don’t have the income of your loved one anymore. You assume your claim will be approved without any problems.
However, then the letter comes: The AD&D insurance company has denied your claim. What are you supposed to do now?
AD&D claim basics
It’s not unusual for insurance providers to deny accidental death and dismemberment claims, for several different reasons. Some of those include the following:
- You or your loved one had a pre-existing condition or illness that contributed to your disability or your loved one’s death.
- Medical treatment you received led to your disability or medical care your loved one received contributed to their death.
- There is evidence you or a loved one was drunk or under the influence of a drug and that contributed to the accident, injury or death.
- The accident that occurred is part of the AD&D policy’s exception list.
When an AD&D claim is denied
If an insurer denies your accidental death and dismemberment claim, you should consult an attorney with experience in this area. The Employee Retirement Insurance Security Act (ERISA) allows for appeals of AD&D claim that workplaces help fund. An attorney can help you gather hard evidence to support your AD&D claim appeal. An attorney also can ensure you follow the appeal process correctly and meet the required deadlines.
You need the AD&D benefits after a serious, disabling injury or the loss of a loved one in an accident. With help, you can receive the benefits you deserve from a workplace accidental death and dismemberment (AD&D) policy.