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Handling wrongfully denied AD&D claims

On Behalf of | Aug 22, 2023 | accidental death and dismemberment (AD&D)

Navigating the aftermath of a denied accidental death and dismemberment claim can be challenging, especially while experiencing grief and loss. Knowing the essential factors related to the appeal process can significantly assist you in advocating for your rightful benefits.

The first step in the appeal process is thoroughly understanding why your claim was denied. Insurance companies are required to provide a detailed explanation for the denial. The denial could be due to various reasons, such as policy exclusions, alleged misrepresentation or failure to meet the policy’s definition of an accident that would require payment of benefits.

Examine the insurance policy closely

Carefully review the terms and conditions of your policy. It’s crucial to understand the definitions, exclusions and requirements laid out in the policy. If the denial conflicts with the policy terms or there’s room for interpretation, this could form the basis for your appeal.

Timeliness is critical

After a denial, there’s typically a limited timeframe within which you can appeal the decision. This can vary depending on your policy and applicable laws, but acting promptly is generally essential. Failure to appeal within the specified timeframe can result in a forfeiture of your right to challenge the denial.

Collect supporting documentation

Your appeal should be supported by as much relevant documentation as possible. This can include medical records, accident reports, witness statements and other evidence backing your claim. A well-documented appeal can increase your chances of a favorable outcome.

Having someone who understands this process can help you learn about your options and develop a plan to move forward. Ultimately, you have the right to fight for the benefits that you’re due.