AD&D Insurance Policy Exclusions Explained

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Are you considering getting an AD&D (accidental death and dismemberment) insurance policy? If so, it’s important to understand all of the potential exclusions that could be included in your policy.

AD&D policies can provide financial protection for individuals or their families if they are killed or injured in a covered accident. But depending on the type of coverage chosen, certain losses may be excluded from the policy’s protection – so it pays to know what those exclusions are before signing on the dotted line.

In this blog post, we’ll explain everything you need to know about AD & D insurance policy exclusions, including how they work and why they’re important.

ERISA attorney explains AD&D insurance policy exclusions to client after denied claim

The Cliff Notes: Key Takeaways From This Post

  • AD&D policies provide financial protection against accidental death or injury, but can have a variety of exclusions.
  • These can include intentional self-inflicted injuries, deaths resulting from natural causes, and injuries from illegal activities.
  • High-risk activities may also be excluded from coverage on an AD&D policy.
  • Exclusions can significantly impact the outcome of a claim, so it is important to understand all details of the policy before signing.
  • An experienced ERISA attorney can be invaluable in understanding insurance policies and navigating denied claims.

Quick Recap: Why Buy AD&D Insurance?

AD&D policies are a type of insurance that provides financial protection for individuals or their families if they’re killed or injured in a covered accident. The coverage can help cover medical expenses and other costs related to injury, or death.

Why Do AD&D Policies Have So Many Exclusions?

Insurance companies must carefully assess the risks associated with each policy they issue. To protect their bottom line, they limit coverage by including potential exclusions in the policy. These exclusions can vary greatly – some policies may exclude injuries or death when alcohol or drugs are involved, even when they are not the direct cause of the death or injury, while others may exclude injuries or death related to medical complications that result from the initial accident or treatment.

AD&D Policy Exclusions Related To Intentional Acts

Many AD&D policies exclude injuries or death that are the result of:

Intentional Self-Inflicted Injuries

Injuries or death that result from an intentional act of self-harm are typically not covered. This includes suicides, attempted suicides, and any injury that was intentionally caused by the policyholder.

Injuries Resulting From Illegal Activities

Any injury resulting from criminal conduct or illegal activities is usually excluded from an AD&D policy. This includes any injury sustained while breaking the law, whether it’s a felony or misdemeanor.

AD&D Policy Exclusions For Non-Accidental Causes

Although AD&D policies are designed to provide coverage in the event of an accident, some exclusions apply for non-accidental causes. These can include losses resulting from:

Death From Natural Causes Or Disease

AD&D policies generally do not cover any death or injury resulting from a natural cause, such as illness or disease. This can include injuries or death caused by heart attack, stroke, cancer, and other medical conditions.

How Non-Accidental Causes Are Evaluated Under AD&D Policies

If you’re filing a claim for an injury or death resulting from anything other than an accident – such as natural causes, substance abuse, or intentional acts – the insurance company will evaluate the situation and determine if it’s covered under your policy.

It’s important to note that AD&D policies can vary in terms of their coverage and exclusions, so it’s best to speak with an experienced ERISA attorney if you have any questions or concerns about the terms of your policy.

Exclusions For High-Risk Activities

AD&D policies may also exclude any injuries or death resulting from high-risk activities that could be considered dangerous or reckless. This could include skydiving, scuba diving, skiing, motorcycling, and any other activity that carries a degree of risk.

How Exclusions Impact AD&D Insurance Claims

Exclusions in AD&D insurance claims can have a significant impact on the outcome of a claim. When filing an AD&D claim, policyholders must be aware of what is and isn’t covered by their insurance policy. If an excluded event is found to be the cause of an injury or death, the insurance company may deny the claim.

It’s important to understand your policy and its exclusions so that you can make an informed decision about whether or not AD&D coverage is right for you. Additionally, if you find yourself in a dispute with your insurance company over an excluded event on your AD&D policy, it’s best to speak with an experienced ERISA attorney who can help.

Should You Have An ERISA Attorney Review Your Denied Claim?

The answer is YES because they can provide invaluable assistance. They can review your policy and the circumstances surrounding the injury or death to determine if you may be able to contest a denied claim. An attorney can also help ensure that your rights are protected throughout this process so that you receive the compensation you’re entitled to.

If you have any questions about your AD&D policy, it’s best to speak with an experienced ERISA attorney right away who can help you understand the details of your AD&D policy.

Client review from past disability claim case in Florida

Issues With Your AD&D Policy? Call Herman & Wells

We hope this blog post has been helpful in understanding some of the key issues surrounding AD&D claims, including exclusions and how non-accidental causes are evaluated. As always, it’s best to speak with an experienced ERISA attorney for personalized advice on your individual situation.

At Herman & Wells, we are dedicated to helping individuals and families navigate the complexities of their insurance policies and maximize their compensation. We understand that denied claims can be devastating – but with our help, we can work to overturn the decision and get you the compensation you deserve. Call (727) 821-3195 today for a free consultation and guidance when it comes to your AD&D insurance claim!