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.

A Floridian involved in a motorcycle accident fills out their injury claim form.

The Cliff Notes: Key Takeaways From This Post

  • 1
    AD&D policies provide financial protection against accidental death or injury, but can have a variety of exclusions.
  • 2
    These can include intentional self-inflicted injuries, deaths resulting from natural causes, and injuries from illegal activities.
  • 3
    High-risk activities may also be excluded from coverage on an AD&D policy.
  • 4
    Exclusions can significantly impact the outcome of a claim, so it is important to understand all details of the policy before signing.
  • 5
    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.

Gathering Evidence For The Appeal

It is important to consider what evidence you need for your appeal and how best to address any potential issues with your application or denial. All disability claims are different. What evidence is needed depends on your disability and your plan. It is important to note that in an ERISA claim if the proper evidence is not submitted on the appeal, there is a good chance you will not be able to provide it after filing a lawsuit. A long-term disability attorney can help guide you through this process, ensuring that all documentation and evidence are properly gathered and presented in order to support your claim.

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.

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.