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Accidental Death Claims: Don’t Back Down in the Face of an Insurance Company Denial

In recent years, it has become popular for consumers to purchase accidental death life insurance. This is generally available in two different forms:

  • Standalone accidental death and dismemberment life insurance. This policy pays a benefit only if the insured person dies in an accident or loses one or more limbs or extremities. A policy of this type typically costs much, much less than life insurance that covers death from all causes.
  • A rider to a complete life insurance policy. This will offer a larger payout (often two or three times the regular policy benefit) if the insured person dies by accident. Often, the rider will also provide benefits for a dismemberment injury, even when the injury is not fatal. Buying this rider usually costs a slightly larger premium than the base life insurance policy.

A lot of experts believe that accidental death life insurance is often a poor deal for consumers. They note that accidental death is fairly rare. The policy does not pay benefits if the insured person dies from illness or old age. Most people who purchase accidental death coverage will not obtain any extra money for their heirs with this insurance. Owning this form of life insurance may discourage people—especially younger people—from purchasing comprehensive life insurance, which is a much better investment.

But what makes accidental death insurance even a worse deal for you is the fact that many life insurance companies regularly deny claims. Life insurance beneficiaries get nothing for the accidental death provisions.

How life insurance companies deny accidental death benefits

Insurance companies refuse to pay benefits for accidental death insurance claims by stating that the death was not the product of an accident. They have many tactics at hand to deny benefits:

  • They may claim that the death was deliberate. They can assert that the death was a suicide, and may try to force the beneficiary to assume the burden of proof to demonstrate otherwise.
  • They may say the death was caused by the policyholder’s reckless choice. For example, a death caused while engaged in a risky pursuit such as parachuting or mountain climbing may cause the insurance company to refuse to pay the beneficiary.
  • They may say that a time delay between the accident and the death makes the insurance policy moot. Consider a case where someone is caught underwater for several minutes by circulation system currents in a public pool. When the person is rescued, he is unconscious and slips into a coma; he dies 45 days later. The insurance company refuses to pay accidental death benefits because the death did not follow immediately after the accident.
  • They may claim that the immediate cause of death was not the accident. Our example case: a young woman is severely injured in a car crash. A day after she enters the hospital, it becomes evident that she is suffering from internal bleeding. During surgery, her spleen ruptures, and she dies from sudden blood loss. The insurance company denies the accidental death claim because the death was caused by a surgical injury, rather than by an injury sustained in the traffic accident.
  • They may assert that an non-covered medical problem caused the accident, and therefore the accidental death benefits are not available. Consider the case where a man suffers a stroke while driving his car, leading to a fatal highway crash. The insurance company may assert that the stroke—a medical problem not covered under accidental death rules—is the triggering incident that arguably would have lead to the insured person’s death, and on that basis they may refuse to pay benefits.

Getting a fair life insurance settlement for an accidental death claim

Our life insurance lawyers have noticed that many insurance companies have no shame when it comes to exploiting the grief of a family wounded by an unexpected death. The insurance executives know that you are in no mood to press your claim at this difficult time, so they are happy to try denying benefits on flimsy grounds. They see it as a no-risk exercise: if you fail to demand the settlement you deserve, then they keep the money.

Our network of life insurance attorneys isn’t satisfied to watch you get exploited like that. If you believe the company is unfairly trying to contest your life insurance claim, you need to look for someone with the experience in the law and familiarity with insurance company deceit. We are the allies you need. We can negotiate aggressively with the insurance company from a position of strength because we have the facts on our side, but we’re not afraid to take the case to the courtroom if we can’t get a good settlement offer.

Contact us today at (215) 531-7961 to schedule a free case evaluation if you have a problem with denial of your life insurance benefits. Our attorneys work with clients across the United States and accept no legal fees unless we can get you a recovery.