Accidental Deaths and Dismemberment claims can be some of the most heart wrenching cases to work with. This goes for both the recently deceased, as well as the beneficiaries that are attempting to claim what they are entitled to. When a family member has been in a very sudden accident, the last thing you would want to hear is that the claim has been denied due to the cause of death. Yet, that is something that goes on quite regularly in cases of AD&D cases.
What Exactly is an Accidental Death and Dismemberment Policy?
Unlike many blanket policies, AD&D policies only ensure that payout is in the event that the death was entirely accidental. This would mean that there is near zero percent fault in the recently deceased policy holder’s part, and that it was on the other party entirely. Because of this reasoning, there are quite a few stipulations that must be followed.
Just a few would include such reasons as:
- Self-Inflicted Death(Suicide)
- Dangerous Sporting
These are more just a few reasons that can prevent a claim from being accepted, but there are other such exclusions as well, such as the Felony Exclusion.
How is a Felony Exclusion Deniable?
To start, you need to understand what the Felony Exclusion entails. The Felony Exclusion is not talking about prior charges, conditions, or such subjects. Those would be taken care of in the application process, where the potential client would be vetted in a thorough process. Felony Exclusion refers to if the insured member died while committing a crime, felony, or offense of any kind.
Many will assume that this only refers to such things like robbing a bank, hijacking a car, or other such grand theft crimes. But, this exclusion can also be applied to minor crimes as well. Drunk driving, public intoxication, reckless driving, any of these can be considered under the Felony Exclusion. Insurance companies will not take these things lightly, either. Insurance companies are a business like any other, and as such, they are always looking to maximize their profits. As such, any reason to not give a hand-out to a claim is reason to pursue.Because of this, many will take the Felony Exclusion as an open chance to pick any type of excuse to deny a claim.
Can a Felony Exclusion Denial be Challenged?
No matter what the denial reason is with a claim, it can always be challenged. Felony Exclusions will actually be a bit easier to challenge, depending on what was committed. This is because the basis as to why the felony exclusion policy comes into effect is based off of neutral information: Toxicity reports for the blood levels, death reports from neutral parties, and many other documents and information. Since they are all collected for each party to see, it can also be brought before a court to be debated, and challenged.
This does not mean to go into it blind, though. Many people affected by such actions by insurance companies tend to jump the gun with denials, and attempt to file an appeal as quickly as possible without reading over the fine print. If this is done, information can be lost and turned against you, resulting in a large loss due to impatience.
The Steps to Challenging Felony Exclusion Denials
The first step is to solidify information. Information is the largest weapon and defense when building a case against a denial of a claim. These can include reports for autopsies, blood work, and even reports about the incidents themselves. Making sure that you have these documents, unaltered by any party, means that you can trust the information in them as well.
Hire an experienced AD&D lawyer or attorney. One big thing that should always be done is having an expert on your side. They can help you work your way around any legal jargon that may be used to throw you off and lead you down the wrong path. They can also protect you from any legal pitfalls that might arise if you were to, say, attempt all the paperwork yourself.
We are highly-experienced life insurance lawyers and attorneys that would be happy to take on your case. With a high rate of completion and success, we would be sure to give you the best work possible. Because we know this isn’t just about the money. This is about closure, and stability. This is about your livelihood. You aren’t just another paycheck for the insurance company. And we aim to prove that for you.