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When an accelerated death benefit is requested, the insurance company will review the policy and medical records to determine whether the policyholder meets the eligibility criteria. If approved, the policyholder will receive a lump sum payment from the policy's death benefit.
Here are some examples of reasons why an insurance company might deny an accelerated death benefit claim:
The policyholder does not meet the eligibility requirements specified in the policy or rider, such as being terminally ill or requiring long-term care.
The policyholder's medical records do not show sufficient evidence of the illness or condition that would qualify them for the accelerated death benefit.
The policyholder did not provide accurate or complete information when applying for the policy or the rider, which could affect their eligibility.
The policyholder's condition does not meet the specific criteria outlined in the policy or rider, such as having a certain life expectancy or being unable to perform certain activities of daily living.
The policyholder has not satisfied the waiting period specified in the policy or rider before being eligible for the accelerated death benefit.
The policyholder has exhausted the maximum amount of the accelerated death benefit allowed under the policy or rider.
The policyholder's illness or condition is excluded from coverage under the policy or rider, such as a pre-existing condition or a condition not covered by the policy's definition of terminal illness.
The policyholder's medical records show that they are not complying with their treatment plan or have not sought appropriate medical care, which could affect their eligibility.
The policyholder has reached the maximum age limit specified in the policy or rider for receiving an accelerated death benefit.
The policyholder's death is caused by an excluded event or circumstance, such as suicide or death resulting from a criminal act.