Our law firm recently won a $2 million payout for a family whose loved one died in an accident the insurance company claimed was not "accidental" under their policy terms. The insurer pointed to vague policy language and tried to rely on an exclusion that didn’t apply. We conducted a full investigation, built a legal case with supporting experts, and forced the company to reverse its denial. If your accidental death claim was rejected, this outcome shows it is still possible to win. If you need a Virginia life insurance denial attorney call us.
Why AD&D Insurance Claims Are Denied So Often
Accidental Death and Dismemberment policies are marketed as financial protection in the event of a sudden tragedy. But when the worst happens, many families are told the death "doesn't qualify" for payment. These policies are filled with limitations, and insurers regularly take advantage of the confusing language to avoid paying valid claims.
Some denials are based on alleged health conditions. Others involve accidents that the insurer tries to reframe as foreseeable, intentional, or excluded due to technicalities. This happens across the country, in cases just like yours.
Examples of Denials We Have Fought and Won
In Nebraska, a farmer was electrocuted while repairing a gate with faulty wiring. The insurer claimed he should have hired a professional and labeled the incident as avoidable. We proved the wiring had been inspected recently and that he followed standard safety procedures. His family received the full AD&D benefit.
A college student in South Carolina drowned while paddleboarding with friends. The water was calm, and there were no drugs or alcohol involved. The insurer tried to argue that she likely had an undiagnosed seizure disorder. We showed that she had no history of seizures, and the autopsy confirmed drowning as the sole cause of death. The claim was paid in full after our firm intervened.
In Missouri, a truck driver slipped on oil while loading cargo and struck his head. The insurer cited a prior back injury and denied the claim, stating the fall may have been caused by a muscle spasm. We challenged their assumption and presented surveillance footage and medical records. The denial was withdrawn, and the widow received the benefit.
A man in California died after being kicked by a horse while visiting a friend's ranch. The insurance company called it an “inherently risky activity” and denied the claim under a vague policy exclusion. We demonstrated that he was not engaging in any activity with the animal and was simply standing nearby when the incident occurred. The case settled shortly after we filed suit.
Another client in Virginia was denied a claim after his brother fell down icy steps outside his apartment. The insurer claimed the fall resulted from the man's diabetes, not the ice. We hired a weather expert and obtained maintenance logs showing the landlord failed to salt the steps. That evidence helped overturn the denial and secure the full payout.
How Insurers Misapply the Term “Accidental”
Insurance companies often try to recategorize accidents as natural deaths or intentional acts. This strategy allows them to avoid paying even when the circumstances clearly involve a sudden, unexpected injury.
We’ve seen denials based on:
A heart condition that supposedly caused a car crash
Prescription medication used exactly as directed
Falls dismissed as preexisting balance issues
Electrocutions blamed on "reckless behavior"
ATV accidents mischaracterized as voluntary risk-taking
In most of these cases, insurers are relying on speculation. They search for any medical history or behavioral detail that gives them an excuse. Our job is to take the facts and hold them accountable.
We Know How to Reverse AD&D Denials
Our attorneys have won cases against the largest life insurance companies in the country. We use expert testimony, detailed policy analysis, and state insurance laws to fight back when insurers try to stretch exclusions too far.
If your claim was denied for any of the following reasons, we may be able to help:
The insurer claimed the death was due to illness, not an accident
A substance was detected, even when not proven to cause the death
The accident involved a fall, and they blamed a health condition
A dangerous hobby exclusion was applied too broadly
The insurer claimed the behavior was reckless or self-inflicted
We examine every detail of your policy and the claim file. If the denial lacks real support or is based on vague language, we build a case and demand payment.