ASK A LAWYER: Accidental Death & Dismemberment Claims

Do AD&D policies cover loss of vision?

Very often AD&D coverage or policies will provide a lump-sum payment in a specified amount for loss of vision. The loss of vision has to occur as the result of an “accident” which may not always have the most obvious meaning that most people think of when they consider what an accident is, but the loss has to be caused by accidental means. In order to determine whether loss of vision is covered, you need to review carefully the schedule of covered losses that form part of the policy.

My husband died after slipping and falling on public property. As his beneficiary, I made a claim for his Accidental Death and Dismemberment insurance benefit. Unfortunately, the insurance company doesn’t agree that the slip and fall was an accident, but instead, negligence on my husband’s part. They have refused to pay the benefit. Do I have any legal recourse?

In order for an incident to be considered an accident, for the purposes of AD&D coverage, it would not generally matter whether the slip and fall occurred as a result of the injured person’s own negligence, subject to the specific exclusions contained in the policy. If a claim for AD&D is denied on these grounds you should have the policy and denial letter reviewed by a lawyer with experience in such claims to determine whether you can successfully challenge such a denial.

How Long Does it Take for a Disability Claim to be Approved? Donation Program

There are many factors that can influence how quickly your claim for long-term disability benefits will be processed by your insurance company. Some of these factors are in your control. Completing your application forms thoroughly, adhering to the insurance company’s deadlines and complying with their requests for further information will help speed up the claims process.

There will also be a waiting or “elimination” period that varies in length depending on the policy. We have seen policies with waiting periods as short as 17 weeks and as long as one year. If your policy has a short-term disability plan, your long-term disability waiting period will be the maximum length of time of your short-term disability coverage--often 26 weeks - which means your long-term benefits should start immediately after your short-term runs out.

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“No one should have to choose between medicine and other necessities. No one should have to use the emergency room every time a child gets sick. And no one should have to live in constant fear that a medical problem will become a financial crisis.” - Brad Henry