Accidental Death Benefits Basics

Accidental death and disability policies (AD&D policies) provide benefits when an individual dies unexpectedly due to an accident. Thus the focus of an insurance company looking at an accidental death policy is the cause of death. Was the death accidental? Was the death caused by illness or suicide? There may also be specific exclusions in the policy that would preclude coverage if the death is caused, for example, by (1) piloting a plane, (2) commission of a felony, or (3) the use of intoxicants.

We have found that even when there is no intoxicant exclusion in a policy, insurance carriers have denied accidental death benefits where the decedent had been drinking alcohol or using medication or drugs at the time of the accident. In such cases, the insurance company will claim that the accident was not an accident because the insured’s conduct increased the risk of harm to the point where death became foreseeable.

Thus, when an insured dies as a result of injuries suffered in an automobile accident after having a few alcoholic drinks, the beneficiary’s claim for accidental death benefits will generally be denied. Of course, suggesting that such a tragic death is not accidental is ridiculous. However, this doesn’t stop the insurers from denying these claims and forcing individuals to fight for their benefits.

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