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What Does Accidental Death and Dismemberment AD&D Insurance Cover?

We are often asked what AD&D – Accidental Death and Dismemberment – Insurance covers.  AD&D is one type of insurance that is governed by the rule that you have to read your policy to know exactly what it covers.  Why?

AD&D policies are written by many different insurance companies.  Whether they are individual or group policies, the terms of AD&D coverage vary more from insurer to insurer than many other types of insurance.

Some common AD&D coverages include the following:

  • death benefit for loss of life due to an accident;
  • benefit payment for loss of one arm or some combination of limbs;
  • benefit payment for loss of a hand or foot;
  • benefit payment for loss of sight; and
  • benefit payment for loss of hearing.

A key to receiving a benefit under an AD&D policy will often be how the policy defines the word “accident” or “accidental.”  While you may consider an accident to be obvious, there are many ways to write the definition of the word, and it is not always what a dictionary might state.  An insurer is free to define a word however it wants; and when an person or employer buys an individual or group policy, they are accepting the life insurance company’s definition.

You cannot just read the definition of “accidental” though.  It is important to also read the policy’s exclusions which limit coverage.  Many insurers insert quite a list of excluded situations where the insurer will not pay a claim.  Some common AD&D exclusions include:

  • acts of war or terrorism;
  • loss due to taking prescribed medication;
  • loss that occurs while drinking alcohol or taking drugs (even prescription medications);
  • losses that occur while undergoing a medical procedure;
  • losses that occur during the commission of a crime (even a minor crime); and
  • losses which are in part due to a medical condition that was being treated or a pre-existing condition, even it was not being treated.

Read your policy carefully.  When making a claim that is anything less than obvious, read the policy before you make a claim, and be sure to explain how the loss falls within the coverage, but outside of the exclusions.

 

If you would like to discuss a claim for AD&D benefits or your rights under an Accidental Death & Dismemberment policy, contact Insurance Attorney John Tucker online or call (866) 282-5260. 

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