Life Insurance Accidental Death Claim Denials

Accidental death and dismemberment (AD&D) coverage is often sold as an add-on to life insurance policies. These benefits can double or even triple the payout if the insured dies from an accident. Unfortunately, accidental death claims are some of the most frequently denied by life insurance companies.

If your claim was denied, you may have received a letter stating that the death was excluded from coverage perhaps the insurer claims it was caused by alcohol, drugs, illness, or a “non-accidental” event. These denials can be devastating for families who expected a larger benefit. But not all denials are valid. Many can be challenged, especially when the insurance company stretches exclusions too far.

The Law Offices of Jason Turchin helps families in Florida, New York, New Jersey, and nationwide fight wrongful accidental death denials. Call 800-337-7755 for a free consultation. You won’t pay any fees or costs unless we recover money for you.

What Counts as an “Accidental Death”?

Most policies define accidental death as one that is sudden, unexpected, and not caused by illness or natural disease. Examples often covered include:

• Car crashes
• Falls
• Drownings
• Fires or burns
• Poisonings
• Electrocutions

However, the exact language in the policy controls and insurers may interpret it narrowly to deny claims.

Common Reasons Insurers Deny Accidental Death Claims

Drug or Alcohol Exclusions

If toxicology reports show the insured had alcohol or drugs in their system, insurers often deny payment, even if those substances were not the primary cause of death.

Risky Activity Exclusions

Policies sometimes exclude deaths during activities like scuba diving, skydiving, racing, or mountaineering.

Illness vs. Accident Disputes

Insurers may argue the death was caused by illness rather than an accident. For example, if a heart attack led to a car crash, the company might deny coverage.

Suicide or Self-Inflicted Injury Exclusions

Most policies exclude intentional self-harm, though insurers sometimes wrongly classify accidental overdoses as suicide.

Lack of Proof of Accident

If circumstances are unclear, insurers may deny claims, arguing that beneficiaries cannot prove the death was accidental.

Florida, New York, and New Jersey on Accidental Death Denials

Florida

Courts in Florida often examine whether the accident, rather than illness, was the primary cause of death. Beneficiaries may challenge denials that rely too heavily on unrelated medical conditions.

New York

New York law requires insurers to construe exclusions narrowly. If an accident was a substantial factor in the death, benefits may still be payable.

New Jersey

New Jersey courts frequently balance the policy language against public policy, sometimes ruling in favor of beneficiaries where the cause of death was primarily accidental.

Why Denials Can Be Challenged

Insurers often overreach when applying exclusions. Families may challenge denials by showing:

• The accident was the primary cause of death, even if illness contributed.
• Toxicology reports do not prove intoxication was the cause.
• Exclusions were written ambiguously and should be interpreted in favor of coverage.
• The insurer conducted an incomplete or biased investigation.

What to Do If Your Accidental Death Claim Was Denied

1. Get the denial letter in writing. Review the insurer’s stated reason.
2. Request the policy and investigative file. Insurers must provide documents upon request.
3. Gather medical and police records. These may show the accident was the true cause.
4. Consult a life insurance lawyer. Many denials can be overturned with legal intervention.

Potential Compensation

If the denial is overturned, beneficiaries may recover:

• The full accidental death benefit (often double the base policy).
• Interest on delayed payments.
• Attorney’s fees in certain bad faith cases.

Frequently Asked Questions

Can insurers deny claims if alcohol was involved?
They may try, but courts often review whether alcohol actually caused the death.

What if illness played a role?
If the accident was the predominant cause, coverage may still apply.

Do I need a lawyer to fight an AD&D denial?
Yes. These cases often turn on medical records, policy interpretation, and state law.

How long do I have to sue?
Most policies especially employer-based ERISA plans may require strict deadlines. Acting quickly can be crucial.

Contact Life Insurance Lawyers for Accidental Death Denials

If your accidental death claim was denied, you may still be entitled to benefits. The Law Offices of Jason Turchin can review your case and fight back against unfair denials. Call 800-337-7755 or use our live chat for a free consultation.