Accidental Death & Dismemberment Benefits

ERISA • Employment Law

Accidental Death & Dismemberment Benefits

Accidental Death and Dismemberment (“AD&D”) benefits are commonly included as a secondary or supplemental benefit to many employer-sponsored life insurance benefit plans.  Accidental death and dismemberment benefits provided through an employee benefit plan are frequently regulated by the Employee Retirement Income Security Act of 1974 (“ERISA”).  ERISA is a federal law that regulates employee benefit plans provided by nearly all employers in the private sector.  (Employee benefits provided by federal, state, and local governments are not covered by ERISA, nor are benefits provided by certain employers affiliated with religious organizations).

Many people assume that they are automatically entitled to AD&D benefits when the covered individual dies.  That is often not the case because the death typically must be the result of an “accident.”  Unfortunately, however, there are many cases in which an insurance company will deny claims arising from accidental deaths, by claiming that the death was not accidental, or by attempting to improperly apply a policy exclusion.  Frequently, these claims arise in cases of certain motor vehicle accidents, inadvertent fatal asphyxiation, accidental overdoses involving medications, and other instances of unexplained death.

If the insurance company denies your accidental death and dismemberment claim, do not assume the insurer’s explanation for the denial of the claim is valid.

You should consult with an experienced ERISA accidental death and dismemberment attorney.  An experienced accidental death and dismemberment attorney will review the facts and circumstances of the insured’s death with you, review the accidental death and dismemberment policy with you, and explain your rights.  If the AD&D policy is an ERISA-regulated policy, you will have a relatively short period of time in which to appeal the denial of your claim.  ERISA AD&D plans all contain a mandatory appeal process that a claimant must go through before seeking relief in court.  An experienced ERISA accidental death and dismemberment attorney can explain this process to you, advise of you of the potential issues with your claim, and help you build a well-developed record with your appeal.


Adam H. Garner is an experienced accidental death and dismemberment insurance attorney.  If you have questions regarding your accidental death and dismemberment insurance claim, please contact The Garner Firm today.

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