What Are An Ad&D Policy?
Ad&D are an insurance company that advertises a product that offers accidental death and dismemberment insurance to individuals. It also claims to provide accidental death and dismemberment insurance to families of those who have died in car accidents, even if the accident was not your fault. This seems like an accident-free insurance coverage. How do they stack up against other companies in the insurance industry, however?
The claim is that Ad&D cover death caused by “accidental deaths” and illness “caused by other persons.” That sounds like pretty good coverage, doesn’t it? So it’s logical that Ad&D would be superior to most other term life insurance policies. Ad&D state that it will cover death caused by illness or car accidents, as well as death caused by suicide. It does not cover accidental drowning, wrongful death, and other types of fatalities that occur in car accidents. And it does not cover “accidental illnesses,” which include viral diseases, food poisoning, and others.
When a person dies as the result of a car accident, the typical insurance policy will pay for funeral expenses and the cost of raising the child. (There are, of course, other exceptions to these guidelines.) Ad&D’s claim that it will pay for expenses resulting from wrongful death and dismemberment is confusing. According to the policy, when an insured person dies as the result of an “accidental illness,” it is considered “disputed death” and the beneficiary will receive payment from Ad&D. If there is any dispute as to the death resulting from illness, the insurer must resolve it before paying out.
Ad&D state that the accidental nature of the accident is not its own distinct feature. The mere fact that it occurred is enough to give rise to a claim for compensation. Therefore, it is likely that the amount payable will be lower than if the accident had been deliberate. This lower amount payable is, of course, in addition to the standard death benefit. But if the beneficiary obtains anything less than the full standard death benefit in the underlying case, she will have little left over should she want to obtain compensation for the loss of potential revenues.
There are two primary types of Ad&D exclusions. The first is “general exclusions,” which apply to all circumstances and to all forms of accidental injury. These include but are not limited to, vehicular injuries, sickness, diseases, malformations, or death. The second type of exclusions is more specific and covers only those conditions for which the carrier is the principal risk. For instance, a policy will specify that the death benefit and the any other specified benefits are excluded if the insured suffers from “adverse physical conditions.”
There are several types of “common exclusions” in Ad&D policies. The most common are those that relate to natural causes. In general, an Ad&D policy will exclude coverage for any illness or injury that is “known or suspected” to result from exposure to “toxic substances,” “poisoning,” or “infectious bacteria.” In addition, the policy will typically exclude coverage for some sexually transmitted diseases (STD), “fungal skin diseases,” and similar conditions.
Another type of exclusion is a “permanent” dismemberment exclusion. With this type of exclusion, Ad&D will typically provide coverage for only those harms that are directly related to a motor vehicle accident and that occur “during” a “course of employment.” This means that a person who has had a traumatic experience (like the inability to move the arm after being hit by a car) will not be entitled to damages because of a motor vehicle accident. As a rule, the courts allow this exclusion to apply even if the harm was caused by the negligence of the employer. For instance, if an employee is killed in a workplace accident caused by the negligence of another employee, the employee would likely have a claim for wrongful death.
In addition to illnesses, the courts generally allow the exclusion of accidental death benefits in cases involving explosions, violence, machine malfunction, and similar incidents. If you suffer an accidental death as the result of an “act of God” or “natural occurrence” as described in the Ad&D Rider, you may be able to recover damages. To obtain such a recovery, you must establish two things: first, that your loved one was in a direct and personal relationship with the defendant for one year immediately prior to his or her death; and second, that your loved one suffered an immediate and serious loss as the result of the incident. If either of these assumptions are rejected by the court, you may not be entitled to recovery. If you do obtain damages, however, your lawyer can attach a double indemnity rider to your life insurance policy to recover additional benefits from the insurer.