The Riverpoint Building
2300 15th Street Suite 200
Denver, CO 80202
Maps and Directions
Greenwood Village
5750 S. Ulster Circle, Suite 300
Greenwood Village, CO 80111
Maps and Directions

(303) 964-1800

AD&D Claims and Prescription Drug Use

February 16, 2015

Accidental death and dismemberment (AD&D) insurance provides individuals with more protection than their basic life insurance policies.  This insurance extends coverage in the event that a person’s death is caused by an “accident.”  Despite what may seem to be a clearly accidental death, life insurance companies attempt to find various ways to delay or deny payouts on legitimate AD&D claims.  The reasons cited range from asserting the death was not accidental to the death was foreseeable (and thus not accidental) to asserting a limiting provision found within the policy applicable to intoxication or prescription drug use.

When the decedent (i.e. the person covered by the AD&D policy) had been using prescription drugs and such drug use may have been a factor in the death, an AD&D claim can get that much more complicated. Given the facts that about 7 out 10 Americans take at least one prescription drug – and that prescription drug use is expected to increase in the coming  years (according to the Centers for Disease Control and Prevention), understanding just how prescription drug use can impact AD&D claims is important. Here’s a look at why.

A Closer Look at AD&D Claims and Prescription Drug Use

Here’s a look at some of the challenges that arise with AD&D claims and prescription drug use. Contact Denver Attorney Shawn McDermott for experienced help standing up to insurers.

Here’s a look at some of the challenges that arise with AD&D claims and prescription drug use. Contact Denver Attorney Shawn McDermott for experienced help standing up to insurers.

When it comes to AD&D claims and prescription drug use, you should know that:

  • Insurances companies may argue that prescription drug use qualifies as a “material misrepresentation” – On standard applications for AD&D policies, there are typically questions pertaining to the use of prescription medications. The issues here can arise when policyholders fail to list any medications in their applications (often because they weren’t taking these medications at the time of applying for AD&D coverage), but then they end up be prescribed medications later.In such cases, insurers may contend that not disclosing prescription medication use is a “material misrepresentation” of the facts and, therefore, no payment should be made on the policy.

    However, there can be various ways to fight back against insurers who may use this reason to deny AD&D claims, such as pointing out ambiguous language in the applications – like when words such as “currently” limit or impact how people submit info on these applications.

  • Insurances companies may argue that deaths related to prescription drug use are not accidental – In the event that prescription drug use directly causes someone’s death, insurance companies may assert the application of an exclusion for loss or injury resulting from the use of prescription medications. Our office has experience in addressing this type of denial.  Contesting the claim denial may require witness accounts of the person’s drug use, autopsy results, testimony from treating physicians and the need for a toxicologist to analyze the situation.Fighting back against this reason for denying AD&D claims can involve pointing out that the decedent did not expect or intend to cause his own death through prescription drug use (i.e., that the death was NOT a suicide) and that, instead, the incident was simply a fatal mistake.  Important to the analysis is the argument that the insurer most likely bears burden to show the drug was the direct cause of death.
  • When issues with AD&D claims and prescription drug use arise, retaining an experienced attorney can be key to the success of these claims – The most important thing to remember when it comes to denied AD&D claims and prescription drug use is that having an experienced life insurance attorney like Denver Attorney Shawn E. McDermott on your side can be crucial to:
    • Standing up against insurance companies when they wrongfully delay or deny payments on valid AD&D claims related to prescription drug use
    • Ensuring that your rights and interests are protected and that you are able to obtain the benefits to which you are likely entitled.

You Can Trust a Denver Life Insurance Lawyer at McDermott Law, LLC

Has your life insurance and/or AD&D claim been denied? If so, you can turn to Denver Life Insurance Denial Attorney Shawn E. McDermott for experience in standing up to insurers and appealing or even litigating your claim denial. Experienced, skilled and trusted, Shawn McDermott has a record of success when it comes to helping people:

  • Stand up to insurers and fight insurance claim denials
  • Navigate the complexities of the legal system
  • Obtain the benefits they need and deserve.

To learn more about how the life insurance denial attorneys at McDermott Law, LLC can help you, set up a free initial consult with our office today by calling us at (303) 964-1800 or by emailing us using the contact form on this screen.

From our offices in Denver, we provide the highest quality legal services to people throughout the state of Colorado, the surrounding states and nationwide.

Categories: AD&D Claims, Blogs, Claim Denials, Disability, Life Insurance

DISCLAIMER

This site does not provide legal advice or services. Rather, it is for informational purposes only. Use of any information on this site is not intended to create an attorney-client relationship. Do not act on the information provided on this site without seeking legal counsel.