Accidental Death Claim Denied Due to the Felony Exclusion?

An accidental death benefit is a benefit that is paid by a life insurance company in the event of an insured’s accidental death. Accidental death policies usually outline which deaths are considered accidental.

For example, death in a car accident or drowning is considered an accident. However, an accidental death is not the only requirement that needs to be satisfied in order for an AD&D claim to be paid. An AD&D claim will be paid if an insured dies in an accident and none of the exclusions in the policy apply.

Exclusions are special provisions in insurance contracts that describe situations when a claim will not be paid.

Some of the most popular exclusions are exclusions for suicide, self-inflicted injuries, intoxication, using prescription medications without a valid prescription, using prescription medications not according to a doctor’s advice, taking illicit drugs and participating in a felony or an illegal activity.


What are Denied Accelerated Death Benefit Claims

Many life insurance policies offer special benefits, such as seat belt benefits, anti-inflation benefits, accidental death benefits and accelerated death benefits.

Accelerated death benefits differ from the rest of life insurance benefits in that they are offered to insureds during their lifetime. Accelerated death benefits are generally available to an insured who is terminally ill and has a life expectancy of two years or less (depending on the contract).

Unlike life insurance benefits that are paid to beneficiaries after an insured’s death, accelerated death benefits are payable directly to an insured and constitute an amount that is 20%-50% less than life insurance benefits.

In order to receive an accelerated death benefit, an insured must comply with certain requirements outlined in the life insurance contract. In the majority of cases, the insurance company will want a statement from the insured’s doctor which supports a finding of a terminal illness and determines what an insured’s life expectancy is.


If You Can No Longer Pay Premiums on Your Life Insurance Policy

When an insured policyowner can no longer keep making premium payments on his life insurance policy, there are several options available.

Cash in the policy

The policy may be cashed in. Depending on the cash value of the policy, this may be a good choice for elderly insureds who need funds to pay for their home care and other living expenses. However, if the cash payout the insurance company has offered is miniscule, cashing it in may not be feasible.


How to Transfer Ownership of a Life Insurance Policy

When a person takes out a life insurance policy, he must fill out a life insurance application.

The application asks the applicant to name the policyowner, insured and beneficiary. In many cases, the insured is the policyowner. Sometimes, however, they are two different individuals.

A policyowner may also be a trust with the designated trustee. An application for life insurance has a special section where an applicant must indicate the person who will be responsible for paying premiums and the billing address.

If an insured is not a policyowner, he may or may not be responsible for paying premiums. However, if the insured assumes the responsibility for paying premiums, the insurance company will send premium-due notices to the insured.

Every life insurance policy outlines the rights and obligations of a policyowner. In a typical insurance contract, “you” means “policyowner”. For example, if a contract states, “You have the right to change beneficiaries”, it refers to the policyowner’s right to change beneficiaries.

A policyowner is the person who is granted many rights by the insurance contract that he can exercise during the lifetime of the insured. One of such rights is the right to change a policyowner. Usually, the ownership arrangement in effect on the contract date will remain in effect unless the policyowner asks the insurance company to change it.


Life Insurance Policy Lapse

In order for a life insurance claim to be paid, several requirements must be met: there must be valid coverage at the time of an insured’s death, a beneficiary must produce a certified copy of the death certificate and file a notice of claim, an insurance company must make sure exclusions do not apply, etc.

The most important requirement of all is the existence of valid coverage at the time of an insured’s death, because if there is no coverage at the time of death, no claim can be filed. An active policy at the time of death means that the policyowner paid the policy premiums on time and did not allow the policy to lapse (cancel without value).


Failure to Convert a Group Policy to an Individual Policy

When individuals are covered by group life insurance plans provided by employers, they enjoy low premiums and do not have to worry about making a premium payment on time, since in most cases, premiums are taken out of their paychecks.

There are many other advantages to group life insurance coverage: help from employers’ HR departments, open enrollment periods, ease of increasing or decreasing coverage and dependent life insurance coverage. If an employee has a question about her benefits, she may simply speak with her employer’s human resources department and get answers.

What happens, however, if an insured is given wrong information by the insurer or the HR personnel and acts in reliance on the incorrect information?