Will the Accidental Death Benefit Pay?

You can choose to add an option provision to your policy concerning accidental death benefits in the form of a rider or amendment to the policy. It may also be called double indemnity because it doubles the standard death benefits if the insured dies from an accident. You can also choose an accidental death policy alone with different coverage options.

According to the National Safety Council, accidents are the nation’s fifth leading cause of death. But the word accident can be confusing.

For example, if the insured dies in an accident but the actual cause of death is a disease, then is the accidental death benefit payable? Only if the accident was the cause of death.

Another example, someone who has a stroke or a cerebrovascular accident and falls, loses consciousness and dies does not qualify for the accidental death benefit. The stroke caused the death, not the fall, even if it occurred prior to the stroke.

If an insured is in an automobile accident but dies from a heart attack, the accidental death will only be payable if the accident can be proven to have triggered the heart attack. Generally, the insurance company is successful in proving that the heart attack caused the accident.

To detail further, the insured died when driving an automobile. The car was severely damaged in an accident associated with death and the cause of death was determined to be a heart attack. However, the spouse claims that the accident caused the heart attack. Proving this is almost impossible and the insurer will only pay the death benefit. According to Edward Graves McGills Life Insurance, legal services would have to be obtained. That can not only be time consuming but more costly than it is worth.

Transamerica Insurance also notes that active participation in a riot or insurrection that causes an accidental death will not pay out in accident benefits. If an accident occurs due to a blood alcohol level being higher the .08, in most states, accidental death benefits will be excluded, so it is important to check with a qualified insurance specialist of exactly what is included and any state variables.  If someone is taking a prescription drug or medication not prescribed by a physician and has an accident, paying out in accident benefits may be in question.

Most accidental death benefits do not provide coverage in the insured death by suicide.


Have more Life Insurance questions? Read our article The Most Frequently Asked Life Insurance Questions

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