AD&D insurance policies only cover accidents. Death or injuries caused by illnesses (and various other non-accidental causes) are not eligible for benefits. This fundamental distinction forms the core of many coverage disputes between policyholders, beneficiaries, and AD&D insurance companies. Why?

Often, the circumstances surrounding a severe accident are unclear. The policyholder may have suffered from a variety of pre-existing conditions. In the AD&D insurance context, insurers routinely base their denials on this lack of clarity with regard to the cause of the injuries or death at issue.

For example, if you are involved in a motor vehicle accident where you suffer severe injuries to your back, neck, and spine and your injuries lead to paralysis in your lower limbs, your claim for benefits may seem perfectly legitimate. But insurers will latch onto any confusing factors that could be used to justify a claim denial.

The insurer will conduct a thorough investigation of the facts, which will likely include your medical history. Now, if the insurer discovers you were suffering from a degenerative spinal issue at the time of the accident, this may lead the insurer to argue that the paralysis of your limbs was caused by the natural progression of your degenerative illness and not by the motor vehicle accident.