by ammowoman » Wed Oct 19, 2011 12:14 am
I have life and ad&d insurance thru my employer that I carry the max offered on myself and my family. I have had this policy for 8yrs acording to the paperwork. Have been employed there and carried it for over 10 yrs and they must of switched providers.
My husband was injured a yr ago in a accident at work. He is now permanantly disabled. I Had called my employer right after the accident and requested a claim form. They reluctantly sent me one. I never completed it because the answer to some of the questions were unknown at that time. I also checked with social security and they stated he had to be out of work for a yr to file as well. Here we are a yr later and now I am starting to file for all.
My employer called the carrier of the policy and explained the situation. They requested my employer fill out their portion and fax it to them to beat the 365 day deadline. We were to complete the rest of the form and send in the medical evidence. Our attorney helped us with that today and it was fed x'd as requested.
My questions are
My policy shows a section reguarding claims where a detemination of disability is required. Thats the oly reference I can find. Do ad&d policys usually pay out for disableing accidents? It is a accident with a workers comp case still open and NEVER disputed. No drugs or alcohol involved and YES he was tested in the ER
When you look at the carriers web site it states that most disableing accidents happen away form work and that this is a good policy to have to protect yourself. I would mention the carrier but not sure if it is allowed.
I am trying not to expect a payout but having been the only income for so long it is hard not to be relieved by the thought of $100,000.
My husband was injured a yr ago in a accident at work. He is now permanantly disabled. I Had called my employer right after the accident and requested a claim form. They reluctantly sent me one. I never completed it because the answer to some of the questions were unknown at that time. I also checked with social security and they stated he had to be out of work for a yr to file as well. Here we are a yr later and now I am starting to file for all.
My employer called the carrier of the policy and explained the situation. They requested my employer fill out their portion and fax it to them to beat the 365 day deadline. We were to complete the rest of the form and send in the medical evidence. Our attorney helped us with that today and it was fed x'd as requested.
My questions are
My policy shows a section reguarding claims where a detemination of disability is required. Thats the oly reference I can find. Do ad&d policys usually pay out for disableing accidents? It is a accident with a workers comp case still open and NEVER disputed. No drugs or alcohol involved and YES he was tested in the ER
When you look at the carriers web site it states that most disableing accidents happen away form work and that this is a good policy to have to protect yourself. I would mention the carrier but not sure if it is allowed.
I am trying not to expect a payout but having been the only income for so long it is hard not to be relieved by the thought of $100,000.
Posted: Wed Oct 19, 2011 05:44 am Post Subject:
An expert would be able to address your querry in a better way.
Meanwhile I can just say as far as my knowledge goes, an ad&d insurance pays out in the event of a fatal accident or an accident that results in losing eyesight, speech, hearing, or a limb.
If your husband suffers from such a dismemberment, then you'll definitely be reimbursed. But if he's disabled in a way that makes him unfit to continue his job then your insurance might not pay.
As I said, only an insurance expert can determine your situation and I'm sure someone will advise shortly.
Posted: Wed Oct 19, 2011 09:46 am Post Subject:
Thank you for your reply. He didn't loose any limbs as a result of the accident but he has suffered partial loss of use on several. He was crushed by 3000 lbs. Main injury, of many, was his broken pelvis. Right now he can manage to walk. He is only 48. In 10 yrs he may not be able to due to the injury.
Posted: Fri Oct 21, 2011 06:04 am Post Subject:
You can always check with your insurer to find out if they would make a payout because of the lose of use of limbs suffered by your husband due to accident. If it's mentioned in your particular policy, you should get your claims.
Apart from this your husband is also entitled to the social security disability benefits.
As you have gone through all the procedures on time, you can expect your insurer to contact you soon. I hope your doubts get resolved shortly. Good Luck!
Posted: Fri Oct 21, 2011 09:20 am Post Subject:
I did call and ask. They wouldn't answer the question. I just called the customer service number. She did show where there was a claim and gave me the claim number and the name of the person assigned to the claim. She offered to forward my contact info for him to return my call but she wasn't allowed to give out his.
I just expect it to be denied. If they do, they will at least give the reason so I'll know. In the section where "determination of disability is required" its mentioned they can get 2, 30 day extensions.
Thank you for your information!
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