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June 2015 Archives

What Does Accidental Death and Dismemberment (AD&D) Insurance Cover?

Most working people buy life insurance for their family's financial protection in the event of untimely death.  And many employee benefit plans that offer life insurance also provide  death and dismemberment (AD&D) insurance, which provides added protection in the event death or loss of limb occurs in an "accident," which the seminal appellate ruling in Wickman v. Northwestern National Insurance Co., 908 F.2d 1077 (1st Cir.1990) defined as a sudden and unintended occurrence, but which exclude situations where "a reasonable person ․ would have viewed the injury as highly likely to occur as a result of the insured's intentional conduct." While death by suicide is usually not covered by AD&D policies, despite the known risks of drunk driving, autoerotic asphyxiation, and other risky behavior, such situations are usually deemed accidents and compensable under AD&D coverage since few individuals either subjectively intend or expect to die while engaging in such conduct.

Headaches, Narcotic Pain Medications, and Disability

Qualifying for disability benefits based on headaches or other disorders that are so painful that narcotic medications are prescribed can be a major challenge.  Since there is no objective way to measure pain and because most migraine and cluster headaches are impossible to diagnose with objective testing such as MRI studies, disability insurers often resist paying benefit claims, especially if the benefit plan or policy requires the submission of "objective" medical evidence.  But there are methods to improve the chances of having claims paid.  

DeBofsky, Sherman & Casciari, PC