What does an accidental death and dismemberment policy cover

1 Financial Impact of Premature Death, MetLife 2020 

Accidental Death & Dismemberment insurance does not include payment for any loss which is caused by or contributed to by: physical or mental illness, diagnosis of or treatment of the illness; an infection, unless caused by an external wound accidentally sustained; suicide or attempted suicide; injuring oneself on purpose; the voluntary intake or use by any means of any drug, medication or sedative, unless taken as prescribed by a doctor or an over-the-counter drug taken as directed; voluntary intake of alcohol in combination with any drug, medication or sedative; war, whether declared or undeclared, or act of war, insurrection, rebellion or riot; committing or trying to commit a felony; any poison, fumes or gas, voluntarily taken, administered or absorbed; service in the armed forces of any country or international authority, except the United States National Guard; operating, learning to operate, or serving as a member of a crew of an aircraft; while in any aircraft for the purpose of descent from such aircraft while in flight (except for self preservation); or operating a vehicle or device while intoxicated as defined by the laws of the jurisdiction in which the accident occurs.

MetLife AD&D and BTA is issued by Metropolitan Life Insurance Company, 200 Park Avenue, New York, NY 10166 under Policy Forms GPN99/G2130-S and GBPNP-04.

Nothing in these materials is intended to be advice for a particular situation or individual. Please consult with your own advisors for such advice. Like most group insurance policies, insurance policies offered by MetLife contain certain exclusions, exceptions, waiting periods, reductions, limitations and terms for keeping them in force. Please contact your benefits administrator or MetLife for costs and complete details. 

"AD&D" redirects here. For the updated version of the original 1974 Dungeons & Dragons rule set, see Advanced Dungeons & Dragons.

In insurance, accidental death and dismemberment (AD&D) is a policy that pays benefits to the beneficiary if the cause of death is an accident. This is a limited form of life insurance which is generally less expensive, or in some cases is an added benefit to an existing life insurance policy.

Accidental death[edit]

In the event of an accidental death, this insurance will pay benefits in addition to any life insurance but only up to a set amount total regardless of any other insurance held by same insurer, held by the client. This is called double indemnity coverage and is often available even when accidental death insurance is merely an add-on to a regular life insurance plan. Some of the covered accidents include traffic accidents, exposure, homicide, falls, heavy equipment accidents and drowning. Accidental deaths are the fifth leading cause of death in the U.S.[1] as well as in Canada.

Accidental death insurance is not an investment vehicle and thus clients are paying only for sustained protection. Most policies have to be renewed periodically (with revised terms), although the client's consent with renewal is often implicitly assumed.

Common exclusions[edit]

Every insurer maintains a list of events and circumstances that void the insured's entitlement to his or her accidental death benefit. Death by illness, suicide, non-commercial aviation, war injury, and natural causes are generally not covered by AD&D. Similarly, death while under the influence of any non-prescribed drugs or alcohol is most likely exempt from coverage. Overdose with toxic or poisonous substances and injury of an athlete during a professional sporting event may void the right to claim too.

Some insurance carriers will tailor their clients' coverage to include some of the above risks, but every such extension will be accompanied by increased premiums.

Due to these restrictions, the process of claiming the benefit may be relatively lengthy; the deceased client may have to undergo autopsy and the accident may have to be officially investigated before a claim is approved by the insurer.

Dismemberment[edit]

Fractional amounts of the policy will be paid out if the covered employee loses a bodily appendage or sight because of an accident.[2][3][4] Additionally, AD&D generally pays benefits for the loss of limbs, fingers, toes, sight and permanent paralysis. The types of injuries covered and the amount paid vary by insurer and package, and are explicitly enumerated in the insurance policy.

Coverage types[edit]

There are four common types of group AD&D plans offered in the United States:

  1. Group Life Supplement – the AD&D benefit is included as part of a group life insurance contract, and the benefit amount is usually the same as that of the group life benefit.
  2. Voluntary – the AD&D benefit is offered to members of a group. An example is an AD&D policy provided in an initial nominal amount with premiums paid by another party (such as a small $1,000 AD&D policy offered to credit union members, with the premium paid for by the credit union itself), with higher elective benefits offered to members where the member must pay the additional premiums separately.
  3. Travel Accident (Business Trip) – the AD&D benefit is provided through an employee benefit plan and provides supplemental accident protection to workers while they are traveling on company business (the entire premium is usually paid by the employer).
  4. Dependents – Some group AD&D plans also provide coverage for dependents.[5]

See also[edit]

  • Bureau of Labor Statistics
  • Life insurance
  • Term life insurance
  • Permanent life insurance
  • Health insurance
  • Health care

References[edit]

  1. ^ Accidents or Unintentional Injuries by Centers for Disease Control and Prevention, accessed July 14, 2011.
  2. ^ "BLS Information". Glossary. U.S. Bureau of Labor Statistics Division of Information Services. February 28, 2008. Archived from the original on 6 May 2009. Retrieved 2009-05-05.
  3. ^ Margaret E. Lynch, Editor, "Health Insurance Terminology," Health Insurance Association of America, 1992, ISBN 1-879143-13-5
  4. ^ "Accidental Death Insurance Coverage and Exclusions". Glossary. death-insurance.com. March 22, 2016. Retrieved 2016-03-22.
  5. ^ Fundamentals of Health Insurance: Part A, Health Insurance Association of America, 1997, ISBN 1-879143-36-4

What is covered by accidental death and dismemberment insurance?

As the name suggests, accidental death and dismemberment insurance provides coverage for a death due to an accident. It generally also pays if you lose a limb or a function such as sight, hearing or speech in an accident.

What qualifies as accidental death?

What Is Considered Accidental Death? Insurance companies define accidental death as an event that strictly occurs as a result of an accident. Deaths from car crashes, slips, choking, drowning, machinery, and any other situations that can't be controlled are deemed accidental.

What is the difference between accident insurance and accidental death and dismemberment?

Accidental Death & Dismemberment (AD&D) Insurance provides benefits if you die as the result of an accident or suffer a permanent impairment such as paralysis, loss of limb(s), eyesight, hearing or speech. Accident Insurance provides a cash benefit if you experience an injury or die as a result of a covered accident.

Is it worth it to get accidental death and dismemberment insurance?

An AD&D policy may be a good idea, especially if you work in a high-risk job. People with riskier jobs pay higher premiums than people with low-risk employment. Supplemental AD&D coverage could be a wise investment regardless, but understand that AD&D doesn't cover you for any type of death or dismemberment.

What's the difference between AD&D and life insurance?

Life insurance provides financial protection for your family and will pay out for almost any cause of death. Accidental death and dismemberment (AD&D) insurance, on the other hand, only pays out for accidental death or accidental injury, such as loss of limb.