15.1 Benefits
Accidental Death and Dismemberment (AD&D) insurance is typically covered in group insurance plans. Group accident and health insurance can be written in several different forms.
- Basic Medical Expense insurance
- Major Medical insurance
- Comprehensive Medical insurance
- Disability Income insurance
AD&D insurance is the purest structure of accident insurance. It provides the insured with a predetermined lump sum for financial consequences if an accidental death or dismemberment takes place under accidental circumstances. Most states require that policies providing any form of accident benefits, as do AD&D policies, base the definition of "accident" on the accidental bodily injury results premise and not on the accidental means premise.
An accident is considered external and violent in nature. Yet, how is the definition of accident determined?
The dictionary defines it as "an unplanned and unfortunate event that results in damage, injury, or upset of some kind, (a mishap) or the way things happen without any planning, apparent cause, or deliberate intent (chance)."
AD&D policies provide two separate definitions:
- Accidental Bodily Injury - Only the injury resulting from the accident must have been unintentional.
- Accidental Means - Both the cause and the result of the accident must have been unintentional. Normally, the death caused by the accident must occur within 90 to 180 days of the incident.
