Lincoln National denies accidental death benefits after jet ski accident and Court agrees
Purchasing an insurance policy that pays benefits for an accidental death and dismemberment would seem like a wise decision since people suffer dismemberment and die from accidents every day. Collecting benefits on an accidental death and dismemberment policy should be simple right? Well, not so fast.
In Keane v. The Lincoln National Life Insurance Company, a recent decision out of the Western District of Michigan, the Court ruled that Mrs. Keane was not entitled to benefits after her husband’s death which resulted from a jet skiing accident. Seems to be a pretty unfair decision, however, this is why it is extremely important to read and understand the policy language and its exclusions prior to purchasing an AD&D policy or any type of insurance policy. In the instant case, Mr. Keane did not purchase his policy, but was provided the ERISA governed AD&D policy by his employer.
The Lincoln National Life Insurance AD&D Policy Has Disturbing Language
On September 12, 2009, Mr. and Mrs. Keane were riding a jet ski on a lake in Michigan when Mr. Keane accidentally fell off the jet ski. When he tried to climb back on, he became fatigued and fell back in the water. His wife was not able to save him and he died. The death certificate listed the causes of death as follows: Acute Myocardial Infarction; Near Laryngospastic Dry Drowning; and Methadone Toxicity. Mrs. Keane filed a claim with Lincoln National Life Insurance for benefits she felt she was owed under a policy her husband was provided by his employer covering them for accidental death or dismemberment. Lincoln denied her claim for benefits.
Lincoln admitted that Mr. Keane fell into the water by accident, but based the denial on the exclusion in the policy stating that “Benefits are not payable for any loss to which a contributing cause is: disease, bodily or mental infirmity, or medical or surgical treatment of these.” According to Lincoln, Mr. Keane did not die from a jet ski accident, but from cardiac arrhythmia caused by physical exertion in combination with the methadone in his system. The methadone was prescribed by a physician due to chronic pain Mr. Keane had been experiencing for several years.
The Plaintiff argued that Lincoln was incorrect, that her husband’s death was as a result of a jet ski accident. The court agreed that yes, he died as a result from an accidental fall from the watercraft. However, the court determined that the exclusionary language for “disease, bodily or mental infirmity, or medical or surgical treatment of these” as a contributory cause precludes coverage in this case. Since Mr. Keane’s pre-existing condition contributed to his death (the cardiac arrest and poor cardiac health), the Court ruled that his wife was not entitled to benefits under the policy.
Can Anyone Collect Under An AD&D Policy?
This decision was unfortunate for the Plaintiff and makes a person wonder whether anyone with any pre-existing medical condition could collect benefits under the Lincoln National Life Insurance Accidental Death Policy. This claim was also exceptionally difficult for the plaintiff since it appears to have been governed by ERISA. It is a sad case and even more sad insurance companies are permitted to sell these policies with exclusionary provisions.
Resources to Help You Win Disability Benefits
Submit a Strong Lincoln Financial Appeal Package
We work with you, your doctors, and other experts to submit a very strong Lincoln Financial appeal.
Sue Lincoln Financial
We have filed thousands of disability denial lawsuits in federal Courts nationwide against Lincoln Financial.
Get Your Lincoln Financial Disability Application Approved
Prevent a Lincoln Financial Disability Benefit Denial
Negotiate a Lincoln Financial Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Policy Holder Rating
Well Documented correspondence
Lincoln Financial made my life a living hell
Reply
Lincoln Financials wants to claw back my money
Reply
This is the second time I've been shorted in my check
Lincoln Financial denied my STD claim because one doctor didn't send them my medical information.
Reply
Lincoln cancelled my benefits because my doctor's notes were handwritten
Reply
Lincoln denied my disability claim even though Dr said I couldn't work
Reply
Lincoln doesn't think renal failute and 4 dyalisis treatments per day are enough to be. Disabled
Reply
Q: Change in Occupation
Q: If I return to work only part time and decide I can't continue, will Lincoln Financial base my income on when I worked part time or full time?
Q: Does Lincoln Financial apply offsets to all claimants equitably?
Q: Does payback to Lincoln Financial, once approved for SSDI, include the first year?
Q: Is LF's doctor, who never spoke with me or evaluated me, allowed to clear me for work?
Q: Can LF discontinue my mental health benefits after 24 months?
Q: Can Lincoln Financial deny a total disability claim approved by a federal judge? Can I get a lump sum payout instead of fighting with them for the next 9 years?
Q: Do I have to tell Lincoln Financial that I was denied for SSDI?
Has Lincoln Contacted You About Your Liberty Disability Claim?
Is Lincoln Relying on MDGuidelines to Review Disability Appeals?
Lincoln Financial to Buy Liberty Life - Does This Affect My Disability Claim?
What Can A Claimant Expect With A Lincoln Financial Group Disability Claim?
Do You Know The Job Requirements To Be A Lincoln Financial Disability Claim Specialist?
Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company
Disability Benefit Denial Reason #3 - Video & Social Media Surveillance
How Do You Fight a Long-Term Disability Denial?
FPL Lineman Wins Lincoln Disability Denial Appeal
Attorney Alexander Palamara of Dell Disability Lawyers gets LTD Benefits Reinstated for former Walmart Manager who is now found disabled from Any Occupation
Lincoln Approves Long Term Disability Benefits After Four Year Fight
Lincoln National LTD Denial for Pre-Existing Condition Reversed on Appeal
Lincoln overturned its previous denial of LTD benefits for Escalation Engineer
After Appeal, Lincoln Overturns Denial of LTD benefits for Trucking Supervisor
Dell Disability Lawyers Wins Short Term Disability Appeal Against Lincoln
Lincoln National Life Insurance Company overturned previous denial of long term disability benefits for Wyoming Professor
Reviews from Our Clients






