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  • Lincoln Financial Disability Appeal Tips and Claim Help for a Disability Benefit Denial

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.

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Can you help with a Lincoln Financial disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Lincoln Financial. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Lincoln Financial.

How do you help Lincoln Financial claimants?

Our lawyers help individuals that have either purchased a Lincoln Financial long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Lincoln Financial:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
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Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

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Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

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Lesley C. (Washington)

This was a very stressful time in my life. The disability company to whom my employer and I had paid premiums to for 30 years and who had paid me disability benefits for the past 12 years had closed my case and denied my appeal. I wasn’t sure what to do.

Following in depth research, endless phone calls and phone interviews of potential representation, I chose Dell & Schaefer to represent me. I am very happy I made that decision.

Rachel and Sonia at Dell & Schaefer listened to my concerns and reasons for wanting to appeal my claim. They requested my personal statements and files from the disability company for their review. I felt they always kept me updated as things progressed and requested additional info when necessary.

This is not a quick nor easy ordeal to have to go through. However, having Rachel and Dell & Schaefer behind me, I felt I had the best representation possible on my side.

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