AD&D result · January 6, 2025
$644,000 in AD&D Case Involving Fall
Life Claim represented the child of a man who fell and hit his head, suffering a subdural hematoma that caused his death. However, because the death certificate listed “metastatic disease” and “prostate cancer” below “subdural hematoma” as conditions leading to the immediate cause of death, MetLife denied our client’s claim, citing a policy exclusion and stating it does not have to pay accidental death benefits for any loss caused or contributed to by physical illness or infirmity.
Through careful analysis of the claim file and structure of the death certificate, we were able to successfully show that there was no evidence metastatic disease or cancer caused the fall that resulted in the insured sustaining the subdural hematoma that caused his death. MetLife agreed and reversed its denial decision, paying the claim in full with interest.
Every case is different, and past results do not guarantee a similar outcome.
