Would it be worth the effort to sue an insurance company for rejecting my sister's AD&D claim after she drowned?

Asked about 2 years ago - Broomfield, CO

No drugs/alcohol involved, we're not even clear on the rejection. We're not sure if they're saying the reason is because she passed away in a coma, not the actual drowning event, or if because of a preexisting condition. (Seizures, which likely caused the drowning. She was swimming in a public pool with a life guard and had been approved to do so by her neurologist.)

We're trying to figure out if it is worth fighting for.

Attorney answers (5)

  1. Christopher Daniel Leroi

    Pro

    Contributor Level 20

    3

    Lawyers agree

    Answered . Mr. Tomberg is correct. You simply have to sit down with an attorney who can review the AD&D policy and medicals for your sister and have the attorney talk with the doctors and the insurance company. The insurance company could have a very valid reason for denying the claim. Or, the could not. Without knowing the provisions of the AD&D policy and knowing whether it might have excluded her seizures as a preexisting condition, it is impossible to know whether you have any basis for a lawsuit. There are plenty of good attorneys in Broomfield, Denver, and Boulder on this Avvo website. Search and find someone with the experience and practice areas that you are looking for. Good luck.

  2. Jeff Tomberg

    Contributor Level 14

    4

    Lawyers agree

    Answered . you should seek the services of a lawyer experienced in handling insurance claims as well as wrongful death claims. its not clear why you wish to sue the insurance company but any lawyer you deal with would be able to determine whether the medicals were properly covered by the insurance policy and if not why not. second your sisters drowning although accidental may have been preventable depending on the circumstances. a knowledgeable lawyer could determine whether the lifeguards were properly trained, vigilant, sufficient in number or location and numerous other factors that could demonstrate that the pool failed to prevent the drowning. additionally the lawyer would investigate whether it was appropriate to allow her to swim depending on the circumstances.

    without a detailed review by a lawyer can all the issues raised in your question be appropriately addressed...... more
  3. Stephen Clark Harkess

    Pro

    Contributor Level 20

    2

    Lawyers agree

    Answered . You need to speak to an attorney who handles insurance bad faith cases. The policy and reason for denial need to be evaluated as well as the amount of coverage at issue. The denial might have been justified, but some insurance companies routinely deny claims understanding that many people will not challenge the initial decision and they may save a lot of money that they should pay out.

    You can reach Harkess & Salter LLC at (303) 531-5380 or info@Harkess-Salter.com. Stephen Harkess is an attorney... more
  4. Andrew Ronald Gillin

    Pro

    Contributor Level 13

    2

    Lawyers agree

    Answered . Yes, it is worth fighting for. I suggest you hire a local attorney experienced in insurance bad faith cases. Good Luck

  5. Steven Mark Sweat

    Contributor Level 19

    1

    Lawyer agrees

    Answered . You should consult an insurance bad faith attorney in CO.

    Nothing in this communication should be construed as creating an attorney client relationship. This is for... more

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