Health · Chapter 13 · Limited Policies — Accident Only
Accidental Death & Dismemberment (AD&D) Policy
Definition
Pays a lump-sum benefit if an accident results in death or dismemberment. The accident must be the SOLE cause of the loss, and death benefits typically require the insured to die within 90 days of the accident. Policies may include an optional provision excluding losses sustained while the insured is intoxicated or under the influence of narcotics — unless the narcotic was taken on the advice of a physician. Sold standalone, as part of a group plan, or as a rider.
In plain English
Pure accident coverage: die or lose a limb/sight because of an accident alone, and a preset lump sum pays out.
Exam tip
⚠️ Exam assumptions: losses from complications are excluded · the accidental-loss window is 90 days (some states allow later death if the insured was totally and continuously disabled from accident until death).
Easy to confuse with
These are what this term gets tested against — if you can't tell them apart cold, drill the contrast.
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