One of the most common questions I get from people about life insurance is what is considered accidental death for insurance purposes?
This question usually comes up if we are talking about an accidental death benefit rider, an accidental death & dismemberment policy (AD&D) or an accident policy – all of which might pay out a death benefit but only if the death was due to an accident.
After discussing how those options work, it’s only natural then for people to wonder what is accidental death and what is not.
And, if someone you know recently died, you might also wonder if they died of an accidental cause or not. Many people wondering the exact same thing have taken the time to post a question in the comments below.
The answer isn’t always easy to figure out.
So, I have a lot to cover but let’s start by going over what an accidental death is and what it means.
The definition of an accidental death is a death that is caused by an unintentional injury. Any death caused by an intentional, self inflicted injury or by a natural cause like old age, a disease or illness would not be considered an accidental death.
To get a clearer picture of what an accidental death is, let’s start by going through some common accidental death examples. After that, I’ll go over some examples that are not considered accidental death.
Accidental death examples are in the news every day.
From people being shot and killed to fatal traffic accidents, many different types of accidental deaths caused by unintentional injuries occur each and every day.
To get an idea of what qualifies as an accidental death, a key to whether a death is accidental or not is if it was caused by some unintentional injury.
Let’s take a look at some examples of deaths caused by unintentional injuries.
Other examples of accidental death:
Accidental deaths are the third leading cause of death overall but are the number one cause of death for people between the ages of 1-44 years of age.
These are just a few examples of the types of accidental deaths.
Next, let’s talk about what is not an accidental death, but is instead a natural death or a death due to natural causes.
Dying a natural death, or of natural causes, is not considered an accidental death. A natural death is one where you die of old age or of an illness.
Here are three of the most common questions people ask about natural deaths:
In all three of these cases, none of these would be considered an accidental death.
This would include dying from old age as well.
Some underlying medical condition or disease is usually the cause.
Now that you know what an accidental death is, why does it matter?
After someone dies, funeral arrangements must be made. Funerals cost money and that’s when your loved ones look for what kind of life insurance you had in place.
In many cases, it’s discovered that the only life insurance in place was accidental death insurance. This poses a big problem for families whose loved one died of natural causes. That’s because the accidental death insurance won’t pay out in that case.
Absent any other life insurance, those families would have to pay for the funeral out of any money you left if any or out of their own pocket.
When faced with this problem, it’s not usual to think that when someone dies unexpectedly of natural causes that it should be considered an accidental death.
After all, the person didn’t mean to die.
It must have been an accident right?
Unfortunately, life insurance companies don’t look at it that way. How old you were when you died isn’t a factor.
It’s the how you died that really matters.
Another reason how you died is important is because the amount of life insurance paid out on an ordinary life insurance policy might depend on how you died.
If you had an accidental death benefit rider or other accident benefits, the insurance company may have to pay out more if it was an accident.
Before an insurance company will consider a death to be an accidental death, they will need to know the specific cause of death. They get that information from what’s called a certified death certificate.
When you submit a claim to the insurance company, you have to include a certified death certificate with the claim to prove not only that the insured died, but also how the insured died.
When you look at a certified death certificate, it it says the insured died of carcinoma of the lung that would not be considered an accident.
That’s because lung cancer is an illness not an accident.
But if the death certificate said that the person died in a car accident, then the insurance company would treat the claim as an accidental death and cover it as such.
In most states, the death certificate lists the cause of death. However, there are some states that don’t list the cause of death on the death certificate.
When that happens, the insurance company will have to conduct an investigation.
Usually, the funeral home will help you get certified death certificates.
Certain types of deaths not caused by illness would not be considered “accidental” by the insurance company. The most common thing people wonder is suicide considered an accidental death.
Suicide is not considered an accidental death because it is a self inflicted injury.
Depending on what state you live in, most ordinary life insurance policies have a suicide clause which excludes payment for suicide in the first one to two years a policy is in force.
However, with accidental death insurance benefits, suicide is always excluded. People have asked how to make a suicide look like an accident, but that’s insurance fraud which you want to stay away from.
Here are some other types of exclusions you might see:
Other examples of exclusions you might see are:
In every accidental death policy or rider, there are a list of exclusions. You’ll want to be sure to check out the exclusions listed in your policy.
When you file an accidental death claim, here are some things you will want to do.
I hope those tips help you file any claim you might have.
After you have filed your claim, then you wait for payment. But what if the insurance company denies the claim.
What do you do then?
I once had an employee tell me that his father had died and the death certificate listed the death as a heart attack. However, the circumstances of where he died and what he was doing led the employee to a different conclusion.
Evidently, his father raised cattle and he was found out in a field. The employee told me that he believed the father was rushed by one of the cattle and struck in the chest which caused his heart to stop and he died.
In order to prove that to the insurance company, he had to have the insurance company investigate the claim. An autopsy was performed and it turned out his theory was right and he was killed by one of the cattle. The cause of death was changed on the death certificate.
Then, his father’s death was ruled accidental and the insurance company paid the claim that way.
If you believe you have a legitimate accidental death claim, but the insurance company denied it, there are a few other avenues you could explore.
Again, these steps would be for a legitimate complaint. If there was no accident it won’t help you get an accident policy to pay.
Remember that the death certificate will be the main source of information that the insurance company has to determine if a death was due to an accident.
The insurance company may obviously investigate any accidental claim regardless of what the death certificate says. I once had an employee die of an accidental gunshot which was eventually ruled a suicide and unfortunately didn’t pay a death benefit.
Medical examiners do a pretty good job of listing the proper cause of death on the death certificate and that’s the overriding factor in determining whether an insurance company will treat a death as accidental death or not.
If you have any questions, let me know in the comments and I’ll try to help.
My husband had accidental death insurance through his bank he was a truck driver flatbed and was tarping a load and had shortness of breath and had a cardiac arrest tried to save him but was brain dead is this covered
I’m sorry to hear about your husband. It will depend on what the death certificate says his cause of death is. If the death certificate says he died of a heart issue, then I would say it would not.
My father died of a stroke but the dr was not give any document and postmortem report. Can I claim the accidental death insurance.
I’m sorry to hear about your father. Unfortunately, if he died of a stroke, you wouldn’t be able to claim his accidental life insurance since a stroke is natural causes.
My Moms death certificate says cancer as cause of death but manner of death says accident. She fell 12 days before she died after just completing radiation for cancer
You might have a tough time convincing the insurance company it’s an accidental death because of the health issue going on at the same time. If there in accident policy involved, I would definitely file a claim and make the insurance company decide.
My husband died as a homicide which is accidental why should that not be considered under double indemnity?
Thank you for your quick response! I would like to know if a person can sue if a person dies from a pulmonary embolism?
In the United States, you can always sue someone but whether you have grounds to do so is the issue. In my non legal opinion based on the info I have is that a pulmonary embolism wouldn’t be something you’d probably see be successfully sued for. If you feel someone was negligent, you’d want to ask a lawyer to be sure.
My mother was in the hospital with COPD for approximately 1 month…although she needed help in and out of bed..she was stable. We received a call from the nurse at 9pm on a Sunday night explaining that she was found face down on the floor in her room..she wasn’t responding and that we should get to the hospital. She passed at 2:15 the next morning…she never regained consciousness. I found the insurance policy only through bank withdrawals, we cannot find an actual,policy anywhere. My brother was told they will not pay. We were called down because of the fall..as I said..she was stable before that. We cannot imagine why she would have that kind of policy in the first place.. it’s very frustrating. Thank you.
My condolences on your mom. I’m assuming the policy was paid current when she died and hadn’t lapsed. If you are the beneficiary you might also be able to get a copy of the policy to see what kind of life insurance it was and if was only an accident policy. When I read your comment I also wondered if the fall had anything to do with her death but I’d imagine it’s pretty tough to know for sure unless there is evidence of it. It’s likely she collapsed from her condition. Have you seen the death certificate to see if the cause of death was listed? Not that it would do any good but if you believe she died because of the fall, you could file a complaint with the department of insurance. I doubt you’d be successful especially if the death certificate states she died of a medical condition. Sometimes people buy accidental death policies because they are cheaper or when they are unable to qualify for a regular life insurance policy. It’s not an unusual purchase as sometimes people think at least it’s something if by chance they happen to die in an accident. Best of luck.
Hi. My brother had a heart attack while driving. His car flipped and fell over embankment into a pond. Some off duty EMTs and Firefighters saw the accident and was able to get him out of water in less than 10 mins. They revived him and got his heart beating again but the doctors at hospital told us that he was in the water too long and was brain dead. There is nothing on his death certificate indicating drowning or anything about his brain. So did we pull the plug for nothing or did medical examiner make a mistake on the findings?
I’m sorry to hear about your brother. The circumstances around your brother’s death are very complicated. My first thought was how did anyone know he definitely had the car accident because he had a heart attack and not the other way around. Was there a witness? Did someone just guess that’s probably what happened and then it was believed? Even then, it seems like he initially survived the heart attack although he may have still died from it if there was no accident involved. I also wondered if there was a cause of death listed on the death certificate. I believe there are laws that govern how long after an accident that a death would still be called an accident. If there is a claim involved, I would certainly send in all the documentation about the auto accident and how you believe his death was caused by the accident. Mistakes can be made in the cause of death. If the claim is substantial, then you might want to check with an attorney.
My dad died after a fall that broke his hip. The death certificate shows 3 causes of death. Heart and kidney failure and broken hip. He has an accidental death policy. Dad had heart issues for years but lived three weeks after the fall. Had surgery and took 8 days before he was taken off the ventilator. Lived about 12 more days. What do you think would be the outcome of accidental death claim?
First off, I’m sorry to hear about your dad. My sincere condolences. Unfortunately, your dad’s death is not as clearly connected as it might have been if he died instantly in an auto accident. My feeling when it’s not clearly connected and other health issues are involved that insurance companies will not consider it an accidental death even if an accidental fall created the chain of events that led to his death. With that being said, there are laws that outline how long after an accident a death can occur and still be connected to that accident and be claimed as an accident. For example, it might be 30 days. It could vary by state. I’d make sure that on the claim forms with the insurance company, you clearly highlight that the death certificate shows the broken hip as a cause of death. It might also be a good idea to consult with an attorney and get their advice. If you have a chance, let us know what the results of your dad’s claim ended up being.
My husband underwent surgery to have a kidney removed due to cancer, The doctor came out and told us after surgery that it was a rough one and he would be sore for a while. Soon after they realized that he was bleeding massively and we found out that they had “nicked” the artery and the adrenal gland. After giving him over 30 units of blood he died. Would that be an accident? COD is listed as blood loss.
I would certainly file a claim for accidental death. However, before you file a claim, I would try and do two things. First, I would see if you can get documentation that supports what you found out about the artery. If you can get that, I would include that with your claim. Second, I’d also see if the cause of death could be changed on the death certificate to reflect that documentation before you file. That being said, it’s my hunch the insurance company won’t see it as an accident since other things were going on. It might be dependent on the specific language in the policy. One thing is for sure, make sure you file even if you can’t get what I suggested and include what you know. I say this because you want to make the insurance company decide and not decide for them. You might ask an attorney for help as well if they deny the claim. I’m sorry for your loss. Best of luck with the claim and let me know what you find out.
My wife passed away in her sleep after taking too much of her prescribed medicine according to the medical examiner. The death certificate lists the death as accidental. I have submitted the death certificate, toxicology report, police report and medical records all showing that those medicines were in her system, with the prescription bottles on her dresser and notes that the doctors were prescribing it. It has taken me over a year to get all of these reports. When I called the insurance company today I was told that the case was under review. What do you think my chances are of getting the claim paid?
Without looking at the policy, it seems like with all that documentation the chances would be pretty good. I would have thought the death certificate would have been enough. Did the insurance company request that additional information or did you take it upon yourself to get more documentation before you submitted the claim?
The insurance company requested all of that. Originally I only sent the death certificate and the form they requested, then they came back and asked for all of the other things. They wouldn’t even work on it until I sent them the medical records, which is what took me so long to get. The doctor’s office didn’t want to let me have them, and the insurance company didn’t even attempt to request them from the doctor’s office. They left it completely up to me.
That’s crazy but I guess it’s not unexpected. Let me know how it turns out. My condolences on the loss of your wife.
If the manner and cause of death on death certificate is listed as undetermined would that pay out as accidental ?
It’s hard to say but it is possible if the insurance company is given more information to prove it was an accidental death.
my son was just found dead in a bathroom stall. they are sending for an autopsy. he was 28. said there was air duster in stall with him. but he also had health issues, as high blood pressure and his father had a heart issues – that cb unbeknownst to us. I have an acc poicy that has a death payout as well as a common carrier. but if he was just in a restroom someone the commercial carrier wn be relevant right? thx
I’m really sorry about your son. An example of a common carrier is a bus, plane or train where you buy a ticket to use the transportation. An example of a common carrier accident is a plane crash where paying passengers died as a result of the crash of the plane. Since your son’s death was not caused by a common carrier being in an accident, the common carrier payout would not apply.
My mom passed away one week to the day after a fall that resulted in a hip fracture. She had several medical issues prior to her hip fracture. She fell in the kitchen, she was wearing her boots that had ice gripper things on them (sorry forgetting the correct name of them). Work great on ice not so much on linolium. They caused her to trip then fall. She was taken to the hospital right away. The doctors had a hard time controlling her pain since her blood pressure would drop with them. She was also on blood thinners so they had to wait a couple of days for surgery. During this time she went down hill. She had dementia prior, but she was interacting, would start conversations, would remember faces, or that people where family. She was taking care of her dog, talking on the phone, and facetiming with my husband, son and I who live in a different state. After she was forgetting who people where, what happened, she was refusing food and drink, and was compative. After surgery she became completely incoherent, no longer even tried to communicate directly. She would sometimes have some recognition but pretty much just prayed and kept saying please help. The fall was wednesday, surgery was friday night, and by sunday she was put in hospice and released to go home. We asked that her defibulator be turned off. She passed away wednesday morning peacefully in her sleep with all of us present. The medical doctor who sent the paperwork to the coroner and/or funeral home stated death was due to heart disease and complications from hip fracture. After reviewing her medical records the coroner labled her death was due to medical complications from a hip fracture, and labeled it accidental. He also listed her other medical conditions on the death certificate under the “other significant medical issues that contributed to the death but not resulting in the underlying cause of death” We learned from our father after her death that they both had an Accidental Death and Dismemberment policy. When we contacted the company they said they would send us the paperwork and instructions from filing the claim then it would be reveiwed by a claim adjuster to see if it is a valid claim. My question is with the death certificate labeling it an accident and stating her other medical conditions did not result in her death, and the fall was due to her tripping (not collapsing) would they even be able to deny the claim? I told my siblings that I didnt think they could unless the policy specifically excluded medical complications and/or hip fractures given what is stated on the death certificate and how she fell.
I’m really sorry to hear about your mom. Whenever there are medical issues involved in an accidental death, it certainly complicates any accidental death claim. In those situations, I think insurance companies err on the side of the medical issues causing the death instead of the accident. Having the accident cause listed on the death certificate will help your case but not necessarily mean they will pay it. You might talk with an attorney if they deny the claim. Let me know how it turns out.
Would you consider death caused by rabies a month after a dog bite or scratch an accidental death rather than one caused by a disease?
That’s a tough one. I think it might be unlikely that it will be considered an accidental death because rabies is a disease. So my guess is no but I’ve never encountered that situation to know for sure. I would still file a claim and provide information on the dog bite.
My brother was bitten by a dog and died due to rabies within few days. I would like to know if we could claim his death (caused by dog bite leading to rabies death) on his accidental death policy. I know you said your opinion above. But, wanted to check if you found anything after your last comment.
Hi, I need to know whether the food aspiration can be considered as accidental death.
The death certificate given cause of death as Food aspiration Natural Death.
This person is 30 yrs of age who do not have any past medical history. There are no eye witness and the cause of death was know from the examinations been done after the death.
While food aspiration is a disease or condition, I definitely think it can be accidental. The tough part here is that death certificate doesn’t indicate it was accidental. Since there was no previous health history of it, I would consider trying to talk to the doctor who signed the death certificate if it’s even possible to reach them. Certainly seems accidental the way you’ve described it. I’d see what kind of luck I had getting in touch with the doctor before filing a claim. Once you find out what happens there, you’ll know more. Definitely file a claim and make the insurance company decide. I’d make sure you include her medical records that prove she never had a history of it. Report back if you can. Good luck.
Thank you Michael.
On the medical report there is a question asking whether the cause of death accidental and doctor answered as “Not accidental” further the same document has given negative answer to the history of illnesses and further say that the cause of death been identified from the examination done after the death. Therefore its not clear why the doctor has say that this is not accidental.
further this person is a soldier and death occurred at the camp. Since he is a soldier and the age just 30 yrs we can assume that this person may not had serious illnesses.
Always possible he checked “not accidental” by mistake. It can happen. Otherwise, he must have had his reasons. Some conditions can go undiagnosed even at young ages. See if you can contact the doctor to find out more and ask him to reconsider his decision if it makes sense to ask after you hear what the doctor says.
Hi, my husband died of anoxic brain injury from being misdiagnosed at least 3 times. The last time he was at the ER department was Dec. 31st with signs of acid reflux. They did do the usual test for heart problems like an EKG blood work and an xray. His pain was in his chest and radiating to his neck and shoulders. They said his test were fine and he could go home. His pain had stopped but that was usual. It would come on for 10 to 15 min. And then stop for a couple of hours and then happen again. I feel this was a accidental death because the doctors were neglegent by not keeping him over night to watch him and make sure it was acid reflux. It turned out to be angina and I feel a doctor should know that signs of angina is the same as acid reflux and should of kept him for observation. So on Dec. 31st he had a heart attack and died Jan. 15th because of a blockage to his heart. So this is why I consider it a accidental death and wanted your insight in this matter as I’m getting ready to hire an insurance lawyer.
It seems like the underlying cause might be a heart attack. My first thought is that the insurance companies won’t consider it an accidental death because of that. I suppose it is possible that the hospital might still be negligent but that may or may not affect the cause of death for the insurance companies. Legal advice is always good in these situations to help you sort these issues out. Let us know how it turns out and my sincere condolences on the loss of your husband.
My wife passed away as a result of aspiration of gastric contents. I found her in the bathroom sitting on her walker. What truly happened will never be known. The death certificate lists the manner of death as accident. It took the ME over 4 months to come up with this. I recently gave the insurance company the information to start the claim. They have yet to ask for any documentation. What do you think are the chances of this claimed being approved and what do you think is going on with the insurance company? Seems they would have asked for something. Thank you for your opinion.
I’m really sorry to hear about your wife. Since the death certificate lists the cause of death as an accident, I think the chances are pretty good that the insurance company will see it as an accident as well – especially since the medical examiner seemed to investigate the matter for several months before making that conclusion. Had the medical examiner listed the cause of death as aspiration of gastric contents instead, I think that would have complicated things with the insurance company. Of course, the insurance company will do their own investigation and need to come up with the same conclusion. Hopefully, they will.
My dad fell a few months ago and hit his head and had to have stitches. He passed away due to a brain aneurysm and we are wondering if this would be considered accidental death.
Because a few months passed between the fall and the aneurysm, I’m doubtful it would be considered accidental death. I would ask his doctor if the doctor felt it was connected and go from there. I’m sorry to hear about your dad.
My mother had dementia. She had a fall that caused a traumatic brain injury. She died 8 days after the fall due to the hemorrhage in her brain. The doctor put dementia as the cause of death and a side note that a frantic brain injury was a contributing factor. He listed her death as natural causes. She had an accident policy we didn’t even know about. Should we talk with the doctor first about death certificate before we send off policy paperwork?
I’m sorry to hear about your mother. The first thing I wondered when I read your comment was how old your mother was. Sometimes accidental death policies or benefits don’t pay after a certain age – like age 70. If your mom was over 70, you might check the policy carefully for an age limitation. As for the doctor, I would consider talking with the doctor. Sometimes doctors have more information that leads them to decide what they do. Maybe there’s a strong reason he listed the cause of death the way he did. If I spoke with the doctor, I’d ask if they think your mom would have died if she hadn’t fell. My guess is that you won’t have much luck with the doctor and probably should just file the claim. When you file the claim, I’d document the fall in the paperwork and explain why you think your mom’s death was an accident and cite that the doctor also listed the brain injury from the fall as a factor in her death. Then I’d wait and see what the insurance company decided. Accidental death claims often need to be clear cut accidents in order for the insurance company to rule them accidental. If they do deny the claim, I’d ask them to review their decision. Then, if you feel strongly enough to go further, you can always file a complaint with the department of insurance or seek legal advice. If you are working with an attorney already to settle her estate, then I’d go ahead and get their thoughts on the matter as well.
I’ve got a client who fell at home and injured his leg on 1/12/19, had complications and had his leg amputated on 2/7/19, and passed away from a blood clot on 4/5/19. The cause of death on the death certificate says “natural,” but it seems clear that it’s all related to the accidental injury and subsequent amputation. Do you think it’s worth appealing the decision?
It’s not clear whether you mean the death certificate or the insurance claim but in either case, it’s worth looking into. The cause of death on the death certificate and the length of time between the accident and the death might make it an uphill battle. Laws are different in every state and every policy definition is different. Might have an attorney weigh in on it as well.
My father in law slipped on a wet floor and hit his head on the sink. He was in a coma for 3 days before paasing. The death certificate listed the cause of death as an accident. The insurance company paid a lesser amount because of his age. Was this legal or should we call a State agency?
Did the insurance company provide a reason for the reduced payout? If your father-in-law was 65 or over, the policy could have had an age reduction schedule built into which could have reduced the amount. It’s a pretty common and legal to do. Also, sometimes accidental death benefits end at age 70 which could also be the reason. A careful reading of the policy would help. Here’s how age reduction schedules work. My condolences on your families loss. https://www.glgamerica.com/age-reduction-schedule/
My husband recently passed in an auto accident. His death certificate says ACCIDENT as cause of death (with nothing pending) the life insurance company asked for a toxicology. If something was in his system, will they still pay?
My guess is that the insurance company wants to double check to make sure that no laws were broken. Many accidental death policies have exclusions on payment in certain situations like if you break the law and die in an accident then that might be excluded. For example, if you are robbing a bank which is a felony and get killed while you are doing it, then payment on accidental death could be excluded. It would be the same if someone was driving over the legal limit which is against the law. It’s probably routine for insurance companies to check the toxicology report just to make sure it was clean. If there was nothing in his system, then it’s most likely just the insurance company verifying it on their end as part of their routine claims process. I’m sorry to hear about your husband.
I understand that, I’m asking what if something WAS in his system. Will they still pay out? Even though the death certificate & police report say it was an accident..
If the toxicology report shows an illegal substance or illegal level of something was in his system and there are exclusions in the policy related to that, it is possible they could deny the claim.
My brother was on the Inca trail in Peru – according the witness – he passed out and fell 8 meters over the edge of the trail hitting his head on a tree in the way down. There was a significant amount of blood according to the witness. The autopsy from the small town Peruvian doctor ruled it a heart attack. We are awaiting more details from the autopsy report. It seems if the heart attack killed him instantly, he would not have bled so much from his head. The fall and head wound were not mentioned on the death certificate. The accident insurance companies are struggling to make a determination.
I’m sorry to hear about your brother. The circumstances surrounding your brother’s death do make it very difficult to determine if it was accidental. What you are saying is logical about the bleeding but it doesn’t sound like the doctor saw it that way. To complicate matters, it appears he might have been in a foreign country at the time it happened. If it isn’t a clear cut accident, it’s likely the insurance company will ultimately decide it wasn’t accidental. You might seek legal advice to see what options you have.
Need advice on this.
ADB Definition – if the life assured sustains any bodily injury resulting solely and directly from an accident caused by outward violent and visible means and such injury shall within ninety days of its occurrence solely, direclty and independently of all other caused resul in the death of the life assured.
The cause of death was poisoning. but its not clear whether he has consume poison or it was accidentally entered in to his body or someone forcefully given poison to him.
As per the ADB definition can be consider ADB on such cases.
The way the definition of ADB reads in your comment, I’m not sure an accidental poisoning would qualify.
My son was killed in a car accident that he fell asleep and hit a pole. My husbands life insurance company now wants the toxicology report from the coroner and wants me to sign a paper for the coroner to release the report.
The letter they sent me says
“ I understand the following:
I understand that my treatment,payment,enrollment, or eligibility for benefits may not be conditioned on signing this authorization.” What does this mean??
Without seeing the authorization, I’m not sure. I would contact the insurance company or your agent and ask them what it means.
Husband died almost 7 years ago (this is all stated on his death certificate…..from Oxycodone and Ethanol Intoxication. -Ingestion of prescription medication to toxic levels while under the influence of ethanol. The death certificate also states: other significant conditions contributing to death but not related to cause as: Cardiomegaly, Atherosclerotic CoronaryVascular Disease. Would this qualify as an accident (even the box is marked “accident” on the death certificate)?
Thank you for your assistance!
Whoever filled out the death certificate didn’t really clearly state whether it was an accident or not and didn’t seem to want to say. Because they checked the accident box, you could make an case that it was an accident. Since it was so long ago, it might not matter now. As a third party it seems self inflicted to me.
My brother was weed eating on a hot day and died from a heat stroke. He had a stoke about 4 years ago. My mom had just took out life insurance on him the same week he passed. We thought the policy would pay full benefits because the coroner listed caused of death being a heat stoke.
I’m not sure what type of life insurance your mom bought for your brother. If it was an accidental death only policy then I don’t believe an accidental death only policy would pay for a death caused by a heat stroke. If it was a regular life insurance policy with an accidental death rider, then it would have only paid the base policy amount and not the rider. This is assuming the policy was approved when she bought it. Many policies have to go through an underwriting process before the policy is approved and only then is it considered inforce. This process sometimes takes a few weeks. It is possible the policy would not have been approved and that might also be what a claim was denied. It might not have been inforce in the first place.
Hi my dad fell in house an broken his back and died
3 weeks before this he was hospitalized due to falling in his house and lying alone for 2 days before my brother found him he was released from hospital them saying he was fit first autopsy done said inconclusive 2nd one was done result saying on death certificate urine infection and pneumonia and that was what he was being treated for in hospital so all this resulted in my father falling again and breaking his back do we have a claim
My father in law fell 10 weeks ago and broke his hip while staying at his assisted living facility. He went to hospital. He had a replacement and returned to the ALF. Unfortunately he fell again and RE broke the same hip. He spent one month in the hospital then returned to the ALF. His wound never healed, he was no longer mobile and was placed on hospice care. He died two weeks later. He had a mental disorder before the accident and smoked but was in fair health before he fell. Now he’s gone. Would his 10 year old ADD policy be a claim here?
I would file a claim but it’s hard to say. What did the death certificate say? Did it list a cause of death?
My father recently passed away. The circumstances were that he fell, hit his head and had a large bleeding contusion. He was in the ICU unit, and while in there for a few days had a stroke from a blood clot on his brain. Three weeks later he passed away. On the death certificate it just states that he had a stroke and COPD, which my dad never had a diagnosis of at least it was never mentioned to us while he was in the hospital. I contacted his accidental death insurance policy and they claim that this was not covered as an accidental death. Do you feel like this is something we should pursue in getting his death certificate changed and contact the hospital for a more detailed description for the insurance company to try to receive his accidental death benefits?
The first thing I recommend is to talk to the official who signed the death certificate if possible and see if they will review the situation based on what you told me. As far as the insurance company goes, I got the feeling you contacted the insurance company but didn’t actually file a claim. I would not just contact the insurance company by phone to get the answer. I would always file a claim. While it is still possible (and likely) they might deny the claim, filing a claim actually puts the insurance company on record and requires the insurance company to look at the claim and officially evaluate it. A phone call does not. I’m not sure how much the accidental policy is for, but you might seek legal advice to check for sure or file a complaint with the department of insurance if you feel you have a valid complaint. Keep in mind though that this is a gray area and it’s not 100 percent certain the accident caused the blood clot and the stroke. It is indeed possible though and worth talking to the person who determined the cause of death and filing a claim.
My wonderful husband suffered from parkinsons and his parkinsons Rx gave him ‘fog Brain’ after each pill for several hours.
During such a brain fog he got in the car dressed in his night clothes and drove into a moving train after going around the working/flashing train’s safety arm and crossing the yellow line in the street, he hit the moving train and died immediately.
It looked like a suicide but after I spoke to the Coroner and advising him of my husbands reactions to his meds, the fact that he was nearly blind in one eye & had set out his clothes, Meds and breakfast for the day for his return home, and that he had had delusions, the Cororner amended the manner of death from first ‘Pending’ waiting for tox results after an autopsy, to suicide, to INDETERMINATE (after he spoke to me) before the Death Certificates were given to the funeral home to dispurse to family.
I just mailed our auto Ins co a certified copy of the Death Certificate with their requested accompanying claim form stating Manner of Death ‘Indeterminate’.
What can I expect to happen?
I think you did the right thing by talking to the coroner. I’d expect the insurance company to investigate it. With no evidence of suicide, I wouldn’t think they could deny it for that but you never know. However, a law was broken when he crossed the train track with with the guards down and that might be an issue. It would depend on the language in the policy. Also, the dosage of the medication could be a factor he was on meaning that if he took more than he should have they may be a factor too. I’m interested in how it turns out if you are able to report back. I’m so sorry for your loss.
My husband was diagnosed with cancer. On the way out after his first chemotherapy, he fell. They admitted him to the hospital. They found a blood clot the next day. He had blood clots in both his lungs when I first took him to ER a month earlier. He was placed on blood thinners. Even after they found another blood clot that next day, he was feeling good. The next morning he vomited and it went back down and he suffocated on it. Vomiting can be a reaction from chemotherapy, but choking on it was not expected. Even though the medical notes are clear and graphic about him suffocating from his vomit, another doctor who was not there at death stated on the Death Certificate that he died of natural causes.
After reading your comment, it makes me wonder if the doctor put natural causes on the death certificate to avoid a possible accident being reported at the hospital.
I found out my mother had an AD&D policy 3 weeks after she passed away in the hospital. the Cause of Death on the death certificate says acute hypoxemic respiratory failure , ie she choked on applesauce in the hopsital and was originally admitted for an accidental slip and fall off of her bed . She was taken to the ER admitted and two days later aspirated and they intubated her and put her on a ventilator . she had a tracheostomy which gave her 40 more days and wasnt able to be weaned off of the ventilator and then got sepsis 37 days later and her kidneys shut down and passed away 3 days later . Since choking caused this could this be an accidental death case for a n insurance pay out or at least file a claim . The certificate doesnt say accidental on it .
Whenever someone doesn’t die right away from an accident, it certainly decreases the likelihood of an accidental death claim being paid. It also might depend on language in the policy. My best advice in these situation is to file a claim and make the insurance company make a formal decision. File a claim and if you think of it, report back and let us know what the result of your claim was. My condolences on the loss of your mother.
Thank you sounds good I will file the claim and let you know what they said . i have all the neccsesary forms to do it .
Through my stupidity, my elderly mother was very overhydrated (after a home remedy to induce vomiting) but neither the first responders who I called for her low blood pressure (very little salt consumed during previous week) or the ER staff asked me or my mother whether she was overhydrated or what was done for her at home. Thinking she was dehydrated, the ambulance responder gave her an IV. In the ER, the first thing a young nurse did was replace the first IV with another IV (without even checking the results of the first IV!), and my mother immediately had multiple signs of hypervolemia and pulmonary edema, which the hospital staff called “Pneumonia.” She was taken to the ICU with a stomach that looked like it had swallowed a basketball. The doctor wrote the cause of death as “natural,” “Pneumonia” and that the duration was “Days”! They covered up the fact that the arrogant misdiagnosis of the first responder and the ER nurse accidentally killed my mother by not asking me–her caregiver of nine years– if she was by chance already overhydrated. I had never heard of hypervolemia or pulmonary edema until I researched what I saw happening in the ER. we waited an hour to get into the ER and neither the first responder or the ER staff checked on her or would help her get up or roll over on her side on the guerny. The ambulance driver would not let her move or sit up because of the IV and his fear that she might fall. She knew something was wrong, and she was trying to save herself by getting up so she could breathe better! Prior to this she had had absolutely zero symptoms of pneumonia! Probably hundreds of thousands of patients are being misdiagnosed and killed in hospitals and they are covering it up and getting away with it!
I’m sorry about your mother. I’m sure that was difficult. I tend to agree with you that death certificates may not be as accurate as they need to be.
My client was seriously injured in a motorcycle accident on 11/22/2018. Afterwards, he had a handful of surgeries as he tried to recover from his injuries. In September of 2019, he was instructed by one of his doctors to have another follow-up surgery. He died on 9/30/2019 during surgery. He has a policy that pays out for accidental death only. The doctor that filled out the death certificate opined that he died of “natural causes.” That doctor had never met the decedent and, to our knowledge, was unaware of his accident. Initially, the Insurance Company has denied any coverage. If I were to go back to his treating physicians and they could tell me that all of his surgeries, including the one during which he passed away, were necessary as a result of the accident, would there be a valid claim for benefits under an Accidental Death policy?
A lot of time passed from his accident to when he died. I believe there are time limitations on how much time can go by before it is no longer considered accidental under a policy. This may vary by policy or it could be by state law I am not sure. I would look into that.
My husband died of a stroke recently. They put natural cause on death certificate. The reason he had a stroke is that he lost his balance and fell hitting his head and chest on the bathtub and lay in-between the toilet and bathtub and couldn’t get up by himself. He told me exactly what happened and I tried to help him get up, I had to call 911 to get him up off of the floor. When the firemen got him up and into a chair he started having a stroke and died a day later. My thought it was a stroke initiated by the traumatization of the fall. This would be a stoke brought on by an accident , right?
Any time someone doesn’t die immediately but dies later after an accident due to another cause (stroke), it will make it easier for the insurance company to deny any accidental death benefits. I would definitely file a claim and document all that you know in the claim. My condolences on the loss of your husband.
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My name is Michael Kuhn. I started GLG America to help employees and individuals with their life insurance and other benefits. Read more about GLG America here.
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