Whoever said the “dead tell no tales” was clearly unfamiliar with forensic claims. In cases of sudden or unexpected mortality, the humble death certificate can provide essential reading for the claims examiner often in conjunction with a police report or medical examiner’s report.
From observations of the body, to evidence of alcohol use, drug abuse or foul play, these reports reveal twists and turns as surprising as any detective story – but the examiner first must know where to search.
Enter forensic claims: the application of scientific techniques to more thoroughly evaluate a claim submission. Depending on the nature of a claim, a well-trained forensic claims examiner will request the death certificate, police, autopsy and toxicology reports and hospital records (it is less common to request a coroner's or investigating detective’s report). All can provide a wealth of information relevant to an accidental death or life insurance claim. After all, clues often come from the most unexpected places, from a flaming helicopter to a steaming cup of poppyseed tea. Consider these actual examples of forensic analysis:
- A young man dies in his home and the cause of death is initially listed as a drug overdose. An autopsy reveals opioids in his bloodstream, but was this the actual cause of death? The opioids were later determined to be natural components of the poppyseed tea he had legally purchased and was drinking at the time of death. However, the true cause of death was his concurrent and unprescribed use of marijuana.
- When a medical internist died of an insulin overdose, it was deemed purely accidental until examiners learned that the man was not a diabetic, which made his injection of insulin a suicidal act.
- When a state police helicopter fell from the sky in a fiery crash, the pilot’s autopsy revealed a toxic blood alcohol level. Was the pilot flying drunk? Examiners determined the high alcohol content was a consequence of a natural chemical reaction tied to combustion.
While forensic claims investigation is a specialty, it is founded in basic facts found in any death certificate. Let’s consider nine key clues examiners should look for today:
1. Recognize that “Undetermined” is a question – not an answer to the cause and manner of death.
In most U.S. states there are only five acceptable options for manner of death: natural, accident, suicide, homicide and “undetermined”. But “undetermined” is really a question, not an answer: it is an admission of continued uncertainty. It is also rare: it’s present in only about 3% of all U.S. death certificates. In some states, the term is used in place of a “pending” status.
When confronted with “undetermined,” clarify whether the death certificate is final. If the cause of death is a drug overdose, and the manner of death is labeled “undetermined”, there could be a question amongst the authorities about the cause: suicide, an accidental overdose or homicide.
2. Know that an “accident” is not always accidental.
Recreational drugs are growing in popularity, variety and chemical complexity. If a death is the result of the toxic effects of drugs or poisoning and there is no documented suicide note or instruction, the medical examiner or coroner will often call the cause of death an “accident” because there are only five choices available in the death certificate. This in no way precludes another entity from more narrowly defining the cause. In the case of an accidental drowning for example, a forensic toxicologist or pathologist would be able to determine from bodily organs if an opiate has been ingested. This could reveal that impairment from substance abuse was a contributing cause, as this central nervous system depressant slows breathing.Read More +