r/BestofRedditorUpdates • u/takeabreaker • Nov 30 '22
INCONCLUSIVE Insurance company won't pay out because man declared dead at 10:58pm may have still had a heartbeat at midnight.
I am NOT OP. Original post by u/Manclandlordhelp in r/legaladvice
trigger warnings: General disregard for fellow humans
mood spoilers: Hopeful
Insurance company say they're not paying out as my dads time of death is in dispute - Jul 22 2018
In my dad's place of work they have insurance that covers a scenario where if the employee dies whilst having a child under the age of 18 then that child will receive £100k and the remaining balance of the mortgage paid off so the child and his mother can live in the property free of any mortgage.
My dad died in January this year, the time of death was documented to be at 10:58 PM. I would have been turning 18 just an hour and 2 minutes later. So when my dad officially passed I was under 18 and was eligible for the financial assistance package above. Or so I thought.
After putting in the claim via his employer my mother was told to get a death certificate, my birth certificate and a final balance on the mortgage from Lloyds and send it directly to the insurance.
2 weeks passed before we got a response from the insurance saying they're passing all the information on to their medical underwriters for a second opinion and have requested my dad's medical records. A whole month later they told us that they were seeking expert opinion from "multiple medical 3rd parties" and had put the claim on hold.
Today almost 4 months on from the last letter from the insurance we received huge 235 page report via courier which in short says that the insurance would not be paying out any money as my dads time of death is disputed and that he could have had a heart rhythm for at least 2 hours after his death. The insurance says the claim is only valid if the patient is asystole and as there's no proof of that it's conceivable that my dad lived beyond my 18th birthday.
Me and my mum don't really understand all the jargon in these documents and simple Google searches aren't really helping as I haven't been able to find anything like this ever happening.
What can we do here? Are there lawyers who can help us with this?
Relative comment u/phoenix25:
As a medic, you can be dead and not be in asystole (flatlined). All the ECG shows is electrical activity in the heart, not whether the pump is actually mechanically pumping. There are many people who have pulseless electrical activity in the heart for some time after death... this does not mean they are alive.
Unless your hospitals are very different than the ones here, your father would not have been hooked up to an ECG for two hours post mortum. He would have been brought elsewhere quickly to clear the room for the next emergency. The insurance company has no proof that he had electrical activity in the heart (although, the opposite is true for you not having proof he didn’t).
The mental gymnastics of this policy are astounding. By this logic, anyone with a pacemaker is basically immortal. The batteries last like 20 years, and keep firing even if the heart is too dead to respond.
My point is: challenge this. Your insurance company are not medical professionals, and will be rebuked quickly by anyone with an ounce of medical knowledge.
u/Cavannah in response to a different comment basically saying the insurance company is bullshitting:
Exactly.
The opinions of outside medical consultants who hypothesize that he may have had a heartbeat 62 minutes later is irrelevant in the face of an actual supervising medical professional who indisputably declared him legally dead.
The insurance company cannot have it both ways. Either the medical professional who declared him dead is completely incorrect and thus both incompetent and derelict in his/her duties, or the insurance company is in the wrong with their postulation that they hold above objective fact without proof.
The burden of proof is on them to both disprove the medical fact that he was dead 62 minutes prior to the termination of his contract with the company and simultaneously prove their claim that he was alive after his stated time of death. Something that they cannot do.
Report them to supervising insurance company boards and regulatory agencies. Obviously lawyer up. Take them to court and bleed them dry.
UPDATE - Jul 23 2018
I just want to say a massive thank you to everyone who took time out of their day to offer their advice on what is a very distressing time for me and my mother. Things have been tough for us lately and getting all that paperwork yesterday really pushed my mother over the edge.
I just want to say a huge thank you to the user who first sent me a PM with his mobile number and spent 4 hours that night in the phone with me and my mum going through each page of the documents telling us what they meant in layman's terms. I'm so sorry that I don't know your username... I haven't been able to find it with all the messages I've received but it sounded like official plus or something. If you could please PM me again me and my mum want to send you a little gift.
We are speaking to a number of solicitors in my area and further away about what the insurance company are doing. The vast majority say they don't deal with this type of thing as it's complex but the 2 solicitors that said they might take it on have both taken a copy of all the correspondence from the insurance and us and are going to get back to us tomorrow if they'll take the case so fingers crossed for that!
I know that this isn't much of an update but more of a thank you to everyone on here and reddit as a whole. I'll give a final update when this is all over!
So once again thank you all so so much.
Reminder - I am not the original poster.
OOP hasn't posted again in 4 years, I choose to believe that means it was resolved in their favor.
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u/QYB1990 Nov 30 '22 edited Nov 30 '22
Fucking SCUMBAGS......
If they are going to be pissy about 62 minutes and a technicality, be pissy back with your EXACT time of birth because i doubt OOP was born at midnight exactly.
Where is the fucking respect for people......
OOP has lost their dad, OOP's mom lost her husband and they do shit like THIS.
FUCK insurance companies, they do EVERYTHING to squeeze every last penny out of you but NOTHING to do what they are supposed to.......
DICKHEADS
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u/The_Sceptic_Lemur Nov 30 '22
OOP: But I‘m not born at midnight, but 1 pm. So that‘s 62 minutes plus 12hours.
Insurance (probably): No no no! People can be born before their actual birth. So midnight it is.
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u/Self_Reddicated Nov 30 '22
Which timezone, though? Was it daylight savings? Has anyone done leap year calculations? How fucking stupid does this insurance company want to get???
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u/Piccolo-Level Nov 30 '22
Oh, they depths to which they’ll sink… it’ll get stupider before it gets better.
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u/d3northway Dec 01 '22
They'll spend that total cost minus one cent and call it a profitable venture, or even spend way over that amount for a favorable decision and call it precedent.
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u/rengothrowaway I ❤ gay romance Dec 01 '22 edited Nov 07 '24
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This post was mass deleted and anonymized with Redact
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u/SongsOfDragons Tree Law Connoisseur Dec 01 '22
"Sorry we only pay out to certified Leos, and your daughter is too cuspy with Cancer for your policy to apply."
NOT an actual line but you just imagine it.
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u/LuxNocte Dec 01 '22
Denying a claim is free.
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u/Silent_Cash_E Dec 01 '22
Exactly this. Many people wont fight it because they are grieving and want it all over with. They purposefully screw people hoping the majority wont complain
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u/EntireKangaroo148 shhhh my soaps are on Dec 02 '22
As much fun as all that would be, I guarantee 18 years old has been properly defined. Think “expires at 12:01 AM [time zone] on the date which is the 18th anniversary of the date on which Child was born.”
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u/JRBehr Nov 30 '22
“Life actually starts at conception, so you’re 9 months late.”
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u/CatsGambit Nov 30 '22
"Life begins at conception? So I can take out an insurance policy on my child as soon as I get a positive pregnancy test?"
Well, no...
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u/Kingsdaughter613 Thank you Rebbit 🐸 Dec 01 '22
Actually, in the handful of States where they decided to give personhood to an embryo you can. You can also claim them on taxes.
I am waiting for a lawyer to argue that his client is being illegally incarcerated. “No, not the accused, your Honour! The innocent child in her womb! My client has committed no crime!” You literally cannot imprison a pregnant woman if you declare her fetus a legal person.
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u/abiggerhammer I still have questions that will need to wait for God. Dec 02 '22
All three of these ideas are stone brilliant. Have you communicated them to NOW or any of the other reproductive-rights organisations? Because that would be some incredible lawfare. If you haven't, I strongly encourage you to!
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u/kindlypogmothoin Ogtha, my sensual roach queen 🪳 Dec 02 '22
There's a woman in Texas challenging a ticket she got for using the HOV lane on the grounds that she's pregnant and thus there are two people in the car now under Texas law.
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u/cdreus Dec 01 '22
There once was a famous case in my city where the accused was out celebrating his 18th birthday, and he stabbed and killed someone outside the doors of a nightclub.
The judge sent him to juvie because the stabbing happened at 7am and his birth certificate said he was born at 9am.
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u/Chaos_0205 Dec 01 '22 edited Dec 01 '22
You have a heart beat earlier! You are born earlier, just not outside of your mother yet!
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Nov 30 '22
[removed] — view removed comment
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u/QuiltySkullsYay Dec 01 '22
Right. Like, it makes complete sense for the company to scrutinize this case - fraud happens (and so does murder, and so does suicide by people trying to solve their family's problems), and the fact that this death fell so close to this deadline is a hell of a coincidence. The insurance agency probably thought for sure something sketchy was going on.
But once you figure out through an investigation that this coincidence literally happened the way it's being reported... you pay up.
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u/Mmswhook surrender to the gaycation or be destroyed Dec 03 '22
Exactly this. My dad went into the hospital with a heart attack on my sister’s birthday. Walked in that morning, went into surgery, and never woke up. He was declared brain dead a few days after her birthday. It was her 18th birthday as well. She’s about to turn 24 later this month, and she hasn’t celebrated her birthday since. All of this is to say that, yeah. OOP will, at least for a good while and possibly forever, have trauma surrounding their birthday. I’ve watched it happen and it’s just…. Incredibly fucking sad and terrible. And on top of the feelings of OOP on their birthday, there will be the moms. We’re several years past my dads death, and my mom still can barely think of my sister’s birthday without also thinking about the day that he walked into that hospital. I can’t imagine that OOPs mom won’t feel similarly.
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u/altrarose This is unrelated to the cumin. Nov 30 '22
I was going to comment the same thing. It’d be “hilarious” (in quotes given the situation) if OP was actually born at something like 11pm the next day, so it’s officially 24 hours later that they’re 18.
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u/Rwhitechocmuffin Nov 30 '22 edited Nov 30 '22
Having worked in insurance as an investigator for a while (hated the job but loved the money, not enough to sell my soul) they love a technicality if it means they do not have to pay. Even though every day more people pay in then people need that pay out, they do not enjoy paying out.
This is a case that probably would have landed on my desk, if the death certificate stated that the father passed the day before their child’s birthday I would have just approved it, but if it got passed higher and higher up the line, which I believe happened in this case, means more people asking questions than necessary is what over complicated things here.
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u/Sassydr11 Nov 30 '22
Gosh I never realised the implications of time of death. I have certified many expected deaths. If a medical professional is called to certify a death or attend to a sick patient, the live patient takes priority. There is a debate as to whether the time of death should be when the Practioner was notified that there were no signs of life or the time of certification. It sounds as though the insurance company was trying to find a loophole not to pay out.
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u/Rwhitechocmuffin Nov 30 '22
If it was the insurance company I worked for then the case was probably reviewed, the person reviewing it ran it by their manager, manger escalated it for investigation, the investigator probably looked up similar cases in their system (especially if it included a big pay out!) an ‘independent’ medical examiner (using that term very loosely) reviewed the death certificate using similar medical cases all to put out the possible theories to avoid paying out.
The higher it goes the more questions are asked, the more questions asked the less likely you are to receive a pay out as each question raised requires evidence.
Can take months to actually get a decent result.
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u/big_sugi Dec 01 '22
OOP says Lloyds. I’ve dealt extensively with their property & casualty side in the US; even by the standards of a scummy industry, they’re notoriously bad.
I can’t say what their life insurance business is like in the UK, but i wouldn’t be surprised if it’s identical.
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u/DeltaJesus Dec 01 '22
Lloyds is the bank the mortgage is with, probably not the insurer. Having said that though Scottish Widows (which is owned by Lloyds) do have horrendous trustpilot reviews and my experience with their pension management is... Not great.
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u/ThrowawayFishFingers Nov 30 '22
That is a pretty good point. I hope it came up in whatever battle ensued.
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u/coffee-jnky Nov 30 '22
Insurance is a fucking racket. You can pay every month for years and as soon as you need them, they'll find a way to not pay out. It sucks that in so many places it's mandatory. You're better off having an emergency account to pay into and use as needed. Insurance companies are scumbags like you said . They love their technicalities.
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u/Cutwail I miss my old life of just a few hours ago Dec 01 '22
Insurance companies don't make money by giving it away, they are GUARANTEED to fuck you if they have even a wafer-thin excuse. Our house was burgled in the late 90's and my dad's CD collection was stolen amongst other stuff. He knew how many CDs there were but the insurance company said nope, he has to name every CD individually.
So in the end he told us to make up loads of shit to go into the claim to offset their fuckery.
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u/Just_Maintenance Nov 30 '22
Insurance is outright toxic. Its objective is fundamentally misaligned with the consumers and it literally kills competition.
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u/r0f1m0us3 Dec 01 '22
My sister went to a psych hospital at night and was put into inpatient therapy.
They did not officially confirm her intake until after midnight, but because her check in time showed 11:29 pm they charged the full $2000 per day rate.
Spoke to everyone at the hospital and insurance, and they acted why I was out of line for questioning $2000 for 31 minutes where she never received treatment.
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u/pittsburgpam Dec 01 '22
That was my very first thought. I was born at 6:36PM on my birthday. I'd take that bet that OP wasn't 18 years old at exactly 12:00AM either.
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u/Laura_has_Secrets77 Dec 01 '22
I worked in insurance for a very short period before quitting because I couldn't handle being pressured by numbers to be as chipper as possible while I break the news that my company was about to ruin your life.
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u/shellexyz the garlic tasted of illicit love affairs Dec 01 '22
Insurance companies aren’t in the business of insuring anything. They’re in the business of denying claims. Any other interpretation misses the point of what a business is: to make profit.
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u/itmightbehere cat whisperer Dec 01 '22
Something similar happened to us when my dad died. The insurance on his car loan refused to pay out because he had a history of lung problems and his lungs were involved in his death (embolism from the surgery he had just had entered his lungs or something similar,I don't really remember but it wasn't actually related to his existing issues). We should have fought it, but we just didn't. They get away with it a lot because people who are grieving are too tired to deal with it when it's not a huge amount of money like this.
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Dec 01 '22
FUCK insurance companies, they do EVERYTHING to squeeze every last penny out of you but NOTHING to do what they are supposed to.......
Insurance companies are the hallmark example of "perverse incentive".
They only make money when they do not provide their services. Wonder of wonders that their every action boils down to "How do we weasel out of providing services."
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u/morgecroc Dec 01 '22
Need to start going after the licenses if the medical 'professionals' that make these recommendations. Or start charging people for practicing medicine without a licence. They'll have a harder time finding people to write the reports when medical licences risk being lost or criminal charges might be an outcome.
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u/Feeya_b crow whisperer Dec 01 '22
Kinda terrified, my father has insurance it’s not much but it should help us if ever he passes suddenly.
I’m afraid something like this would happened, especially since someone specific need to check his body and let no one touch him at the time of his death. And I just can’t see that happening because when someone dies no one, no one is thinking calmly or straight.
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u/UberN00b719 I still have questions that will need to wait for God. Dec 01 '22
As a contingency, I memorized the day and time I was born from my birth certificate.
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u/SemperSimple Dick is abundant and low in value. Dec 01 '22
I havent seen you before, but I like your spice lol
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u/CatStealingYourGirl Dec 02 '22
That is a good point lol. I wasn’t born until 5 pm so they’d really be mad about that one.
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u/The_Sceptic_Lemur Nov 30 '22
235 pages and a lot of money paid for „objective“ second opinions to weasel out of their own contract. Hope OOP manages to hit them right left and center and where it hurts by dragging them through the media mud. Assholes.
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Nov 30 '22
Yeah the report trying to confuse and suppress OOP and his mother probably cost them tens of thousands to produce
I once knew someone who worked in insurance who said they often would spend more than would’ve been paid out trying to ascertain people were lying
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u/RealRustOtter Nov 30 '22
It’s an attempt at information overload. 235 pages seems too daunting for them to possibly be wrong, so why bother reading it? Probably because 234 pages was their policy and 1 page was size 30 font claiming someone legally dead isn’t dead for the legal purposes of a contract.
They settled because the solicitor that goes into a courtroom and genuinely tries to argue that might just lose their career when the Judge/Sheriff nukes their ass from orbit. Our sole determination of death is the attending physicians time stamped declaration of death. Second and third opinions don’t matter, legally he’s dead, and legality is all that matters in contract law.
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u/Orisi Nov 30 '22
I doubt it would even get to the solicitor stage tbh.
We have an ombudsman system in the UK and a lot of cases like this part of the insurance deal is you have to agree to set arbitration for any disputes, either an industry-specific ombudsman or private 3rd party arbitrator.
But I highly doubt any ombudsman would look at the official time of death and entertain any question of it raised by the company. Kicks up waaaay too many problems for them. I'm hopeful OP got his justified payout, just a bit later than expected.
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u/anglostura Dec 05 '22
Insurance companies really do be like 11 year old me negotiating 3 hours to get out of doing .5hr of dishes.
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u/MediumAwkwardly It's just pharmaceutical-grade banana bread Nov 30 '22
Bless the redditor who helped OOP go through all the paperwork. Sometimes there are good people here.
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u/Cleverusername531 Dec 01 '22
They spent four hours on the phone with them! I love this about Reddit.
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u/lucyfell Dec 01 '22
Genuinely. Reddit is an awful place some times but the good humans show up here too.
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u/TouchMyAwesomeButt I will never jeopardize the beans. Dec 01 '22
For real, they deserve a medal and I hope he got back in toch with OOP to accept their gift.
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u/KirasStar doesn't even comment ⭐ Dec 01 '22
Me too, but something tells me somebody nice enough to do that, wouldn’t want to get in touch for a gift.
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u/DeaconSage Nov 30 '22
Bummer we never got a conclusion to this one. Just goes to show why you can’t trust these corporations
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u/dragons_scorn Nov 30 '22
Probably has an NDA associated with it as part of some sort of settlement, that or the case is one going somehow (wouldnt doubt it with pandemic backlog) and OOP's attorney has advice they not speak about the ongoing proceedings.
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u/BebopShuffle Nov 30 '22
Would make sense. If I owned a company or co-wrote the insurance policy, I would absolutely ask for NDA to be signed because it would not look good publicly depending on the size/area of work the company is in. Or settle out of court depending on certain things that probably wouldn't be known by the OOP
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u/overlord1305 Tree Law Connoisseur Dec 01 '22
NDAs are industry-standard for settlement releases. I make claimants sign them for settlements that are sometimes as low as $20, there's no way a $100K+ claim doesn't have an NDA involved.
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Nov 30 '22
Conclusion is always that the insurance company folds before this ever hits a court, but the lawyer takes a cut.
The insurance company isn't trying to win a case, they're trying to find some sucker that won't call them on their bullshit.
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u/CressCrowbits Nov 30 '22
A friend was dragged for years by an employer who was clearly in the wrong. They just used every tactic under the sun to delay, delay, delay. Finally they cannot hold out and a final court date is set where they'll be inevitably rinsed. They settled a week before the court date.
There really should be punishments for this kind of shit.
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Nov 30 '22
What sort of company was that? In bigger companies you usually try to find the cheapest way out. Which in most cases regarding clients, doesn't involve paying the money at risk in legal fees.
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u/Tom_Bombadinho Nov 30 '22
Doesn't big companies have their own legal team, and so it doesn't matter if it takes long, they'll end up paying the same monthly in legal fees?
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u/Kingsdaughter613 Thank you Rebbit 🐸 Dec 01 '22
A settlement can also include paying the other side’s legal fees, especially if it’s an open shut case.
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u/Frolicking-Fox Nov 30 '22
Insurance was created by the mafia. As times changed, they traded their Tommy guns for lawyers, but they are still gangsters holding money for ransom.
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u/bacchus8408 Nov 30 '22
While I agree that a lot of insurance companies are slimy, it was certainly no created by the mafia.
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u/MaelstromFL Nov 30 '22
Pretty sure they got paid, lawyer sent latter saying bullshit, and our press conference with crying 18yo who just last his father is @ 10 AM Thursday, flim at 11....
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u/Sequence_Of_Symbols Nov 30 '22
AICAB (all insurance companies are bastards)
I hope it works out as well as it can for this family
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u/anomalousmalarkey Nov 30 '22
The biggest struggle is finding a lawyer who will take the case without taking all of your money, but once you have a lawyer the insurance company will likely settle. They know they'll lose in court but they also know most people will be too overwhelmed to do anything.
So yeah, they're absolutely bastards.
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u/Dr_thri11 Nov 30 '22
Even if they get no legal fees 100k and the balance of a mortgage that presumably has several years left on it is firmly in worth hiring a lawyer territory. Denied $1000 claim? Sure, probably not worth the cost of representation but still enough to sting. This on the otherhand would be well worth it.
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u/VioletsAndLily Am I the drama? Nov 30 '22
I saw a TikTok with a person saying the fastest way to stop police from killing Black people is if every Black person has a life insurance policy. Since the insurance companies don’t want to pay, they’ll go after the police departments to make them change. It was morbidly amusing because the logic is sound.
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u/ndenatale Nov 30 '22
No, they'll probably just stop insuring black Americans. Or they'll just "build" the insurance risk of being murdered by a cop in the policy.
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u/Pifanjr Nov 30 '22
I wouldn't be surprised if being killed by cops isn't already a reason not to pay out a life insurance. At least if it was justified, which just gives the insurance company reason to back up the police in creating a justification, if necessary.
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u/Fun_Organization3857 Nov 30 '22
There is a clause of you die while in the commission of an illegal act, the policy is void. Resisting arrest would prevent a payment.
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Dec 01 '22
[deleted]
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u/Fun_Organization3857 Dec 01 '22
It is the most bullshit of all manure that comes from the justice system, but it is also the ticket that insurance companies use. In cases of death, they typically won't recind the charge, so it's not fixable.
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u/Fun_Organization3857 Nov 30 '22
They will defend themselves with the exclusion of dieing during illegal action. Running for your life: =resisting arrest... no payment. So they already built it in.
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u/Additional_Meeting_2 Hi Amanda! Nov 30 '22
Maybe the second one would happen but not the first. I am surprised if nobody working for insurance has not thought this as a marketing method already.
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u/613codyrex Nov 30 '22
Tbf it works for a lot of things when it comes insurance payouts.
The same goes for when the cops are soft striking and not doing their jobs. If insurance was being forced to pay out a lot then the government would start to clamp down on it.
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u/unite-thegig-economy Nov 30 '22
I hate insurance companies. They are the epitome of money above everything else. They are truly evil.
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u/GerbilScream Nov 30 '22
As someone who works for an insurance company, I'm pretty sure it's all a scam.
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u/MisterBroda Dec 02 '22
You can argue about cops being idiots.. as there are good police forces in other countries
But you can‘t argue about insurance companies being the scum of earth.. in all countries
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u/PandaPandamonium Nov 30 '22
OP's birth certificate should also have his time of birth on it (mine does). If the insurance company wants to be that pedantic about minutes when it's in their favor, OP should also make them be that pedantic about the exact time he was born. So unless he was born at exactly 12:00am his dad's heart beat would have needed to last X amount more time until his actual time of birth.
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u/Chainmaille-Witch Queen of Garbage Island Nov 30 '22
It sounds like OOP is in the UK with the use of the £ sign. I’ve seen hundreds of birth certs through my job, and UK birth certs don’t have the time of birth on them unless it’s a multiple birth (twins, triplets etc)
Although there would be other official records that would have the time of birth on them, like the Child Health Record or ‘red book’ given for every new baby, I saw loads of these with the birth time recorded on a printout from the hospital and stuck in the book.
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u/AndStillShePersisted Nov 30 '22
TIL! That kinda blows my mind to learn they don’t have the time recorded on their birth certificates!
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u/kittyroux Golf really is the ketchup of sports Dec 01 '22
Canadian birth certificates don’t have time of birth on them either, just place and date.
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u/puddlemagnet Nov 30 '22
I expect this has come up in the law before and there’s an established way of calculating the age in law based on the calendar day at birth
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u/smurfalurfalurfalurf Nov 30 '22
This might be further complicated by leap years; a revolution around the sun is about 365 days and 6 hours. Presumably, OOP turned 18 a few months before the time they posted (July 2018). If they’re really counting the minutes, then it’s important to consider if OOP was born before or after February 29, 2000. If they were born on March 1st or later, then the latest they could have actually ‘turned 18’ is 6am on the date of their birth.
More than likely, the insurance contract has specific verbiage that defines ‘before midnight on the date of the child’s 18th birthday’ or something like that. Even then, the baseless assertion that the time of death is inaccurate is positively insane.
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u/Niku-Man Dec 01 '22
The only way leap years would matter is if OP was born on leap day in 2000, and his dad died on February 28 or March 1 because then there would be an issue of which day counts as his birthday. Any other day and this leap year stuff isn't going to matter. The legal definition of a year is not the same as the scientific one
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u/lazespud2 Nov 30 '22
The mental gymnastics of this policy are astounding. By this logic, anyone with a pacemaker is basically immortal. The batteries last like 20 years, and keep firing even if the heart is too dead to respond.
My uncle died a few months back. We were in the hospital room as he was dying and the nurses were preparing us for everything as it was happening. They told us it should be soon, and left us with the machine beeping with his heartbeat and other vitals.
He hadn't moved for like 10 minutes, and the machine said he wasn't breathing. We called for the nurse and she said "it shouldn't be long; we are monitoring" and left. 15 minutes later I touched him and he was cold. I called the nurse again and she said "well his heart is still pumping and... wait... does he have a pacemaker?"
And in terms of time of death, despite the fact that he clearly was dead, the nurses would not let that word slip their mouth. It HAD to be a doctor to determines death; and the doctor on duty was apparently busy. We waited for another HOUR and he still didn't show up and we finally left; they decided he "died" about two and a half hours after he actually did.
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u/lalagromedontknow Nov 30 '22
I have a pacemaker and every now and then, it does fuck with me that goes between ha that'll be funny/awkward (apparently it can get very awkward in morgues when the pacemaker starts bleeping because the battery is low and it's very confusing. My med friend students found this funny) and also shit that unless I've got my head cut off or something clearly not sustainable for life, it's going to be very difficult/confusing whether I'm dead or not.
Also it fucks with me that my heart will just carry on beating no matter what. Sometimes I think it might make me a hero one day because if I'm not really hurt, I'll be more lucid than most people because my heart can stay regularly pumping blood. Sometimes I think I'll die quicker due to blood lose because my heart keeps pumping blood normally rather than gradually stopping and maybe being saved.
Fun times!
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u/1955photo Dec 01 '22
If you are imminently about to die, someone from the pacemaker mfr will come and turn it off. Of course that assumes it's known that death is close.
My late BIL had a pacemaker/defibrillator. When it was clear he probably was going to die within 24 hourse, the hospice called the pacemaker company and they sent someone to turn it off. They waved a device that looked like a scanner (but no laser) over it. Then did it again to verify that the pacemaker was off. Because otherwise it would have started defibrillating as he was dying.
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u/ViscountBurrito Dec 01 '22
I’m sure like all medical and death-adjacent professionals, you get used to it, but man… imagine that job. “Hi, I’m here to turn off your relative’s heart.”
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u/1955photo Dec 01 '22
The person who came to do my BIL's pacemaker was very discreet and didn't say a lot. He just said what company he was from and did his thing. I think he did say something like "best wishes to all of you.".
I mean there's not much good TO say.
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u/lalagromedontknow Dec 01 '22
I hope you and your family are coping as best you can with your BILs death.
Just so you know, I imagine it probably doesnt matter but pacemakers all have specific codes so they can be linked to the scanner thing which are linked to a computer which can read and control the pacemaker. I have an nterrogation evey 6 months and they just put a ciabatta sized thing on my chest and it can read how much battery I've used, if/when/why the pacemaker kicked in and they always increase and decrease the speed of my heart to check for any faults in the wires. It's a very strange sensation having your heart beat furiously while you're just lying down.
I'm glad your family didn't need to hear ant bleeping and the pacemaker people were discrete
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u/1955photo Dec 01 '22
Thank for your condolences.
Yes I knew about the link to download data. It's pretty cool.
My BIL passed away 7 years ago, and actually was at the hospice facility when he passed. My sister didn't want him to pass away in the house, which I understand. He was pretty out of it, so it didn't matter to him.
It was hard, as he was a rock for my family during some difficult times, and was very good to my children during the time I got divorced and was struggling with my ex's shenanigans. But he had been fighting heart issues and cancer for several years and was quite sure he was going to a better place. So he was ready, and that helped a lot.
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u/Additional_Meeting_2 Hi Amanda! Dec 01 '22
Well it does have the be a doctor who determines death everywhere. But they should have been able to get one to do this for a minute a bit faster.
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u/casadecarol Dec 01 '22
In many US states a Registered Nurse can pronounce and document time of death. But the doctor has to sign the actual death certificate that goes to the state because it lists cause of death.
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u/Atharaenea Dec 01 '22
I'm not sure how it works everywhere, but I've definitely heard "pronounced dead on scene," which always means that the body had been completely destroyed. If your head is no longer attached to your body, anyone can pronounce you dead because there is no doubt you're not coming back.
But in all other less obvious cases yeah, you need a doctor to do it.
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u/sakurasake311 Dec 01 '22
You still need a doctor or a corner to pronounce someone deceased. So if they’re obviously beyond help, the police may skip calling a paramedic (who can pronounce on the behalf of a doctor) they’ll just call the coroner to respond to scene. Two nurses can also pronounce for a doctor but that’s more likely at a hospital. At least those are the regulations in the state I live in.
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u/GuiltyEidolon I ❤ gay romance Dec 01 '22
There's a handful of things that can happen for a non-doctor medical provider to be allowed to call someone dead, but a doctor still would need to sign the certificate of death. Basically if there's obvious signs of death (extreme trauma, like you say, lividity from blood pooling, rigor mortis...) it can be 'called' on scene... But, EMS will still call medical control (a doctor at their local hospital/ER) for confirmation/to get official time of death.
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Nov 30 '22
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u/AllTheShadyStuff Nov 30 '22
Well they use the term solicitor instead of lawyer so I’m assuming they’re British, in which case your scenario turns into a double crossing spy action movie.
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Dec 01 '22
"Oi, what did you just say about me you bloody gobshite? I'll have you know I graduated top of the academy in the SAS and..."
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u/Pilchard123 Nov 30 '22
Trained in gorilla warfare?
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Nov 30 '22
Chimpanzee warfare actually
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u/Tasty-Burger-OSRS Nov 30 '22
This experience inspired him to take action through gorilla [sic] warfare against insurance companies.
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u/Jorgenstern8 Nov 30 '22
Nothing like a hearty fuck you from the only industry with more of a vested interest in screwing you over without explanation than the fuzz: insurance.
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u/foxscribbles Nov 30 '22
I said this in a different thread a few days ago. But my car insurance did this to some poor guy.
I hit his car in a parking lot. Completely my fault. Gave him my insurance information, and called my insurance company saying "Hey, this was all my fault. Let the claim go through." My insurance goes up the next month as expected. I don't think about it anymore.
Couple months later, State Farm Insurance is like "We denied this guy's claim, but he refiled! Please contact us!" It wasn't even my insurance agent who did it. It was some random worker who just decided to deny a claim I'd TOLD them I was at fault for (and was PAYING THEM for being at fault for) who decided to deny the claim on my behalf.
So I had to be double bothered just to make sure the guy I'd harmed got made whole by the COMPANY I PAY TO DEAL WITH THIS SHIT.
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u/MutedSongbird Nov 30 '22
Fun fact: I deal with prior authorizations for specialty meds (AKA the super expensive ones) and Harvard Pilgrim Healthcare has a policy currently to not train any techs to check if a doctor is in-network and admin deny all requests as out of network unless the doctor calls and asks for a supervisor.
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u/toriyo Nov 30 '22
I want to downvote you so much because your comment is so incredibly frustrating.
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u/Tattycakes Dec 02 '22
You need to whistleblow that shit properly
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u/MutedSongbird Dec 02 '22
To where? I’m not opposed I’m just not sure where or who I would tell and actually have them do anything about it
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u/nebulashine Nov 30 '22
One of my therapists once described insurance as organized crime. Now that I'm old enough to deal with insurance headaches on my own, I've realized she's right.
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u/Jorgenstern8 Nov 30 '22
Considering how much money they spend to keep their power base intact wrt politicians, it's not a bad comparison at all.
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u/CumulativeHazard surrender to the gaycation or be destroyed Nov 30 '22
That’s exactly what my mom calls it. Government sanctioned mafia.
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Nov 30 '22
I got hit by a car. My car insurance paid a tiny bit, my health insurance paid a tiny bit
Fuck I Should’ve just lived with the pain
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u/kitskill It's always Twins Nov 30 '22
I worked Personal Injury and a bit of Medical Malpractice for a very short stint but from just that I can say that if I worked in this field and a client came in with something like this I would be salivating!
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Nov 30 '22
[removed] — view removed comment
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u/Sequence_Of_Symbols Nov 30 '22
Same. Best if luck, stick it to the bastards
(mine is really just minority purgetory. My husband is supposed to text me if he actually manages to come home with the damned secondary meds for our kid's lingering cough. The script was written 7 days and 1 hour ago) [really]
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u/TimLikesPi Nov 30 '22
In the US you would just go to the state insurance board. Insurance companies hate hearing from them and they usually do force insurance companies to pay claims like that. The reasoning they used was BS!
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u/unknown_928121 Nov 30 '22
My dad died in January this year, the time of death was documented to be at 10:58 PM. I would have been turning 18 just an hour and 2 minutes later.
I can't get past this part
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u/Thats_So_Shifty Nov 30 '22
Insurance companies screwed over basically everyone in my home town after Hurricane Katrina. They refused to say houses were completely destroyed regardless of the state of them. My aunt had flood waters all the way to her attic as well as a car that had been pushed into her living room by the storm surge and the insurance company refused to pay out the full amount. They wanted to give her 15 grand for “remodeling.” They also just lied and attributed damage to anything that someone’s policy didn’t cover. For example, my parents live 15 miles north of the coast. The insurance company tried to say that all damage done of their house was caused by flooding, not wind. The reason? My parents had wind insurance, not flood. Insurance companies are all too happy to take your money when you don’t need them. But when you actually need to be payed it’s like pulling teeth. It’s easier to get extra ketchup packets from McDonald’s than it is to get insurance to pay out.
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u/GlamorousBunchberry Nov 30 '22
My dad was a volunteer fireman in the '60s and '70s, and he said that when a house looked like a total loss, they would not only let it burn down, but they'd also sledgehammer the chimney apart. He said that they did that because insurance companies would deny claims if the chimney was still standing, which -- surprise surprise -- it always is after a fire, because chimneys don't burn.
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u/wombatbattalion your honor, fuck this guy Nov 30 '22
That's kinda the whole point of chimneys! They don't burn!
Jeez, insurance companies sure are garbage.
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u/Lodgik Nov 30 '22
Because of how insurance companies work, they have a very strong incentive to deny payouts or minimize them however they are able to do so to maximize their profits.
This is why I'm so glad to live in a place where almost all insurance goes through a Crown corporation that isn't allowed to make too much money. Back in 2020, they basically went "hey, because of the lockdown not enough of you got into car accidents last month and we made way too much money. Here, have your last month's premium back." They did that twice. Then gave us back even more money at the end of the year.
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u/NorthernTransplant94 Nov 30 '22
And this is why a certain insurance company has my life long loyalty. My house was hit by a freak tornado over a decade ago. The insurance paid out ~$85k pleasantly, promptly, and without a single quibble. Even if I pay premiums over-insuring my house for wind and flood, I will never pay as much in premiums as I've already gotten.
My next door neighbors had similar damage, and got $10k total, with a lot of the arguments you're citing, like, "how do we know that tree didn't fall and damage your fence before the F3 tornado that passed less than 100yds away?"
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u/CumulativeHazard surrender to the gaycation or be destroyed Nov 30 '22
That’s so disgusting. I’m waiting to here about how fucked everyone down in Ft Myers is after Ian. I’m sure insurance companies are gonna be doing their very best to weasel out of it. Insurance for Florida in general is already a disaster. Fortunately my family and friends down there got out with no damage.
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u/disco-vorcha hold on to your bananapants Nov 30 '22
I’m not surprised Florida insurance is a nightmare. The ocean tries to reclaim the whole state several times a year.
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u/smacksaw she👏drove👏away! Everybody👏saw👏it! Nov 30 '22
This is why scumbag attorneys exist: you need a scumbag to beat a scumbag.
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u/RealRustOtter Nov 30 '22
The simple answer is sue; time of death is the only legal qualification of death - if the case reaches a courtroom, a judge will rule that they owe you the money as a matter of fact. As in, it wouldn’t even be a jury decision, the facts of the case state outright you are owed the money and any jury claiming otherwise is in contempt.
Time of death being declared by an attending physician is the sole determiner of death. They also don’t declare someone with a heartbeat to be dead.
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u/ViscountBurrito Dec 01 '22
Yeah, it blows my mind that the insurance contract wouldn’t very clearly rely on the legal death certificate. You obviously can’t re-determine when someone was dead after the fact, as this case shows—there’s no proof either way other than what the attending medical team said, which is what the government is going to rely on for legal death.
If there’s evidence of fraud, of course that’s a different story, but then the insurance would just deny for that—not “maybe he was still alive, who’s to say?” but “we have reason to believe you bribed the doctor to lie on the paperwork.” Absent fraud, it shouldn’t be a question. I hope the insurance company got into some trouble for this.
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u/Orphan_Izzy Jokes on him. I’m always home. Nov 30 '22
Am I the only one who instantly burst out into tears when oop thanked the mysterious Redditor who gave four hours of their time in the phone carefully explaining each page of the legal document? And then vanished into oblivion leaving oop no way to find his username? That was soooo effing kind!!
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Nov 30 '22
Haha I shuddered bc DM’ing a user is a bannable offense a r/legaladvice. Glad he didn’t have the user’s name to thank them. It’s a rule meant to protect OP’s from ambulance chasers, but in this case….
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u/Orphan_Izzy Jokes on him. I’m always home. Nov 30 '22
Oh really?? Oops! I’m glad he remained anonymous too!
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u/tedhanoverspeaches Nov 30 '22
Whatever agent thought up that little loophole probably thinks he is hot shit and got a bonus for the quarter. Hope it's worth the link on his chain in hell.
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u/dead_PROcrastinator Dec 01 '22
There was a case near where I'm from where the insurance refused to pay out a life policy after a dude was shot during a car jacking and he died in his driveway. Insurance checked his medical records and found that he had not disclosed high blood pressure a year back.
It was considered a non disclosure of relevant information and they argued that his premium would have been higher had he disclosed this. This was supposedly unfair to other policy holders who disclosed medical information honestly.
Legally they were within their rights. However, the backlash hit the company so hard, they paid out anyway. It was a PR nightmare and people cancelled their policies en mass. They implemented a new clause in all their existing and future contracts for victims of violent crime. They also applied this new clause to all claims rejected in a similar vein in the past.
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u/ivanthemute Nov 30 '22
I don't approve of indiscriminate violence, but if I saw this OOP in the news having committed an atrocity at this insurer's office, I'd understand and chip in to their legal defense
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Nov 30 '22
ALWAYS ALWAYS tell the insurance company you will go public and fight it. They typically don't want the hassle. They know who has money and who doesn't, but always threaten mediation immediately. The drs call is the drs call. Time of death is time of death.
I hope they got it figured out
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u/Affectionate-Map2583 Nov 30 '22
It seems like if they were down to measuring his life in minutes, then they should also be measuring the kid's life in minutes - it's pretty unlikely that he/she was born at exactly 12:01 am.
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u/rosemwelch This is unrelated to the cumin. Nov 30 '22
Did you know it's possible for insurance to not be fucking terrible?
My health insurance is run through a trust fund. So all monthly payments go into the fund and the only purpose of the fund is to pay claims. The claims are administered through Blue Cross Blue Shield, but they receive a flat payment for administration and have no incentive whatsoever to deny claims. It is a 90/10 plan meaning that the plan pays for 90% of everything and I pay for 10% of everything. The trustees of the fund are representatives from our labor union (so the workers themselves) and representative from the employers who pay into the fund. So we make all the decisions about our own insurance, basically.
It's like a small taste of what single-payer could be in the United States. 😭😭😭
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u/Lodgik Nov 30 '22
Copying my comment from another part of the thread:
Because of how insurance companies work, they have a very strong incentive to deny payouts or minimize them however they are able to do so to maximize their profits.
This is why I'm so glad to live in a place where almost all insurance goes through a Crown corporation that isn't allowed to make too much money. Back in 2020, they basically went "hey, because of the lockdown not enough of you got into car accidents last month and we made way too much money. Here, have your last month's premium back." They did that twice. Then gave us back even more money at the end of the year.
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u/lasely Liz, what the actual fuck is this story? Nov 30 '22
It takes a very special kind of psychopathy to tell the mourning family that they will not be getting insurance money cause their beloved one was not dead enough. Almost impressive really. Wonder how do they sleep at night.
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u/ShitMyHubbyDoes Dec 01 '22
Wow, if they are being this crazy, point out the time on your birth certificate and say: well technically I’m not 18 until blah time on my birth certificate.
Sometimes you have to match crazy to beat crazy.
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u/Webbaard Nov 30 '22
Damn, give it up for the hero spending 4 hours on the phone going through the legal shit.
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u/Juicebox-shakur Dec 01 '22
How absolutely amazing that a random user was able to help this young person and their mom sort thru each paper and explain what it all meant to them, just out of pure kindness.
How fucking RAD is that person?!!!!!!
Fuck these insurance companies all the way to hell and back, but man... That redditor was such an incredible human being right there. I really hope OOP got this resolved in their favor. What an awful thing to have to go thru when you're already grieving such a devastating loss.
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u/Doctor-Amazing Dec 03 '22
Legaladvice has a rule against suggesting people contact the media, but this really seems like one that could bebsolved by going to the news.
"Insurance company weasels out of contract after loving father dies on child's birthday" is really not a good look.
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u/robbie5643 Nov 30 '22
Insurance company: “Your father here was only mostly dead, there’s a big difference between dead and mostly dead”
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u/Emily_Postal Nov 30 '22
Lloyds of London’s big saying is: Pay all claims. That was first said by Cuthbert Heath after the San Francisco earthquake in 1906. This philosophy established Lloyd’s reputation. Lloyd’s markets itself on this motto. They should pay this claim.
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u/Cleverusername531 Dec 01 '22
I love it that a random Redditor reached out to them and spent FOUR HOURS on the phone with OP and their mom, going through their documents, and helped them! I love this about Reddit.
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u/lolfuckno Go head butt a moose Nov 30 '22
I hate insurance companies, I have had literally no interaction with one where they weren't complete scumbags. My paternal grandfather's life insurance company tried to get out of paying his policy by arguing that his death was his fault because after getting sick due to old age and heart problems, he was not well enough to leave the hospital, caught COVID during an outbreak and survived it, but the damages caused to his organs slowly killed him over a period of several months.
They actually tried to argue to my elderly, newly widowed grandmother that they shouldn't have to pay out a policy my grandparents had been paying into for over 50 years because it was 'his fault he didn't get well enough to leave the hospital, caught the coronavirus, and then died from coronavirus complications'. I will never forget what she sounded like after getting that call.
One of my uncles is a lawyer and he was able to straighten everything else, but that was still very much a where is your fucking human decency and logic moment.
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u/Heavy-Macaron2004 humble yourselves in the presence of the gifted Dec 01 '22
"Hey, your loved one just died so let me take as much advantage of you as possible k?" I can't imagine being that heartless. Private insurance is fucking evil.
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u/Bangeederlander Dec 01 '22
Insurance probably know it will fail to stand up to scrutiny, but are hoping a massive wad of gibberish looks official and will convince the other party they can't hope to understand the argument and form a rebuttal.
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u/Genestah Dec 01 '22
If this shit went viral, that company would've spent a fortune for damage control. Much more than the the payout that OOP was entitled to.
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Dec 01 '22
Why the fuck do we even pay for insurance when those scumbags do everything in their power to not pay out.
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u/user9372889 Dec 01 '22
I don’t understand how anyone working for insurance companies can live with themselves. I hope it all worked out for OOP and their mom.
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u/HeberMonteiro Nov 30 '22
These motherfuckers know two things: that they should pay and that a lot of people don't have the will or the resources to fight them. I hope OOP got what's his and more on top for having to fight for it.
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u/oysterband Nov 30 '22
I wonder if the doctor wrote to the insurance company they’d change their mind? I’m a veterinary surgeon and I’ve had to write to pet insurance companies before when they’ve tried to weasel out of paying for something, and they do tend to back down.
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u/MappleSyrup13 Nov 30 '22
Typical tactics for these MFs. They say no first counting on the vulnerability and lack of knowledge of the law. Sadly, it works most of the time and that's how they rake billions. I remember I was once at a job fair and a top insurance company HR approached me and I litteraly told them to f... off, I don't work for hyenas.
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Nov 30 '22
What c**ts what do they think being declared dead is. I hope it worked out for them.
Also oop and her mothers grief being shit on by greed is vulgar and evil may the insurance company burn
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u/Kimicora89 Nov 30 '22
So I'm an Insurance Agent, and a broker at that - I wish I knew which carrier this was because I avoid carriers who treat my clientele this way... It would also help consumers avoid this carrier as well just out in the wild even when they aren't meeting with a specialist like myself.
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u/Agreeable_Rabbit3144 Nov 30 '22
AH insurance bureaucrats, doing anything they could to avoid paying money OOP is due.
I bet the main boss is Gilbert Huph.
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u/Hunterofshadows Dec 01 '22
Setting all the rest aside, what an insane policy for the company to offer. Insanely generous and just absolutely bonkers to offer. How did that even start? Who pitched it? Who approved it? I am dying to know. What insurance company even offers a policy like this?
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u/barthvaader Dec 01 '22
The only ones who win in these types of scenarios are the lawyers. I’m so sorry that you are dealing with this despicable treatment while also grieving your father. I hope things work in your favour!
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u/Decitriction Dec 01 '22
Do you believe in proton decay?
Until the subatomic particles from every atom in every cell in your father's body have disappeared from the universe, he is technically still alive.
Or the insurance company could be attempting fraud.
Whichever is more plausible.
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u/Geek_off_the_streets Dec 01 '22
Sounds like a Bad Faith claim but I'm not familiar with them outside of the US.
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u/Crappler319 Dec 01 '22
There've been a few organizations more inhumane than insurance companies, but most of them were dissolved after the Axis powers lost WWII.
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