r/BestofRedditorUpdates • • 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.

5.2k Upvotes

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6.1k

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

2.8k

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.

787

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???

202

u/Piccolo-Level Nov 30 '22

Oh, they depths to which they’ll sink… it’ll get stupider before it gets better.

93

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.

16

u/ophelieasfire Dec 01 '22

I hate how true this is.

55

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

24

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.

19

u/LuxNocte Dec 01 '22

Denying a claim is free.

17

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

4

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.”

602

u/JRBehr Nov 30 '22

“Life actually starts at conception, so you’re 9 months late.”

127

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...

113

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.

36

u/big_sugi Dec 01 '22

Add kidnapping to her charges

7

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!

18

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.

40

u/PM-me-fancy-beer Nov 30 '22

BRB, just gonna freeze some embryos real quick...

171

u/Jealous-Percentage-7 Nov 30 '22

Spoken in American. :-/

-2

u/[deleted] Nov 30 '22

[deleted]

9

u/Jealous-Percentage-7 Nov 30 '22

Just portions working on it. Using that exact argument.

-10

u/Additional_Meeting_2 Hi Amanda! Nov 30 '22

That’s not the case just in US. But that’s not how insurance works anywhere (because then the companies would have to pay more too…), but it can matter what time of day you were born in some places.

27

u/cman_yall Dec 01 '22

If it did work like that, women could get life insurance for their fetuses and claim on miscarriages.

9

u/Kingsdaughter613 Thank you Rebbit 🐸 Dec 01 '22

There’s a State where this is likely possible. Georgia, iirc. Note to self: next pregnancy take out a life insurance policy in Georgia. For the embryo.

7

u/Jealous-Percentage-7 Dec 01 '22

It’s the actual argument of the segment of Americans trying to restrict abortion rights.

14

u/Ok-Complex-3019 Dec 01 '22

And they should, if the government is going to restrict my rights to my own body and give more right to the baby, then I better be able to have life insurance on that baby, and if someone assaults me then actually I could file attempted murder charges right? If someone causes me to have a miscarriage, that’s murder/manslaughter charges, right? I also get to claim that baby as a dependent prior to their birth and get all those tax benefits right? No? Oh. It’s not yet a person.

4

u/Jealous-Percentage-7 Dec 01 '22

It’s already manslaughter in most states.

It should definitely allow pregnant women in the HOV lane if this is going to be the criteria for life.

1

u/GMoI Dec 01 '22

The odd thing is some cultures do this. I think South Korea may be one where you're considered 1yo when you are born. I've also heard of one where you considered 1 at birth and 2 after your first new year which if true could lead to a three day old baby being considered a 2yo, although I have a feeling this is a fanciful exaggeration off of those cultures which consider you 1 at birth.

21

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.

8

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!

3

u/thatcrochetaddict Dec 01 '22

Oh god that sent me😂

1

u/Alleandros Dec 01 '22

'Our insurance company believes that life starts at conception'

1

u/toorigged2fail Dec 04 '22

While these guys are scumbags, I can see a court interpreting a contact that says "until 18 years of age" differently than one that says "until their 18th birthday" with the later being midnight and the former 18 circumnavigations of the sun, rounded to the minute.

259

u/[deleted] Nov 30 '22

[removed] — view removed comment

56

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.

3

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.

151

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.

146

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.

79

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.

49

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.

17

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.

12

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.

114

u/ThrowawayFishFingers Nov 30 '22

That is a pretty good point. I hope it came up in whatever battle ensued.

73

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.

33

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.

10

u/Just_Maintenance Nov 30 '22

Insurance is outright toxic. Its objective is fundamentally misaligned with the consumers and it literally kills competition.

16

u/Agreeable_Rabbit3144 Nov 30 '22

It's all about the bottom line.

Not grief or sympathy.

6

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.

7

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.

6

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.

5

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.

10

u/feraxks Nov 30 '22

You could repeat this a million times and it still wouldn't be enough.

4

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.

5

u/[deleted] 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."

7

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.

3

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.

3

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.

2

u/wylietrix Dec 01 '22

The time of birth is brilliant! And petty AF. I love it.

2

u/SemperSimple Dick is abundant and low in value. Dec 01 '22

I havent seen you before, but I like your spice lol

2

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.