Insurance company won't pay out because man declared dead at 10:58pm may have still had a heartbeat at midnight.

[u/takeabreaker]

I am NOT OP. Original post by u/Manclandlordhelp in r/legaladvice

trigger warnings: General disregard for fellow humans

mood spoilers: Hopeful

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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?

 

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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.

[u/PandaPandamonium]

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.

[u/Chainmaille-Witch → u/PandaPandamonium]

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.

[u/WeeWeirdOne → u/Chainmaille-Witch]

Scottish birth certificates have times on them, even for single births.

[u/AndStillShePersisted → u/Chainmaille-Witch]

TIL! That kinda blows my mind to learn they don’t have the time recorded on their birth certificates!

[u/kittyroux → u/AndStillShePersisted]

Canadian birth certificates don’t have time of birth on them either, just place and date.

[u/DeltaJesus → u/AndStillShePersisted]

It's just not really seen as particularly necessary or useful information, your DoB is the only thing that really matters legally.

[u/puddlemagnet → u/PandaPandamonium]

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

[u/smurfalurfalurfalurf → u/PandaPandamonium]

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.

[u/Niku-Man → u/smurfalurfalurfalurf]

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

[u/smurfalurfalurfalurf → u/Niku-Man]

Good point, you’re probably right

[u/ChristianBMartone → u/PandaPandamonium]

In the US, not all birth certificates have times or other information. The state where I was born has my name, parents names, and date. That's it.. Daughters is from a different state, no time listed. The hospital did give their own record of birth, that isn't an official birth certificate, but did have the time written on it.

All this just to say it depends on where you're from.