Families are often told that a life insurance claim cannot be paid until an autopsy is completed. This can be deeply distressing, especially when the family did not request an autopsy or when the process is delayed by authorities.
While insurers are allowed to investigate claims, they do not have unlimited authority to condition payment on an autopsy in every case.
When Insurers Demand an Autopsy
Insurance companies typically insist on an autopsy when they believe it may clarify:
• Cause of death
• Manner of death
• Potential suicide or intoxication
• Application misrepresentation
• Policy exclusions
In many cases, the autopsy demand is reflexive rather than justified.
Autopsies Are Not Always Required by Law
Most deaths do not legally require an autopsy. Medical examiners decide whether one is necessary based on circumstances.
Insurers cannot force an autopsy to occur. If an autopsy is not ordered by authorities, insurers may not be able to insist on one as a condition of payment.
Delays Are Often Outside the Family’s Control
Even when an autopsy is ordered, completion can take months. Toxicology and pathology results are frequently delayed due to backlogs.
Families have no control over these timelines, yet insurers often refuse to make any payment until the final report is issued.
This shifts the burden of systemic delays onto beneficiaries.
Policies Do Not Always Allow Autopsy Based Delay
Many life insurance policies contain autopsy provisions, but those provisions are often limited. They may allow the insurer to request an autopsy, but not to delay payment indefinitely.
Courts often require insurers to show that the autopsy is reasonably necessary to determine coverage.
Autopsy Delays Are Sometimes Used to Avoid Decisions
Insurers may rely on pending autopsy results to:
• Avoid making a coverage determination
• Extend claim review indefinitely
• Gather unrelated evidence
• Pressure beneficiaries to wait
Delay becomes a strategy rather than a necessity.
When Autopsy Based Delay Becomes Improper
An insurer may be acting improperly when it:
• Refuses to pay despite clear evidence of covered death
• Ignores preliminary findings
• Delays after receiving partial results
• Demands autopsy when none is legally required
• Fails to explain how the autopsy affects coverage
At some point, delay crosses into bad faith.
ERISA Policies Still Require Reasonable Timelines
Employer provided life insurance policies governed by ERISA must comply with strict claim handling timelines.
An autopsy does not suspend ERISA deadlines indefinitely. Insurers must still issue timely decisions or face potential liability.
What Beneficiaries Should Do When Payment Is Tied to Autopsy Completion
If an insurer refuses to pay pending an autopsy:
• Ask for the specific policy language relied upon
• Request a written explanation of why the autopsy is necessary
• Demand partial payment if coverage is otherwise clear
• Document all delays and communications
• Seek legal help if delays persist
Waiting without action often benefits only the insurer.
Autopsy Delays Can Often Be Overcome
We regularly challenge autopsy based delays and recover benefits for families who were initially told they had to wait indefinitely.
Our firm represents beneficiaries nationwide in delayed and denied life insurance claims. There is no fee unless benefits are recovered.
If your life insurance claim is being delayed because the insurer insists on waiting for an autopsy, contact us for a free case evaluation.