Many life insurance beneficiaries are told their claim cannot be paid because the medical examiner has not finalized the cause of death. Insurers often cite medical examiner backlogs as the reason they cannot move forward.
While insurers are allowed to request official records, prolonged delays caused by examiner backlogs frequently exceed what the law allows.
A backlog does not give an insurance company unlimited time to withhold payment.
Why Medical Examiner Delays Are Increasing
Medical examiner and coroner offices across the country are facing staffing shortages, increased caseloads, and funding constraints. Autopsies, toxicology testing, and final reports often take months longer than expected.
These delays are administrative problems, not coverage issues.
How Insurers Use Examiner Backlogs to Stall Claims
Insurance companies often rely on examiner delays to:
• Avoid issuing a decision
• Extend investigations indefinitely
• Delay payment without formally denying the claim
• Shift responsibility away from themselves
In many cases, insurers already have enough information to make a coverage determination.
A Final Cause of Death Is Not Always Required
Many life insurance policies do not require a final medical examiner report before payment. If the death certificate lists a manner of death that is covered and there is no policy exclusion triggered, payment should proceed.
Insurers may not delay simply because additional details might exist later.
Interim Death Certificates Often Support Payment
In numerous cases, an interim or preliminary death certificate is sufficient to confirm coverage. If the listed cause does not fall under an exclusion, insurers are expected to act.
Waiting months for administrative finalization can be unreasonable.
ERISA Group Life Policies Have Strict Deadlines
Employer provided life insurance policies governed by ERISA are subject to mandatory claim handling timelines. Medical examiner delays do not suspend these deadlines.
Insurers must either issue a decision or provide a valid written explanation for any extension.
When Examiner Related Delays Become Improper
Warning signs include:
• No explanation of how the report affects coverage
• Delay despite no applicable exclusions
• Continued delay after preliminary findings
• Requests for unrelated medical records
• Repeated vague status updates
These tactics often signal bad faith delay.
What Beneficiaries Can Do During Examiner Delays
If your claim is stalled due to a medical examiner backlog:
• Request a written explanation tied to policy language
• Ask whether payment can proceed based on available records
• Demand a timeline for decision
• Track all deadlines carefully
• Avoid waiting passively
Delays become harder to challenge the longer they go unanswered.
Medical Examiner Delays Are Often Overcome
We regularly handle life insurance claims delayed due to examiner backlogs, including cases where insurers ultimately paid without waiting for final reports.
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 medical examiner has not finalized the death report, contact us for a free case evaluation.