Insurance companies always face certain difficulties when insured dies in a foreign country. For some years, the life insurance industry has dealt with questions of whether death claims originating in developing regions of the world were legitimate or fraudulent. In order to prove a payable life insurance claim, an insurer must often be prepared to engage in a thorough investigation of the death. This investigation involves a series of measures that generally fall into 2 categories – obtaining official documents and interviewing medical personnel.
OBTAINING OFFICIAL DOCUMENTS
In Russian Federation, when a foreign citizen dies, certain procedures take place:
First, medical administration passes diagnosis sheets and the body of the deceased to Anatomic Pathology Department, where the specialists carry out autopsy and file an Autopsy Report (rus. “Протокол патолого-анатомического исследования”, “Protokol patologo-anatomicheskogo issledovania”). In this report they note whether Clinical and Pathologic diagnoses concur. If they do, in Postmortem summary there will be stated: “Совпадение диагнозов”, “Sovpadenie diagnosov”. Autopsy Report is signed by the Head of Anatomic Pathology Department, but no seal is attached.
Besides Anatomic Pathology Department issues another document called Medical Certificate of Death (rus. “Медицинское свидетельство о смерти”, “Meditsinskoe svidetelstvo o smerti”), where the seal is required. Medical Certificate of Death includes all registration data of the deceased, but it doesn’t specify diagnosis or causes of death.
Afterwards, Civil Registry Office (rus. “ЗАГC”) draws up an official document – Death Certificate (rus. “Свидетельство о смерти”, “Svidetelstvo o smerti”), printed on special form sheet with a watermark and validated by attaching an official seal.
It is essential to know that all abovementioned documents are handed to family members only. In order to obtain them to confirm the death claim, it is crucial to get a POV (Power of Attorney) signed by the heir of the deceased. This document must be endorsed with an Apostille, otherwise it will not be legitimate on the territory of Russian Federation.
U.S. Consulate General is obliged to inform the relatives of the deceased within 24 hours after the death. Then they issue own document called Report of Death of an American Citizen Abroad, which is send both to relatives and insurance company within a week. It includes all registration details of the deceased as well as information about the cause of death, disposition of the remains and effects. The original copy of this document is being placed in the permanent files of the Department of State, Washington, D.C. 20520.
INTERVIEWING MEDICAL PERSONNEL
In some cases obtaining official documents is not enough. There is always a risk that those individuals who pursue fraudulent death claims could possibly falsify death certificates, hospital or medical records, therefore sometimes it is necessary to take extra measures. Interviewing doctors and medical staff, who were in charge of treating the U.S. citizen, can possibly resolve all doubts concerning validity of death claims.
The biggest problem in terms of interviewing doctors on such cases in Russia is that they may refuse to answer any questions without being shown documents authorizing individual to investigate death circumstances. Therefore it is preferable if the interviewer is a licensed private detective or at least carries some POV, where it is clearly stated that this person is entitled by heirs of the deceased to obtain “all information as to health history, diagnosis and treatment, prognosis and death circumstances”.
Vested with such POV the investigator will be able to:
1. Ascertain whether the doctor who signed medical records or a certificate of death really treated the insured, and can truly confirm his death;
2. Verify that the official whose name is on the public record actually signed the document.
It is a good idea to provide investigator with a high-resolution photo of the insured person in order to verify this image with hospital staff to confirm the person they treated is the same person in the photo. If relatives do not have any recent high-resolution photos, the photo can be taken from Obituary.
If insurance company approved and controlled medical services rendered to the insured, its name would be familiar to the doctors and personnel. Therefore, when they learn that interviewer is acting in the name of this very company, they might be much more eager to cooperate and provide him or her with necessary information.
All these measures are rather time-consuming and expensive, but they might help understand whether death claims are legitimate or not. Nevertheless this issue on the whole remains a continuing challenge to the life insurance industry.
For verification of the death of a foreigner as well as for insurance fraud investigation in Russian Federation and CIS please contact Analytical department of Staf-Alliance Security Group.