Death of participant - proof needed

We have a participant who died, his wife beneficiary was injured in the car accident as well and has medical bills so she is in a big hurry to get his account which is $100,000+.  (So the plan sponsor puts the medical bill guilt on us.)

We asked for the death certificate but was told it would not be available for 12 weeks.  The record keeping platform does not require a copy.  

I see 2 options:

- Ask the plan sponsor owner to confirm that the participant died and then we rely on his direction (such as did you go to the wake and see the deceased?)

- or wait it out and require the death certificate.  I'm strongly inclined to require this. I don't want to take any chances.

Comments?

Thank you, Tom

If they want to process it have the Trustee certify he's dead and release you from any liability for processing as a death benefit payment or provide a death certificate.

Just to give you a way to think about this as you prepare to get your lawyer’s advice:

Relying on the plan administrator’s and trustee’s instructions about the service you’re asked to do might be enough if :

you’re a nonfiduciary service provider;
your service agreement releases you from liability for following instructions;
your service agreement indemnifies you from liabilities and expenses from your having followed instructions; and
your indemnitors have enough money to make good their promises.

But if you are or your affiliate is a fiduciary (of whatever kind), one might consider a cofiduciary’s responsibility regarding what another fiduciary does or fails to do.

Beyond whatever the plan’s administrator considers about its responsibility to the plan, the surviving spouse might want her lawyer’s advice about whether it’s unwise to be too quick to pay medical expenses from the accident. (Who caused the car accident: the decedent, or someone else?)

This is not advice to anyone.

From the phrasing of the original question, "we" appears to be a TPA (or something similar).  As @Peter Gulia states, your service agreement will be the first place to start.  He also (correctly) implies that the action of the TPA may be guided by its own attorney, who will also pay attention to the comments/advice from the plan's attorney.  Those are not the same person.  

I would never expect to "go to the wake and see the deceased."   (My Dad was cremated.)  One other way to consider "proof of death" might be whether there is a published obituary.  (Sorry, I don't know if fraudulent obits are a thing.)

As David said in so many words, look up the obituary! 

The SPD outlines the claims procedures which will place burden of approving the payment on the fiduciaries who are responsible for reviewing and approving claims.  If that is not you or your company, consider informing the plan administrator that you require a death certificate (and a valid beneficiary election or identification of a default beneficiary) before you can approve a payment.

If the plan administrator is unwilling to approve the payment (which tells you something about how they feel about the situation), then the plan administrator can inform the wife that she can file a claim.  The fiduciaries can then follow the claims process which has its own built-in timing, but it will be on them if they wish or do not wish to expedite the approval.

However this works out for the timing of the payment, this approach will put the spotlight on where it belongs - on the plan fiduciaries.

Just some thoughts.  1. A written statement from the attending physician?  2. Police reports.  3.  Autopsy report or other medical records.  Good luck.

Off the wall question:  How quickly can/will the medical bills become due after the accident?  Within that 12-week window?

And does she not have insurance? 

11 minutes ago, ratherbereading said:

And does she not have insurance? 

.... which would further stretch out the time frame.

21 hours ago, Tom said:

(So the plan sponsor puts the medical bill guilt on us.)

Indeed.  Recognizing that might motivate one to in fact begin to question the urgency.

Also, consider past practice of processing life claims and planned practice going forward. I would aim for consistency. From working on the Benefits Admin side, I've often heard that it will take longer than it actually does to get the death cert. Unless there are extenuating circumstances with an autopsy causing the delay. I was going to say that I would likely take an autopsy report (even a pending one), but that could raise the issue if there were some exclusion at play (was the accident deemed a death by suicide and was the individual in/past the suicide exclusion window).

12 weeks?!?  My husband died at home (unattended) on July 28 and we had the death certificate on August 4.  Maybe I watched too many true crime shows during the pandemic but my spidey senses are tingling--wonder who was driving?  Would a so-called "slayer statute" potentially come into play?  And it was many months before we started seeing our share of the medical bills after the insurance company did its thing.

9 minutes ago, EPCRSGuru said:

12 weeks?!?  My husband died at home (unattended) on July 28 and we had the death certificate on August 4.  Maybe I watched too many true crime shows during the pandemic but my spidey senses are tingling--wonder who was driving?  Would a so-called "slayer statute" potentially come into play?  And it was many months before we started seeing our share of the medical bills after the insurance company did its thing.

You would be surprised to learn that many States take longer than the usual week or so.  There are a variety of reasons why, including state regulations and backlog.  NC, NJ, NY and a few others tend to take 8+ weeks.

It doesn't pass the smell test.  CYA at all times.  

In addition to a death certificate, you could also seek a signed statement of death from the deceased's funeral director (I think there is a Social Security Form that is used for this) or a certified copy of the coroner's report of death.  Also, I would not discount the possibility of the slayer statute coming into play as noted by @EPCRSGuru as we have recently had to withhold a distribution to a beneficiary due to its application (still awaiting trial). 

On 4/29/2025 at 8:21 PM, david rigby said:

I would never expect to "go to the wake and see the deceased."   (My Dad was cremated.)  One other way to consider "proof of death" might be whether there is a published obituary.  (Sorry, I don't know if fraudulent obits are a thing.)

I don't know about fraudulent obits but I can tell you we have found over the decades a shockingly large number of possible beneficiaries by reading obits.   Including several times we called the church where the service was held and ask the minister to reach out to any known close relatives of the deceased to help get the process started.  Those tended to be for small amounts as asking for people to call to get money can create issues.  The first time I did this was for a benefit of about $80 and everyone was willing to risk paying the wrong person to get the benefit off the books.   A guy who could prove he was the sibling saying he was the last surviving relative got the money as that who is the person the minister talked to.   That was over 20 years ago and as far as I know no other person claiming to be the rightful heir has come forward.   

Is there a database a recordkeeper or third-party administrator could use for records of deaths?

In your experience, is the database reliable?

1 hour ago, Peter Gulia said:

Is there a database a recordkeeper or third-party administrator could use for records of deaths?

In your experience, is the database reliable?

The right participant  search firm can do a "death audit".   They are checking against the Social Security Administration record of SSNs that have been reported as the person is deceased.  I just couldn't tell you how quickly it is updated.   As noted in an earlier comment either funeral directors or corners have to report deaths to the SSA so they know to declare the SSN no longer active and if they are paying benefits to stop   

timely article

42 minutes ago, ESOP Guy said:

The right participant  search firm can do a "death audit".   They are checking against the Social Security Administration record of SSNs that have been reported as the person is deceased.  I just couldn't tell you how quickly it is updated.

Here's a timely article that might address some of those questions.  (No affiliation, just came across my screen earlier this week.)