Missing person death claims offer a unique set of challenges to determine the legitimacy of the claim. While most ultimately end up being legitimate, separating the legitimate claims from those where illicit actors have feigned a death requires knowledge, skill, and diligence. Understanding the legal processes in the United States for obtaining presumptive death certificates when the insured person is missing and how the processes can be manipulated and exploited can mean the difference in paying or denying a false claim. Just as important is to know when and how to investigate these cases. Persons who are missing overseas have an added dimension of complexity.
In its simplest form, life insurance policies pay a death benefit upon proof of the insured’s death. In nearly all deaths, the body is left as evidence and death certificates are readily issued. In cases when there is no body, the courts must be solicited to issue a presumptive death certificate. A “presumptive death certificate” is just that – presumptive. And it is refutable if there are facts raised that bring doubt about the person’s fate.
How it works, in principle
The first thing to know is that the laws involving presumptive deaths vary by state so it is important to know the laws of the state where the petition for a presumptive death certificate will be made. Generally, however, there are two paths for obtaining a presumptive death certificate.
The path involving the least amount of time is when there is an explanation for the insured’s disappearance and it is reasonable to assume that the insured is dead. This most often happens when the insured is placed in the location of a peril, and ideally, there are witnesses who saw the insured in danger. A couple of examples of this are someone falling overboard from a vessel at sea, or an airplane crash where the passengers are not located. We have also seen cases where people with mental deficiencies have wandered away from the safety of their environs into the elements only to disappear with death being the only reasonable outcome. In cases where the insured’s death is anticipated due to the facts presented, and the death explains the disappearance, the courts will likely issue a presumptive death certificate.
The path that involves more time is when there is no explanation for the person’s disappearance. It is the passage of time without any known contact with the person that becomes the trigger for the presumption that the person must be dead. The time and processes required for a state to declare a person presumptively deceased varies by state and ranges from as short as three years, as in Nevada, to as long as seven years with five years being the most common. The process typically requires the petitioner to attest to the court that neither they nor anyone else who normally would have had contact with the person has heard from him or her. The courts may also require proof that a diligent search for the person has taken place including placing notices in newspapers and social media. While the laws vary, a couple of statutes to highlight the requirements are provided in the appendix to this article. Note that the date of death is generally determined to be, in the absence of another reasonably explainable date, the end of the presumption period.
When a missing persons claim is received, one of the first questions the claim manager should examine is whether the person actually existed or was the person a synthetic identity created for fraudulent purposes such as filing a life insurance claim. This requires a careful review of the underwriting files along with the facts that can be gathered upon notice of death. A more comprehensive background check may also be warranted should the insured have a limited footprint.
Assuming that the missing person was real, it isn’t enough to presume just the death since often the manner of death determines whether benefits will be paid. For example, was the death a suicide within the suicide exclusion period; was it a homicide and if so, is the beneficiary a suspect in the murder; or was it simply an accidental or natural death. The date of death can also make a difference if the death could have been within the contestable period and there is possible misrepresentation in the application (note that fraud is often defendable even if outside of the contestable period). These are all questions a claim manager must answer.
The next question that the claim manager must address is whether there is a motive for the parties involved to stage the insured’s death. Motives can vary but often are financial in nature; however, the motives are not always financial. Motives may be financial, but they may also be related to legal or relationship issues. Insurance may be involved in the hoax, but it could be tangential to the real driver. Also, one cannot assume that the beneficiary is aware of the hoax. The beneficiary may also be the victim of the hoax, but in a much crueler way than the insurer.
Case examples
Aubrey Price
Price was an investment banker who, in 2012, was under investigation by the SEC for securities fraud (motive). He, along with his wife and four young children, resided in Georgia. Instead of facing the impending indictments, he decided to stage his death as a suicide. To accomplish this, he left a note stating, among other things, that he was going to Florida to commit suicide by jumping off a ferry. He went to Florida and purchased a set of diving weights and a ferry ticket by credit card, thus creating a paper trail and the method for his staged death. He was caught on surveillance camera boarding a ferry in Florida, but he was not videotaped leaving the ferry. No other word was heard from him.
Six months after his disappearance, his wife petitioned the courts to declare him dead so she could get on with closing his affairs and moving on with her life. From all accounts, neither her nor her children were aware that their husband and father was still alive. Given the preponderance of the evidence – the note suggesting his intent to end his life, the purchase of the dive weights and ferry ticket, and the video of him boarding the ferry - the court approved the petition. At least two insurance policies totaling just under $2 million were paid out based on the presumptive death certificate. If there was an investigation done by the insurance companies, it was not presented as evidence in the courtroom.
Eighteen months after Price’s disappearance, he was pulled over in a traffic stop, and the gig was up. He was using an assumed name and, according to the Atlanta Journal and Constitution, he had several IDs with multiple names when he was arrested. Price ultimately admitted to who he was and plead guilty to securities fraud, wire fraud, and bank fraud.
The insurance policies were ancillary to Price’s motives, and in this instance, his wife was reportedly a victim of his scheme too. Throughout the 18 months Price spent in hiding, federal law enforcement believed that the death was staged and were continuing their investigation albeit they did not interfere with the court's declaration of death. He was sentenced to 30 years in prison and ordered to pay $51 million in restitution.
The insurance companies involved had already paid their benefits. It is doubtful they will ever see the funds returned, but in some ways, they were fortunate. Because they paid the full benefit without settling for a lesser amount, the companies were able to claim entitlement to the funds they had paid. Had they settled the claims for less than the full policy benefits, it is unlikely they could have become a claimant in the matter since the payment of the lesser amount would have been deemed a settlement.
Julie Wheeler
Ms. Wheeler was facing sentencing after conducting a health care fraud scheme that bilked nearly $300,000 from the Veterans Administration. In February 2020, she plead guilty to submitting fraudulent applications for health services rendered and inflating the rate and hours she was supposedly working. As she was awaiting sentencing, she and her family concocted an elaborate hoax stating that she had fallen off an overlook at the New River Gorge on May 31, 2020. Her body was not discovered – at least not in the manner that she and the family had hoped. She was quickly found hiding in her home in a closet. [1]
David Staveley a.k.a Kurt Sanborn
Mr. Staveley applied for COVID relief claiming nearly $440,000 in loans to pay employees of his three restaurants. The problem was that two of the three restaurants for which he was claiming benefits were not open prior to the pandemic and had no employees, and he had no affiliation to the third restaurant. Charges were brought against him in May 2020, and he was released with a monitoring device pending trial. To avoid prosecution, he staged a scheme to fake his death in Massachusetts. He left a suicide note along with his wallet, driver’s license, and credit cards in his car which was found with the keys in the ignition. While on the lam, he traveled to multiple states and was eventually found in Georgia [2]. He is awaiting trial at this time.
Like Price and Wheeler, the motive for Staveley’s disappearance was to avoid legal issues. Cases like this may or may not involve life insurance fraud.
Best practices when it comes to investigating missing persons:
- Always get a skilled investigation company such as Diligence involved early. These cases require that facts be confirmed, and allegations are substantiated. Interviewing and investigation skills are critical, and the earlier the investigation begins by a skilled investigator, the better the chances of a successful resolution are.
- Don’t assume anything, and let the facts take you where they lead you. If it is a fraud, the beneficiary may or may not be knowledgeable about the scheme being played out.
- As soon as the possibility of death is reported, begin your investigation while memories are fresh. Waiting until the presumptive death certificate is issued may be too late as memories fade, witnesses are no longer available, or in the case of fraud, stories are rehearsed. There will also be increased pressure to pay the claim once the certificate is issued which may force any investigation begun at that time to be compromised.
- Attempt to recreate at least the last known 24 hours of the insured’s life including all activities, contacts, locations, etc.
- Interview friends, family, and last known contacts of the missing person to understand the circumstances of the disappearance, the person’s and state of mind, and any other facts that may become relevant later. If fraud is involved, it is better to get the stories recorded early before they are rehearsed.
- Look for motives to disappear such as legal issues, financial issues, relationship issues, etc. Establishing whether there is a motive for the insured to disappear can assist in the investigation and provide leads should the insured be alive.
- Surveillance can be critical, particularly if fraud is suspected. Ideal times may be around important dates such as the birthdays of children, anniversaries, and holidays.
- Look for unusual financial activity on the person’s bank accounts including after the disappearance.
- Forensic phycological exams may provide valuable evidence in certain circumstances, particularly if the manner of death may have been suicide.
- Pay attention to the type of death certificate issued. In some cases, we have seen presumptive death certificates that specifically state that they were issued for administrative purposes only.
- When fraud is suspected, it is always best to find the missing person, but this isn’t required.
- The burden of proof of death generally rests with the beneficiary, not the insurance company, and while courts may be sympathetic to a beneficiary, if evidence points to something other than death, then the case may be defendable.
- Check with your reinsurer to see if other insurance companies may be involved. If the case is fraudulent, then the facts presented to the various companies may not align. Also, if the missing person loaded up on insurance immediately prior to the disappearance, it could mean that the disappearance was planned.
Finally, always get a company such as Diligence, which has skilled, experienced investigators, involved early as mentioned above. Not all investigation companies are the same, and it takes diligence to get to the facts. These cases nearly always have unique circumstances, and this requires that facts be confirmed and allegations are substantiated by someone experienced in these types of cases. This may mean utilizing a combination of tools such as interviews, court and other record retrievals, cyber-investigating, and surveillance.
We are here to help and be your partner in these cases. If you have a missing persons case or other complex cases, please call us and let us know. We want to be your first choice and best choice in your investigation solutions.
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SOURCE
[1] Source: United States Department of Justice, https://www.justice.gov/usao-s...
[2] Source: NBCNewsBoston, https://www.nbcboston.com/news...
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APPENDIX
2020 FL Chapter 731 § 731.103(b): A person who is absent from the place of his or her last known domicile for a continuous period of 5 years and whose absence is not satisfactorily explained after diligent search and inquiry is presumed to be dead. The person’s death is presumed to have occurred at the end of the period unless there is evidence establishing that death occurred earlier. Evidence showing that the absent person was exposed to a specific peril of death may be a sufficient basis for the court determining at any time after such exposure that he or she died less than 5 years after the date on which his or her absence commenced. A petition for this determination shall be filed in the county in Florida where the decedent maintained his or her domicile or in any county of this state if the decedent was not a resident of Florida at the time his or her absence commenced.
Official Code of Georgia annotated and provided by Lexis Nexis:
§ 53-9-1. Presumption or proof of death; presumption that missing person predeceased other deceased individual; perils or tragedies resulting in probable death
(a) A domiciliary of this state who has been missing from the last known place of domicile for a continuous period of four years shall be presumed to have died; provided, however, that such presumption of death may be rebutted by proof. The date of death is presumed to be the end of the four-year period unless it is proved by a preponderance of the evidence that death occurred earlier.
(b) When any domiciliary of this state has been missing from the last known place of domicile for a continuous period of 12 months or more, the death of the individual may be proved by a preponderance of the evidence.
(c) Notwithstanding any proof of a date of death that is earlier than the end of the four-year period set out in subsection (a) of this Code section, the missing individual shall be deemed to have predeceased any other individual who has died prior to the date any petition for letters or other action on the missing individual's estate is filed and from whom the missing individual would have taken an interest in property as an heir or beneficiary or otherwise.
(d) When any domiciliary of this state has been exposed to a specific peril or tragedy resulting in probable death, the death of the individual may be proved by clear and convincing evidence at any time after such exposure.
Regardless of which path is taken, parties who have knowledge that the person may be alive is able to voice their concern to the courts.
