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The ‘Cause of Death’ on a Death Certificate Explained

12 minute read

Whether at short notice, or as part of a longer-term plan that is put into action, the paperwork aspect of arranging a funeral is often something that causes anxiety. If you have questions about the ‘Cause of Death’ part of the Death Certificate, then this article aims to help you understand things a bit better.

We would also just like to say that, if you have recently found yourself in the position of needing to arrange a funeral, whether for a loved one or anyone else, then we recognise the complexity of your situation. Aside from helping you understand the paperwork aspect of things, we offer our direct cremation services to those in need now, and those looking to organise a funeral plan for the future.

Doctor with stethoscope
The cause of death is supplied by the attending physician, verified by the Medical Examiner, and sometimes referred to the coroner

Understanding the Death Certificate and cause of death

A Death Certificate serves as an official legal document that verifies someone’s death. It not only records personal details of the person who has died (such as age, name, marital status, etc.), but also lists both the immediate and underlying causes of death. A helpful way to think of it is that the Death Certificate legally verifies the person’s death, whereas a Medical Certificate of Cause of Death (MCCD), which is different, handles the medical matters. You’ll need the MCCD in order to register the death and secure the Death Certificate.

How long it takes to get these two documents sorted will impact how long it takes to arrange a funeral for the person who has died. 

What is the purpose of a Death Certificate?

A Death Certificate’s main aim is to provide an official record of someone’s death, and the cause behind it. Getting this certificate is one of the main things you’ll need to do when someone dies. It’s an essential document for the financial affairs of the person who has died, allowing you to access their estate, pension, and bank accounts. Alongside the MCCD, it also plays a critical role in gathering vital statistics for public-health, by helping the government to track death rates and causes. This can inform health policies and preventative measures in the future.

The information on the Death Certificate is also crucial for various legal procedures: it is required before the settlement of the person’s estate can occur, as well as for life insurance claims, and for registering the death with different government departments, if necessary. Therefore, it can be quite important for ensuring that a family is reimbursed for its cremation costs

Who is responsible for certifying the cause of death?

In September 2024, there were some changes to the death-registration process in England and Wales, bringing it more into line without how it already was in Scotland. It’s now designed to be much easier and less likely to result in delays. Now, a ‘Medical Examiner’ needs to certify the MCCD, verifying the cause of death given by the physician attending the person who has died. In cases where it’s not clear that the death results from natural causes, or where the circumstances are uncertain, the Medical Examiner can investigate and certify the cause. 

They can also act as a point of contact for the family of the person who has died, giving them the chance to air any concerns they might have and to ask any questions. They can also refer the death to the coroner (or Procurator Fiscal in Scotland) if they feel the circumstances are suspicious. Ultimately, they must determine the cause of death before signing the certificate, vouching for the accuracy of the information given.

Once the Medical Examiner has done this, they will then send the MCCD to the local Registrar; at this point you can set up a meeting with the Registrar in order to obtain the Death Certificate and officially register the death. It’s the cause of death provided by the MCCD that goes on the Death Certificate given by the Registrar.

 

Process of determining the cause of death

A cause of death is given by the attending physician, verified by the Medical Examiner, and possibly outsourced to the coroner (or the Procurator Fiscal in Scotland) in cases where the death might be suspicious. They will consider various different things before proposing a cause of death.

Investigating the cause of death

The cause of death can be determined by a doctor in a number of different ways, usually by evaluating different pieces of information, such as the medical history of the person, clinical findings, and, where necessary, by conducting a full, surgical post-mortem, if it’s not apparent enough already. A post-mortem isn’t always necessary, particularly if the attending physician had been with the person who died regularly prior to their death. 

The cause of most deaths can be found and verified without any trouble by the attending physician and the Medical Examiner. But in cases where the death was unexplained and indeterminable by further analysis, or if it was suspicious, then it may be referred to the coroner for further investigation.

 

Immediate v underlying cause of death

The Death Certificate separates the cause of death into two categories: the immediate and underlying causes. An immediate cause would be the final medical event that directly led to death, such as a heart attack. The underlying cause is a preexisting condition or disease that contributed to or triggered the immediate cause, like cancer or chronic illness.

Immediate cause of death

When somebody dies, the cause of their death can seem simpler on the surface than it actually is. It might be the case that somebody suffers a stroke, which leads to the loss of their life, but that they had numerous underlying health problems that contributed to the occurrence of the stroke. 

Underlying cause of death

The underlying cause(s) of death, quite simply, is any possible health problem contributing to the immediate cause of death. In the above example of the stroke, this could be something like high-blood pressure, which can’t lead to a death itself, or even a trauma injury, but which could result in one of a number of different immediate causes of death.

It’s important for medical professionals to show their working on what possible underlying causes could have contributed to the immediate cause, as well as what evidence they have to support their arguments, as this is how we can determine whether there was any foul play or suspicious circumstances. A heart attack occurring in an elderly person who has a family history of heart disease or high-blood pressure is much easier to explain than the same thing occurring in a young person.

 

Legal and administrative use of the Death Certificate

The Death Certificate is the legal key that unlocks the financial matters of the person who has died. It kick-starts the process of executing their estate, and is also usually necessary for claims to be made on any over-50s life insurance policies they may have had in place.

Legal implications of a Death Certificate

One of the things that people often notice when someone close to them dies, and they have to organise everything afterwards, is that there is a considerable amount of admin that needs to be done. A lot of that admin relates to the financial legacy of the person who has died, including their personal bank-accounts, pension policies, property deeds, and, of course, the execution of their estate. 

It’s often the case that the family requires access to these areas of their life in order to pay for their funeral, or in order to continue to support themselves. Hence the reason it’s really important that all the identification information on the document is correct, as any inconsistencies can cause delays when trying to close their bank accounts or process inheritance.

Insurance and financial uses

If the person who has died had an over-50s life insurance policy in place, and that’s how their family intends to pay for the funeral, they may end up seeing delays as a result of the Death Certificate. Insurance providers often withhold payment until they receive extensive documentation relating to the death of their policy-holder, and they can even dispute your position and ask you for further information before processing the claim. The Death Certificate legally certifying the death of their policy-holder is one of the documents they will likely request.

 

Autopsy and cause of death investigation

An autopsy (also known as a post-mortem) isn’t always necessary, but may be required if the cause of the death is unclear from an assessment of the other information available, or depending on the circumstances of the death.

When is an autopsy performed?

If the attending physician is unable to determine the cause of death based on the information they have in front of them, i.e., the medical history of the person who has died, or the immediate circumstances of their death, then they may feel that an autopsy is required for the avoidance of doubt. This involves a surgical analysis of the body’s underlying pathology, in order to see if anything can be learned from what’s beneath the surface. 

An autopsy may also be ordered in circumstances where the Medical Examiner disputes the cause of death supplied by the attending physician, and feels that more analysis is required to give a clear answer. Furthermore, if the cause of the person’s death cannot be explained by an analysis of medical information, it may suggest that they have died in suspicious circumstances. At this point, the matter would be referred to the coroner (or procurator fiscal in Scotland), who would then take charge by possibly launching an inquest.

 

What happens if the cause of death is unknown?

In cases where someone’s death is unknown, the coroner can launch an investigation that may or may not include an ‘Inquest’. You will be issued with ‘Interim Death Certificates’ whilst they investigate, which will allow you to proceed with all the matters that a normal Death Certificate would allow you to do.

Correcting or contesting a Death Certificate

It isn’t possible to change the cause of death on a Death Certificate once it has been issued, but there are circumstances in which the Death Certificate can be amended.

The only corrections that can be made are of a clerical nature, i.e., concerning the personal information of the person who has died which may have been recorded wrongly by accident. It means that if, once you receive a Death Certificate, it becomes clear that names, addresses, occupations, or dates are incorrect, or if there are typos, you can apply to have them corrected.

The amendments won’t replace the original certificate, but you will be able to see an updated version alongside it.

How to correct errors on a Death Certificate

You can apply to the UK government to amend a Death Certificate if you are the informant; a relative or partner of the deceased; or a person who would have been able to register the death. If you are not the person who originally registered the death you’ll need to provide a letter from them showing that they agree to the correction, as well as other documentation.

There is also a fee for applying to correct the information, which could be between £83.00 and £99.00 depending on the circumstances. 

Can a Death Certificate be contested?

There isn’t much scope for disputing the ‘Cause of Death’ on a Death Certificate in the UK, as it is given by a medical or law-enforcement professional. It needs to go through quite a long and rigorous process before its conclusion. However, according to the Citizens Advice Bureau, you can report your concerns to a local coroner, who can launch an investigation for you, if you feel that the cause already given doesn’t represent the situation as you understood it.

With the new changes to the regulations around death registration, you have an opportunity to talk to the Medical Examiner about any concerns you may have had about the standard of care received by the person who died shortly beforehand. If your dispute relates to the fact that you feel medical negligence was an underlying cause of death, you now have a clearer opportunity to address this with them before the Cause of Death is defined.

 

Angel support

We hope that you have found this explanation of the Death Certificate useful. If you’re currently organising a funeral for a loved one, we want you to feel as comfortable and as well informed as can be. Our Angel team is always ready to take your call if you have any questions with the required admin; they’re here to support as much as is needed.

 

Kim Greenacre
Kim
Amy Rees
Amy
Tracy Field
Tracy
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