The United States accounts for a large number of British deaths abroad through tourism, work, and family ties. The US funeral industry handles international repatriation routinely, so the process is usually efficient. The one feature that surprises families is that there is no national system: everything runs at state level. This guide answers the questions families ask.
For the full process and consular detail, see our complete guide to repatriation from the USA. This article focuses on the immediate questions.
First steps
Finding travel insurance is the first priority, because most British deaths in the US involve visitors who hold a policy. The death is registered with the records office of the state where it occurred, which issues the certified death certificate. A US funeral home then carries out the local steps under the coordinator’s instruction.
If there is no insurance, the family appoints a coordinator directly, and the cost falls to the estate or the family.
Why the state matters
The US has no single national death register. Each state operates its own death registration system, with its own forms, fees, and processing times for certified death certificates. This matters because the certified certificate is the document the rest of the process depends on, and how quickly it is issued varies from state to state.
A coordinator works with a funeral home licensed in the relevant state, which knows the local procedure. Major hubs such as New York, Los Angeles, Miami, and Orlando have funeral homes with extensive international experience.
Timelines and the medical examiner
An expected death certified by a physician moves quickly. A sudden death is referred to the county medical examiner or coroner, who may order an autopsy before release. Practice varies by county, and the family cannot decline a medical examiner’s investigation.
Once the certified death certificate is issued and any investigation is complete, the body is prepared and booked onto a flight to the UK. Belongings and affairs can be handled separately and do not delay the repatriation.
For further guidance, see our articles on documents needed to repatriate a body to the UK and dual national deaths: which country’s process applies.