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An autopsy will only happen if the coroner feels there is fowl play. If the family requests one, they pay for it and its expensive.
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actually it’s not true that autopsies are only done when foul play is suspected. An autopsy determines the cause of death so they are done when death is accidental, a suicide, or simply unexplained. Also depending on age, autopsies can be mandatory. Usually if someone is under 19, an autopsy is mandatory. Families can request an autopsy, if the patient dies at the hospital they request it there. Otherwise you would go through the coroners office. The coroners office does autopsies but so do hospital pathologists. And again, they are done whether foul play is suspected or not
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I would think that if whoever passed away’s death was questionable ie criminal an autopsy would be performed automatically. But if it’s an elderly person whose doctor’s determined died of natural causes and you want an autopsy for say, insurance policy payout (to prove it wasn’t suicide for instance) then you can request it but may have to pay out of pocket for the autopsy which is expensive.
My mother passed at 89 and I am pretty sure it was because of a stroke, but wasn’t ever going to do an autopsy on her to find out for sure.
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Turns out there are different laws regarding autopsies depending on the state. Here is a link that has extensive information.

https://www.cdc.gov/phlp/publications/coroner/investigations.html
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Thank you all
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