Last Breath

Last breath rolls. When you die, I make a big spectacle of secretly rolling a d20 behind the screen. They don't know the exact mechanics but I can say here. On a 1-5, you die. On a 6-20, death is willing to make you a deal for your life. You don't have to accept, of course. The lower the number rolled, the harsher the deal. I also don't play with resurrection spells. It makes death real and threatening, but gives excellent plot hooks and my players LOVE the extra "safety buffer" and the whole deal with death thing.

Sure! My personal favorite deal:

We had a cleric/werewolf who had torn his own eyes out believing that sight of the moon itself is what caused him to shift.

We also had a dex based fighter who relied on skill and finesse to best foes.

We reached a point where the party was trying to identify statues of the gods in an ancient underground forgotten city, but only the cleric had enough religious knowledge to do so after failed rolls from everyone else. Sadly, he was blind. My fighter fell in combat not long after. I rolled and got a 6. Which indicates to me I need to come up with a deal that is potentially very harsh, without destroying a player's enjoyment of the character.

Death decided that in order to complete their quest, they needed to identify the statues. Death allowed the fighter to survive if he would offer his eyes as a sacrifice to the cleric. This was devastating temporarily, but they soon found someone who was willing to teach the fighter a form of daredevil-esque echolocation. He was able to fight again and use his character, but was unable to make visual perception checks going forward.

Others can be things such as taking out a prominent necromancer who is breaking the cycle of death, or perhaps on the flip side a cleric who heals people who are supposed to die. One of those is far more harsh than the other for good characters. Both are good plot hooks. Perhaps death needs someone to check up on a temple to one of the Gods. It comes down to two things: What does death want? And/or what would be a useful lesson for this character/party to learn?