TSGLI Claim Denied? Here’s What You Need to Know and How to Fight Back
When a servicemember suffers a life-changing injury while protecting our nation, they deserve more than just thanks—they deserve support. The Traumatic Servicemembers' Group Life Insurance program (TSGLI) was created to provide exactly that. But for far too many veterans and their families, a TSGLI claim denial turns what should be financial relief into frustration, confusion, and hardship.
If your TSGLI claim was denied, you’re not alone—and you’re not without options.
What Is TSGLI?
TSGLI stands for Traumatic Servicemembers’ Group Life Insurance, a benefit designed to provide financial compensation to servicemembers who suffer severe injuries in the line of duty. It’s a rider attached to the broader Servicemembers' Group Life Insurance (SGLI) policy and offers a one-time payment—ranging from $25,000 to $100,000—for qualifying injuries. These funds are intended to help cover lost wages, rehabilitation costs, and the everyday expenses that arise when life changes in an instant.
Importantly, TSGLI applies even while the policyholder is still alive. Unlike traditional life insurance, its purpose is to assist with recovery and daily living after a traumatic injury—not just provide benefits after death.
Common Injuries Covered by TSGLI
TSGLI covers a wide array of catastrophic injuries, including:
Loss of sight, hearing, or speech
Amputations or loss of use of limbs, fingers, or toes
Severe burns and facial reconstruction surgeries
Injuries requiring extended hospitalization or coma
Conditions that prevent the performance of Activities of Daily Living (ADLs), such as bathing, dressing, or eating
Because these injuries are both physically and emotionally devastating, a denied TSGLI claim can add an unfair financial burden to the pain already endured.
Why TSGLI Claims Get Denied
Despite the program’s intent, TSGLI denials happen frequently—and often without clear explanation. Some of the most common reasons for denial include:
Missing or inaccurate medical documentation
Confusion over policy eligibility or SGLI enrollment status
Disputes over whether the injury meets the definition of “traumatic”
Disagreement about the timing of the injury relative to policy activation
Improper classification of the injury's severity or impact on ADLs
In many cases, the problem is not the injury itself but bureaucratic red tape, miscommunications, or administrative errors.
Insurance Companies Don’t Always Get It Right
Insurance administrators working on behalf of TSGLI claims may deny valid claims due to paperwork errors, vague language in medical records, or misinterpretation of the policy. Worse, they sometimes suspect intentional injury or fraud when an injury occurs shortly after enrollment. This suspicion, although rarely justified, can cause delays or outright denials.
You’ve served your country. You’ve suffered. You deserve better than being told your injury “doesn’t count.”
How to Fight a TSGLI Claim Denial
If your TSGLI claim has been denied, it’s critical to act quickly—and strategically. Here are the key steps:
Gather All Documentation
Secure copies of your medical records, the TSGLI denial letter, your SGLI enrollment documents, and any military incident reports. If your injury impacts your ability to perform daily activities, make sure you have documentation from caregivers, physicians, and rehabilitation professionals that clearly outline those limitations.Understand the Denial
Review the insurer’s stated reason for denial. Was it due to lack of evidence? Was the injury’s severity questioned? Did the claim fall outside the policy's timeline? Knowing the exact reasoning allows your legal team to respond with precision.Consult a TSGLI Denial Attorney
Don’t fight this battle alone. Our attorneys specialize in denied life insurance and TSGLI claims, and we’ve helped countless servicemembers reverse unjust denials. We know what documentation is persuasive, what language meets policy criteria, and how to work with (or around) the Department of Veterans Affairs and insurance providers.
Our Legal Team Can Help
We’ve seen TSGLI claims denied for reasons that don’t hold up under legal scrutiny. Sometimes the insurer simply didn’t read the documentation correctly. Other times, they ignored new medical evidence or failed to understand how the injury impacted your life. Our lawyers step in with a thorough review, coordinate with doctors and experts, and present your appeal with the strength and clarity it deserves.
We also represent family members whose TSGLI claims are denied on behalf of living servicemembers who are incapacitated or unable to advocate for themselves. In situations involving guardianship, traumatic brain injury, or extended hospitalization, we ensure no detail is missed and no benefit is left on the table.
What If You’re Unsure Whether Your Injury Qualifies?
Don’t assume the injury isn’t covered just because a form letter says so. We've won appeals for:
Partial amputations
Internal injuries
Extended ADL impairments
Facial trauma and reconstructive procedures
Psychiatric complications following head injuries
If you’re unsure whether your injury meets TSGLI guidelines, reach out. We offer free consultations to review your denial and evaluate your chances of success.
TSGLI Denials Affect Real People—We Treat Them That Way
This isn’t just about policies and codes. It’s about veterans and military families facing one of the hardest times in their lives. We understand that a TSGLI denial can derail recovery, jeopardize financial security, and create unnecessary emotional stress.
You’re not just a claim number to us. You’re someone who stood up for your country. We’re here to stand up for you.