Our life insurance law firm is pleased to announce the successful resolution of a $232,000 denied FEGLI life insurance claim.
If you have experienced the loss of a loved one who was covered by a Federal Employees' Group Life Insurance (FEGLI) policy, dealing with a delayed or denied claim can add unnecessary stress during an already challenging time. In this article, we explore the intricacies of filing claims for FEGLI death benefits, reasons for potential rejection or delays, and the instances when seeking legal assistance becomes crucial.
There are various grounds on which a claim for FEGLI death benefits may face denial. At times, the rejection may stem from uncertainty regarding the designated beneficiary – disputes may arise between supposed beneficiaries or multiple claims may be submitted by competing individuals. Other scenarios include an invalid designated beneficiary, one who has already passed away, or the absence of any designated beneficiary on record. FEGLI distinguishes itself from private life insurance policies and comparable group programs for state or local government employees in several ways. Firstly, it is governed by federal law, superseding any state legislation. Additionally, death benefits exclusively go to the designated beneficiary, regardless of their relationship status with the deceased, even if the designation occurred decades before the federal employee's passing. This underscores the importance of maintaining up-to-date beneficiary information. Unlike accidental death insurance, FEGLI pays out claims even in cases of suicide.
Given FEGLI's independence from state laws, the order of precedence for death benefits distribution is outlined as follows:
- Designated beneficiary (without exceptions)
- Surviving spouse in the absence of a designated beneficiary
- Surviving children if neither of the above is applicable
- Surviving parents if none of the aforementioned
- Executor or administrator of the deceased's estate if none of the above
- Next of kin if there is no designated beneficiary, surviving spouse, children, parents, executor, or administrator
- After four years without a filed claim, the funds escheat to FEGLI.
Apart from beneficiary-related issues, FEGLI claims can be denied due to other factors such as eligibility problems (e.g., no coverage at the time of death), insufficient supporting documents, or non-payment of premiums. Federal employees are automatically enrolled in FEGLI basic, but they can opt out, leading to coverage termination at the end of the relevant pay period or 12 months post "discontinuance of pay." Confirming the deceased's coverage status may necessitate legal assistance.
In the case of delayed FEGLI claims, defined as those unpaid after 30 days of submission, the beneficiary initiates the process by providing the death certificate to the Office of Personnel Management (OPM). OPM responds with a "FE-6" claim form, which the beneficiary sends to FEGLI. Further documentation, including certification from the employing agency's office, may be requested by an examiner. Various issues could contribute to delays in FEGLI death benefit claims, such as insufficient supporting documents, lack of a death certificate, beneficiary disputes, or contests. Legal counsel may become essential for complex cases and delayed claims to streamline the process effectively.
Our top life insurance law firm handles all: denied FEGLI claims; denied AD&D claims; beneficiary disputes; and Interpleader actions.