Don’t Let a Denied FEGLI Life Insurance Claim Go Uncontested
FEGLI life insurance is coverage that is governed by the Federal Employees Group Life Insurance Act, which ensures that federal employees are protected by life insurance through a group plan. The laws surrounding FEGLI life insurance are complex and difficult to understand. If a loved one who has passed away was a federal employee with a FEGLI life insurance plan, don’t let a denied FEGLI life insurance claim go uncontested. Because there are extensive regulations to contend with, consulting with an attorney who is experienced in this specific area of insurance law is essential.
FEGLI currently offers life insurance protection to over four million members, including postal employees, federal employees and their families. If you are eligible for this coverage, you were automatically given coverage when you became an employee unless you signed a waiver form. Your FEGLI insurance may also have a dismemberment clause that pays if the insured loses a limb, is blinded, loses his or her hearing and other catastrophic injuries. For those under age 45, there is additional coverage without a corresponding increase in premium. You may have also been offered the opportunity to purchase additional coverage by paying a monthly premium. It sounds wonderful – that is, until the insured individual dies and his beneficiaries learn that they are being denied the money they are entitled to. This is when it’s essential to call for a free consultation with an attorney experienced at handling denied FEGLI life insurance claims. You don’t want to fight the federal government insurance provider on your own.
Have You Provided the Necessary Paperwork?
Before any FEGLI life insurance claims are paid to beneficiaries, the insurance provider will need specific paperwork, including:
- A form FE-6, Claim for Death Benefits, from the beneficiary or beneficiaries
- A copy of the death certificate or some other form that is proof of death
- A form SF 2821, or Agency Certification of Insurance Status
After they have received the documents above, the claimant should be paid the amount the deceased was insured for. Because this is the federal government, there could be delays or requirements that slow the process of appealing a denied claim, which is why it’s so important to have an attorney to help you fight for what you deserve.
Reasons Your FEGLI Life Insurance Claim Could Be Denied
There is a laundry list of reasons why denied FEGLI life insurance claims occur so often, including:
- More than one beneficiary was designated
- The beneficiary’s eligibility is disputed
- The insured’s eligibility is disputed
- Invalid designation of the beneficiary
- The insurer claims there was no coverage when the individual died
- Insufficient documentation
- Full or partial denial of a claim because it isn’t clear what optional coverages are in place
- Denial because premiums weren’t paid in a timely fashion
Divorce and FEGLI Life Insurance
There are special circumstances surrounding FEGLI life insurance beneficiary designations that may not apply with other types of policies. When the insured has designated his spouse at the time the policy is put in place, this individual will remain the beneficiary even after a divorce unless the proper paperwork has been submitted. While many states have laws in place that ensure that the current spouse is the beneficiary of a life insurance policy even if the paperwork wasn’t done, these state laws don’t apply to FEGLI coverage. Federal law requires that the beneficiary named in the policy be the recipient, even if the couple was separated or divorced at the time the insured individual passed away.
Additional Concerns About Beneficiaries
In certain situations, the beneficiary may not be designated in a FEGLI life insurance plan. The federal laws governing these policies will automatically pay the surviving spouse if the individual was married at the time of death. If there is no spouse, the claim should be paid to the children. If there are no children, payment should go to the parents of the deceased. Problems can arise when there are stepchildren, adopted children, or other claimants who could blur the beneficiary guidelines. When there is no clear next of kin or there is an estate involved, more issues will need to be addressed.
An attorney versed in FEGLI coverage and its complexities can help you determine how to proceed if the insurance company has denied your claim. This is especially important because FEGLI life insurance isn’t governed by state law, but by federal law, which makes the situation thornier because there are strict timelines for filing an appeal or any other paperwork. There may also be limitations on what remedies can be pursued for a denied FEGLI life insurance claim.