SGLI, or Servicemembers Group Life Insurance, is a benefit available to active members of the United States armed forces. The typical policy amount is $400,000 and coverage is very broad. Indeed, unlike some traditional life insurance policies, a SGLI policy will pay surviving beneficiaries even when the insured dies as the result of an act of war.
As you might suspect, however, SGLI coverage can be lost if the servicemember is deemed to have engaged in some sort of unpatriotic conduct. Things like treason, espionage, and going absent without leave (AWOL) can all result in a denial of coverage. Of course, when it comes to these sorts of misconduct, the facts are often far from clear. This can often mean that claims against a SGLI policy are denied when, in fact, the insurer should be paying the claim.
These are situations when the policy beneficiary needs a lawyer specializing in the wrongful denial of life insurance claims. A lawyer who has practiced in this area for any length of time will have experience with the intricacies of SGLI claim denials. In this article, we explore one case where the lawyer was able to obtain a SGLI payout for the named beneficiary long after a claim denial was issued.
A record of exemplary service
This particular case involved a man named Joe. Joe was a Sergeant in the United States Marine Corps. He was a natural leader and had a twelve-year track record of successfully leading his soldiers through dangerous combat missions. At the time of his death, Joe was serving his third tour in Afghanistan.
When he died, Joe was leading a group of 10 soldiers on a reconnaissance mission in the Kandahar Province. They were looking for a Taliban leader who had gone into hiding and was believed to be the mastermind behind a series of attacks on U.S. troops.
As the group traversed a narrow mountain trail, they suddenly found themselves showered in gunfire. Within moments, an IED exploded, sending several of the U.S. troops toppling down a mountainside. By the time backup arrived, it was clear that this was going to be a pure recovery mission. Sadly, the bodies of eight of the 10 soldiers involved in that mission were recovered that day.
The bodies of Joe and his best friend, Mark, were not found. Indeed, the two men appeared to have vanished without a trace. Not only were their bodies missing but all of their gear was missing as well. At the time, everyone involved presumed the two men had been killed.
As fellow soldiers packed up Mark’s belongings, they found some things that shocked them. Evidence hidden in Mark’s mattress revealed that the man had been communicating directly with the Taliban and may have given them intel on the timing and location of upcoming missions.
In light of this discovery, military brass changed its presumption that Mark had died in the recent attack. Instead, they assumed he had gone AWOL and was now living among the Taliban. Because Joe and Mark were the only two men to disappear and because they had shared such a close friendship, the military presumed Joe had gone AWOL too. This was true notwithstanding the fact that there wasn’t a shred of evidence to suggest Joe had any knowledge or complicity with his friend’s treasonous acts.
When Joe’s wife Sarah was notified of the incident, she immediately reached out to several of the remaining soldiers that Joe had served with. Without fail, each of them told her they were confident Joe had not been complicit in communicating with the Taliban. They told Sarah that everyone on base believed that Joe had simply been killed on the day of the incident. Nonetheless, the military had him designated as AWOL.
A real dilemma for the family
As far as Sarah was concerned, her husband was dead. Desperate for some sort of income to keep her and her four children afloat, Sarah filed a claim for benefits against Joe’s SGLI policy. Approximately one month later, Sarah received a claim denial letter in the mail. The letter said that the claim had to be denied because Joe was considered to be voluntarily AWOL and there was no indication he had been killed. The insurer also notified Sarah that she had up to one year to appeal the denial decision.
At that point, Sarah simply gave up on the claim as there was no way for her to prove her husband was dead. Eighteen months later, however, Sarah got a knock on her front door. When she answered, two uniformed officers stood at attention. They informed Sarah that Joe’s body had been found during a recent mission. From the condition of his body, it appeared he had died during the firefight that occurred a year and a half earlier.
Feeling somewhat vindicated, Sarah filed a second SGLI claim for benefits against Joe’s policy. This time, the insurer denied the claim on the grounds that Sarah’s “appeal” of the first denial decision was untimely. Frustrated and unable to get anywhere with the insurance representatives on her own, Sarah contacted a lawyer specializing in the wrongful denial of life insurance claims, including SGLI claims.
The lawyer had seen this before. The insurance company representatives were just being lazy. Rather than actually looking into the facts and circumstances of Joe’s death, they simply looked on the computer, saw that Sarah had had a claim against Joe’s policy denied more than one year earlier, and denied her new claim as a “untimely appeal.” The lawyer cleared everything up. He put together a letter brief setting for the timeline of events and presenting other cases where a policy payouts had been granted after the body of a person presumed AWOL had been found.
The letter brief was persuasive. Sarah received the full policy payout, plus interest dating back to the date of the initial claim. Sarah’s case is a good illustration of how involving a specialized lawyer can speed up the process of getting the life insurance money that has been wrongfully withheld from you. Our attorneys fight for SGLI beneficiaries all the time. Call us today to see if we can help with your claim.