Common Reasons FEGLI Claims Are Denied
Although FEGLI is backed by the federal government and administered through the Office of Personnel Management (OPM), claims can still be denied for a range of reasons. Here are some of the most frequent:
1. Non-Payment or Lapse in Coverage
If the employee failed to pay required premiums—especially after retiring or changing employment status—coverage may lapse. In many cases, OPM may fail to notify beneficiaries that premiums were not being deducted, leading to unexpected claim denials.
2. Suicide Within the Exclusion Period
FEGLI includes a suicide exclusion that applies within the first two years after initial enrollment or reinstatement. If the insured dies by suicide during that time, the claim may be denied under this exclusion.
3. Material Misrepresentation or Non-Disclosure
If the policyholder failed to disclose significant medical conditions, lifestyle habits, or other material facts when applying for coverage, the insurer or OPM may void the policy—especially if the death occurs during the contestability period.
4. Ineligible Beneficiary Designations
FEGLI requires that beneficiaries have an insurable interest. Naming a party with no legal interest in the insured’s life—such as an unrelated third party—may result in denial. Beneficiary disputes involving ex-spouses, estranged family members, or outdated designations often trigger claim delays or rejections.
5. Improper or Outdated Beneficiary Designation
If the beneficiary form was filled out incorrectly, is missing, or wasn’t updated after major life events (such as divorce or remarriage), OPM may not honor the intended designation. FEGLI is strict about paperwork, and errors can delay or derail payment.
6. Death Related to Excluded Activities
While FEGLI is broader than many private policies, certain high-risk scenarios—such as death during military conflict (if not on active civilian duty)—may trigger exclusions. These are rare but can be disputed.
What to Do If Your FEGLI Claim Was Denied
If you’ve received a FEGLI claim denial letter, you are not out of options. The denial will include the reason(s) for rejection, and you have the right to appeal or challenge the decision. Often, the initial denial is based on incomplete records, administrative errors, or misunderstandings of the facts.
Steps to take:
Request a copy of the denial letter and policy documents
Gather all supporting records (death certificate, employment records, beneficiary forms)
Consult a life insurance attorney with experience in FEGLI appeals
Act quickly, as strict deadlines may apply to administrative appeals
Our law firm has recovered life insurance benefits in cases involving denied FEGLI claims due to outdated designations, payment lapses, miscommunication with OPM, and interpleader lawsuits. If your claim was denied, let us help you fight back and recover the benefits your loved one intended for you.
Contact Us for Help With Denied FEGLI Claims
We understand the complexities of FEGLI policies and the unique rules that govern them. Our top-rated life insurance attorneys can guide you through the appeal process and work to reverse the denial. We’ve successfully handled cases involving MetLife (the FEGLI carrier), OPM disputes, and contested beneficiary issues.
Call us at 800-330-2274 for a free consultation and find out how we can help you recover the life insurance benefits you’re owed.
FAQ: FEGLI Life Insurance Claim Denials
What is FEGLI?
FEGLI stands for the Federal Employees’ Group Life Insurance Program, which provides life insurance coverage to eligible federal workers and their families.
Who administers FEGLI claims?
While MetLife is the insurance provider, claims are handled in coordination with the Office of Personnel Management (OPM).
Can a FEGLI claim be denied after retirement?
Yes. If premiums were not properly paid post-retirement or the retiree didn’t elect continued coverage, the claim may be denied.
Does FEGLI have a suicide exclusion?
Yes. Death by suicide within the first two years of coverage or reinstatement may result in denial under the suicide exclusion clause.
What happens if the beneficiary form is missing?
OPM may default to the standard order of precedence: spouse, children, parents, executor, then next of kin. But without proper paperwork, delays and disputes are common.
Can I challenge a denied FEGLI claim?
Yes. You have the right to appeal. A lawyer can help you file the necessary paperwork, present evidence, and request a formal reconsideration.
What if the insured never updated their beneficiary after divorce?
This is a common issue. Federal law typically honors the most recent signed designation of beneficiary form, even if it names an ex-spouse. However, state-level automatic revocation laws don’t apply to FEGLI due to federal preemption.
Can I claim FEGLI benefits if I’m not a family member?
Yes, if you were properly designated as a beneficiary on the signed form. Otherwise, you may have no legal right to the proceeds.
How long does it take to receive FEGLI benefits?
If all documents are in order, it may take 6–12 weeks. If disputes or errors arise, it could take months.
What if OPM says the coverage lapsed?
An attorney can investigate whether the lapse was caused by administrative error or improper communication. Reinstatement may be possible if the lapse was not the insured’s fault.
Are FEGLI denials common?
They are more common than most people realize, especially when forms are incomplete, beneficiaries are disputed, or there are retirement or reinstatement issues.
Do I need a lawyer to appeal a FEGLI denial?
It’s strongly recommended. FEGLI appeals require knowledge of federal regulations, MetLife protocols, and OPM administrative procedures.
Can a FEGLI claim be delayed for investigation?
Yes. If there are questions about the beneficiary, cause of death, or eligibility, OPM and MetLife may conduct a lengthy review.
Can a FEGLI policy be contested after payment is made?
In rare cases, yes. Competing beneficiaries may challenge the payout in court, often through interpleader actions.
Will a criminal investigation affect my FEGLI claim?
Yes. If the beneficiary is a suspect in the insured’s death, the claim may be delayed or withheld under the “slayer rule.”
What’s the difference between Basic FEGLI and Optional coverage?
Basic coverage is automatic for eligible employees, but optional coverage requires enrollment and additional premiums.
Is FEGLI coverage active during unpaid leave?
It may be, but it depends on the length and type of leave. Failure to return from leave or make back payments can result in lapse.
Can I recover denied FEGLI benefits after a late filing?
It’s possible if you show good cause, but strict deadlines apply. Legal assistance can improve your chances.
What’s the best way to avoid a denied FEGLI claim?
Keep beneficiary forms updated, maintain premium payments, and ensure clear documentation of coverage elections.
Does state law apply to FEGLI disputes?
No. FEGLI is governed by federal law, so state laws like automatic revocation statutes do not apply.