To file a FEGLI claim, you must first report the death to the deceased person’s HR office or the Office of Personnel Management (OPM). At ERISA Insurance Claim Attorneys, our Federal Employees’ Group Life Insurance (FEGLI) claim denial attorney is here to help you handle this process.
Our law firm focuses only on fighting denied insurance claims, and we help people all over the country. Read on to learn more about how to file a FEGLI claim.
Understanding What FEGLI Is
The federal life insurance program is a huge program designed to provide life insurance coverage for most people who work for the U.S. federal government or are retired from it. It offers a basic life insurance amount and has several options for extra coverage that the employee might have chosen when they were hired.
The program is set up and controlled by the federal government under rules made by the Office of Personnel Management (OPM).
The actual claims, where the money is paid out, are handled by a private office called the Office of Federal Employees’ Group Life Insurance, which is the program’s claims administrator.
Our firm has over 30 years of experience fighting complex claims in Federal court, making us qualified in this kind of legal battle.
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Reporting the Death to the Right Office
The first step you should take is to officially tell the federal government that the person has passed away. Who you call depends on whether the person was still working or was already retired from their federal job. This step is necessary to prove the person was covered when they died.
If the person was an active federal employee at the time of death, you need to call or contact the Human Resources (HR) office at their last federal workplace or agency. This HR office will then send the necessary paperwork to the claims office and start the process to get you the proper claim forms.
If the person was a retiree receiving a pension or annuity check from the government, you need to contact the U.S. Office of Personnel Management (OPM) Retirement Services.
OPM will then check the person’s insurance coverage and send the FEGLI claim paperwork to the correct beneficiary, who will receive the payment.
Filling Out the Claim Form
After you report the death, the OPM or the HR office will send you the official claim document, which is the Claim for Death Benefits form.
You must fill this paper out completely and clearly using dark ink or by typing all of the requested information. Making a mistake or leaving something blank can slow down or even stop your payment.
The most important official document you must send along with the completed claim form is a certified copy of the death certificate. This is a document with an official stamp or seal from the government that proves the person has passed away. You must send a certified copy, not just a photocopy, or your claim will be delayed or denied.
Once everything is filled out and you have the certified death certificate, you will send the package to the program’s claims office at the address listed on the form. It is wise to make a copy of every document before you send it, just to be safe and to keep a record.
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Understanding Who Gets the Money in a FEGLI Claim
When a FEGLI claim is approved, the money must be paid out in a specific order that is required by federal law.
The first person to receive the benefit is the one the employee specifically named on an official government form called the Designation of Beneficiary. This is the most important paper for deciding who gets the money.
If the employee never filled out that official form, the law uses a strict Order of Precedence (a fixed list of who comes next). The money goes first to the surviving husband or wife, then to the children, then to the parents, and so on down to the next of kin.
A major problem often happens when there is a divorce, but the employee has never updated their beneficiary form.
Due to federal law, the benefit may still go to the ex-spouse who is named on the old form, even if the person meant for the money to go to their current husband or wife. This is why everything needs to be up to date.
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When the Claim Involves an Accident
Some federal life insurance policies include Accidental Death and Dismemberment (AD&D) coverage, which pays an extra benefit if the death was caused by a sudden accident.
The claims office often tries to deny these claims by saying the death was not an accident, but was instead from “natural“ causes, like an illness or a disease the person already had.
In these disputes, our job is to get detailed official records, like police reports and medical exams, to prove the death was caused by an accident and not by a natural cause or a policy exclusion.
What Happens if Your FEGLI Claim Is Denied?
A denial is not the final answer, but it is a serious event that starts a strict and fast deadline. When the claims office denies your claim, you must formally ask them for a Reconsideration. You usually only have a very short time of about 31 calendar days to do this, and you absolutely cannot miss this date.
The appeal process for a denial is very much like the process for the private insurance claims we handle: it is all done on paper before an official record is closed forever. If your administrative appeal is not strong enough and does not include all the right documents, you will have a very hard time winning if you have to go to Federal court later on.
This is the best time to call our firm. We can step in immediately to build a strong, professional appeal using reports and detailed legal arguments.
Learn How to File a FEGLI Claim
If your claim has been denied, remember that the denial is not the end of the line. ERISA Insurance Claim Attorneys is ready to use our decades of focused experience to fight for the benefits you are owed.
Let us put our experience to work for you to get the financial peace of mind you deserve. Contact us today for a free consultation.
Call or text (225) 201-8311 or complete a Free Case Evaluation form
