Denied or Delayed FEGLI Claim?


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Federal employees may have many benefits associated with their employment: life insurance coverage (FEGLI), retirement benefits (CSRS), disability benefits, annuity, etc. When a federal employee dies, his beneficiaries on the FEGLI policy may have questions not only about their FEGLI benefits, but also about their Civil Service Retirement System Benefits (CSRS).

FEGLI is group life insurance coverage provided to federal employees as part of their employment benefits. It is generally valid while an employee is employed.

 

Upon termination of employment, insured employees have a choice to convert their FEGLI policies into individual policies without producing additional evidence of insurability. Generally, FEGLI policies have a provision that states that insurance on an employee stops on the date of his separation from the service, subject to a 31-day extension of regular life insurance coverage. During this 31-day extension of regular life insurance coverage a person may, upon application and without medical examination, convert all or any part of his regular life insurance to an individual policy of life insurance at rates applicable to his attained age and class of risk unless, within 3 calendar days after the date his regular insurance stopped, he returned to a position in which he is not excluded from coverage.

FEGLIA Preempts Conflicting State Law.

 

The Federal Employees’ Group Life Insurance Act of 1954 (FEGLIA) establishes a life insurance program for federal employees. Since FEGLIA is a federal statute, it includes an express pre-emption provision which provides that the provisions of any contract under FEGLIA which relate to the nature or extent of coverage or benefits (including payments with respect to benefits) shall supersede and preempt any law of any state, which relates to group life insurance to the extent that law or regulation is inconsistent with the contractual provisions.

FEGLI claims may be denied for many reasons. The most common reason for denial, however, is a denial based on an invalid beneficiary designation form. The following is a list of situations where a FEGLI beneficiary designation form may be invalid.

FEGLI coverage provides peace of mind to Federal employees and their families. FEGLI is designed to provide financial security to the Federal employee’s family members in case of the breadwinner’s untimely death. However, this financial security comes only when a FEGLI claim is paid after the insured’s death. If a FEGLI claim is denied, beneficiaries are left with unpaid bills, financial strain and loss of income. Moreover, beneficiaries are left with unanswered questions: