Denied or Delayed FEGLI Claim?

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Q. What should I do if my FEGLI claim has been denied?


A. If your FEGLI claim has been denied, you can file an appeal. A FEGLI attorney can assist you in filing an appeal. FEGLI claim denials are complex and should never be a do-it-yourself project. Consult with a FEGLI claim denial lawyer to understand your rights.


Q. Who will get the FEGLI benefits if there are no beneficiaries on record?


A. If there are no beneficiaries on record, the benefits will be paid in a particular order, set by law. First, the benefits will be paid to the widow or widower. If none, to the insured’s child or children; if none, to the insured’s parents; if none, to the executor or administrator of the decedent’s estate; if none, to the insured’s other next of kin according to the laws of the state where the Federal employee lived.


Q. What should a beneficiary do in order to collect on a FEGLI policy?


A. The beneficiary must complete a claim form and submit it to OFEGLI, an office of MetLife.


Q. What should I do if my FEGLI claim has been denied due to the insured’s LWOP status at the time of death?


A. Generally, a FEGLI policy will continue for 12 months after a Federal employee leaves without pay. In most cases, the federal employee does not have to pay premiums while he is on LWOP and coverage is extended for 12 months premium-free. At the end of the 12-month period, there is an additional 31-day extension period during which a FEGLI policy is valid. If a claim is denied due to the fact that the insured was on LWOP at the time of his death, you need to investigate the facts to see if there was coverage at the time of his death. A FEGLI denied claim attorney can help you understand whether the claim was wrongfully denied.


Q. How much should my FEGLI claim be?


A. A FEGLI claim is usually the amount of the Basic life insurance that the Federal employee had. If the insured died when he was younger than 45, there must be additional Extra Benefit. The amount of the Extra Benefit depends on the insured’s age. It is double the amount of the basic coverage when the insured is 35, but decreases by 10% every year afterwards.


Q. How can a Federal employee receive FEGLI benefits while living?


A. Usually, FEGLI benefits are paid to beneficiaries after the insured’s death. In some cases, however, living benefits may be paid to the insured while living. To qualify for a living benefit, the insured must have a terminal illness. If an insured if terminally or chronically ill, he may choose to assign his FEGLI policy to a viatical settlement firm that will pay him a settlement amount in exchange for the right to receive the proceeds of his EFGLI policy in the future.


Q.What should I do if my FEGLI claim has been denied due to failure to convert?


A. Conversion is an insured’s right to replace his FEGLI policy with an individual policy at the end of his employment. Usually, the insurance company gives the insured 31 days during which the insured can convert to an individual policy and during which the FEGLI coverage will stay in effect. If your FEGLI claim has been denied due to the insured’s failure to convert, consult with a FEGLI lawyer to see if you can overturn the denial of your claim on appeal.


Q. Can a former spouse who is not a beneficiary on a FEGLI policy file a court order which entitles her to receive FEGLI benefits?


A. Yes. A former spouse can submit a court order which states that the former spouse should receive the divorced employee’s FEGLI benefits. A court order must be valid in order to prevail over the insured’s beneficiary designation. To determine whether your court order complies with FEGLI requirements, call a FEGLI lawyer for a consultation.


Q. My claim has been denied due to an incorrect beneficiary change made by a person who had a power of attorney on the insured. May I appeal the denial?


A. If your FEGLI claim has been denied due to an incorrect beneficiary change, you have to consult a life insurance lawyer. If your claim was denied because a person other than the insured signed the change of beneficiary form, most likely, you will not be able to receive the benefits. Only the insured has the right to change beneficiaries. If someone with a power of attorney signs a Designation of Beneficiary form on behalf of an insured federal employee, such designation is not valid.


Q.My FEGLI claim has been denied due to late submission of the beneficiary change form. Am I entitled to the FEGLI benefits if the change of beneficiary form (designating me as the beneficiary) was sent to the OFEGLI after the insured’s death?  


A. In order for the for the Office of Federal Employees' Group Life Insurance (OFEGLI) to pay the benefits, the designation form must be submitted to the right office before the insured’s death. If the form is sent to the wrong office, OFEGLI will pay benefits in accordance with the next prior designation on file or under the order of precedence, if there is no designation.


For more information, call us at 888-510-2212.


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