Filing a FEGLI Death Benefits Claim

Losing a loved one is never easy, and when the financial security of your family hangs in the balance, the last thing you want is a delay or denial in claiming the Federal Employees’ Group Life Insurance (FEGLI) death benefits. In this article, we will explore the process of filing a claim for FEGLI death benefits, common reasons for claim rejection or delay, and when it’s advisable to seek legal assistance.

Understanding FEGLI Death Benefits

FEGLI, unlike private life insurance policies and state or local government employee group programs, operates under federal law, superseding any state legislation. This uniqueness extends to the rigid rule that death benefits can only be disbursed to the designated beneficiary, regardless of their relationship to the deceased. This emphasizes the importance of keeping beneficiary information up-to-date.

Moreover, unlike accidental death insurance, FEGLI still pays out in cases of suicide. However, claims can be denied for various reasons unrelated to beneficiaries, including issues with eligibility, lack of coverage at the time of death, insufficient documentation, or non-payment of premiums.

Federal employees are automatically enrolled in FEGLI basic, but they have the option to opt out, which leads to the termination of FEGLI coverage. Determining whether the deceased was covered by FEGLI at the time of death can be complex and may necessitate legal assistance.

Order of Precedence for FEGLI Death Benefits

The order in which FEGLI death benefits are distributed is as follows:

1. The designated beneficiary (no exceptions)
2. If no designated beneficiary, then a surviving spouse
3. If none of the above, then any surviving children
4. If none of the above, then any surviving parents
5. If none of the above, then the benefits go to the executor or administrator of the deceased’s estate.
6. If there is none of the above and no executor or administrator, then death benefits go to the next of kin.

If no beneficiary files a claim after four years, the funds are escheated to FEGLI.

Common Reasons for Claim Denial or Delay

1. Unclear Beneficiary: Disputes between potential beneficiaries or multiple claims from competing beneficiaries can lead to claim delays or denials.

2. Invalid Designated Beneficiary: An invalid or deceased beneficiary designation can result in a denied claim.

3. No Beneficiary on Record: If there is no designated beneficiary on record, the claim may be rejected.

4. Eligibility Issues: Problems related to the deceased’s eligibility for FEGLI coverage, such as opting out or discontinuing premium payments, can lead to claim denials.

Dealing with Delayed FEGLI Claims

A claim is considered delayed if it remains unpaid for 30 days after submission. The process begins with the beneficiary sending the death certificate to the Office of Personnel Management (OPM), which responds by sending a “FE-6” claim form. Additional documents, such as certification from the employing agency’s office, may be requested.

Several factors can contribute to delayed FEGLI claims, including:

• Insufficient supporting documents
• Lack of a death certificate
• Beneficiary disputes or competing claims
• A beneficiary designation form received after the date of death
• Technical issues with the listed percentages for multiple beneficiaries
• Competing claims from multiple executors of the estate

For complex cases and delayed claims, seeking legal counsel may be necessary to expedite the process. Experienced attorneys familiar with the FEGLI Act can help navigate the intricacies of the system, appeal denied claims, and resolve beneficiary disputes.

The Importance of Preparation

Federal employees who are covered by FEGLI can ease the claims process for their beneficiaries by ensuring their information is current, premiums are paid, and all necessary documentation is in order. By taking proactive steps to maintain their FEGLI coverage, federal employees can provide peace of mind to their loved ones in times of need.

In conclusion, filing a claim for FEGLI death benefits can be a challenging and sometimes frustrating process, especially when faced with delays or denials. Understanding the unique rules and requirements of FEGLI, keeping beneficiary information up-to-date, and seeking legal assistance when necessary are crucial steps in ensuring a smooth claims process during difficult times.