If you’re here today, you’re likely facing a difficult and confusing situation with your Federal Employees Group Life Insurance (FEGLI) claim. Perhaps you’ve recently lost a loved one, and now you are dealing with the denial of their FEGLI benefits. If that’s the case, we understand the emotional toll it can take. You may feel overwhelmed, frustrated, or unsure of what steps to take next. At our firm, we want you to know that we are here to help guide you through this process with empathy and a clear plan to get the results you need.
Dealing with a denial of FEGLI benefits is no small matter. The loss of a loved one is already painful enough, and when the financial support promised by life insurance is denied, it can feel like an additional burden. Fortunately, there are legal strategies that can help you challenge this denial and increase your chances of success. This blog will walk you through the steps you should take and how we can assist in fighting for the benefits you deserve.
Understanding the FEGLI Program
The FEGLI program provides life insurance coverage to federal employees and retirees. If your loved one was a federal employee or retiree, they likely enrolled in this program to ensure that their beneficiaries would receive financial support in the event of their passing. However, in some cases, beneficiaries find themselves facing a denial of the benefits they are entitled to.
There are many reasons why a FEGLI claim might be denied. In some cases, the insurance company may argue that the deceased person failed to meet certain requirements, such as not filling out the correct paperwork or not maintaining active coverage. Other times, they might claim that there was an issue with the beneficiary designation or that the policyholder’s death was caused by something that is not covered under the terms of the policy.
Regardless of the reason, it is important to remember that a denial is not the end of the road. Legal strategies can be implemented to challenge the decision and get the benefits to which you are entitled.
Common Reasons for FEGLI Denial
Before we dive into legal strategies, it’s important to understand some of the common reasons why a FEGLI claim might be denied. This will help you identify what might have gone wrong in your case and how to approach a potential legal challenge.
One common reason for denial is a technical error, such as incomplete or incorrect paperwork. Federal employees must fill out the necessary forms to enroll in the FEGLI program, and if any details are missing or incorrect, it can lead to a denial of benefits. Another reason for denial might involve the beneficiary designation. If there was any confusion or dispute regarding who was named as the beneficiary, the insurance company might refuse to pay out the benefits.
A third reason for denial is related to the cause of death. FEGLI policies typically do not cover certain types of deaths, such as those resulting from suicide or illegal activities. However, even in cases where the cause of death seems to be excluded, it’s important to seek legal advice. Often, there may be a valid argument that the cause of death is covered or that the denial was based on an incorrect interpretation of the policy’s terms.
In some situations, the denial might simply be due to an administrative mistake. These types of errors can often be corrected through legal action, ensuring that the benefits are paid to the rightful beneficiary.
Legal Strategies for Challenging a FEGLI Denial
If you are facing a FEGLI denial, there are several legal strategies that can be employed to challenge the decision. These strategies can vary depending on the circumstances of your case, but the goal is always to secure the benefits that your loved one intended for you to receive.
We contacted Trief & Olk to help us with a life insurance issue and Shelly Friedland was the attorney assigned to our case. Before Shelly took our case she explained to us that the likelihood of our success without going to court was possible but not likely. Unfortunately we did not get the outcome we had hoped for but it was our decision to not move forward and have our case litigated. Shelly is very knowledgeable and was very straight-forward in her assessment of our case as we moved forward. She was very patient and thorough in answering our questions. She always responded in a timely manner and listened to our concerns. We would certainly recommend Shelly and would use her firm again in the future.”
- John Ramig
If there is any possibility of winning your life insurance case – this is the place to do it for you. They are efficient, honest and will achieve the best possible outcome.
Shelly Friedland worked on my case where a life insurance policy had lapsed and was even a few days beyond the grace period. Farmers had rejected my claim twice and was unwilling to take a second look. Shelly was able to get them to pay the entire claim without going to court, and the full amount was deposited in my account within a couple months. Highest recommendation.”
- Kathleen Brown
Trief & Olk is a superior law firm. Their attorneys and other legal professionals have a brilliant understanding of the law and the litigation process. They diligently perform their work in an efficient, strategic and cost-effective manner to ensure the best possible outcomes for their clients.
- Christopher Hughes
One of the first steps in challenging a denial is to thoroughly review the insurance policy and the reasons given for the denial. It’s important to understand the terms and conditions of the policy to determine if the denial was based on a misunderstanding or misapplication of the policy’s rules. In many cases, simply pointing out an error in the insurer’s interpretation of the policy can lead to a successful appeal.
If a technical error, such as incorrect paperwork, was the reason for the denial, you may be able to correct the issue and resubmit your claim. In these cases, it’s important to act quickly and ensure that all documentation is accurate and complete. An attorney can help you gather the necessary paperwork and ensure that everything is in order.
Another strategy is to challenge the insurer’s decision on the grounds that the cause of death does not fall under one of the exclusions outlined in the policy. If the insurer claims that the death was caused by a suicide or another excluded event, a lawyer can help investigate whether that determination was accurate. If you believe the cause of death was misinterpreted or wrongly classified, you may have grounds to appeal the decision.
Additionally, if there is a dispute over the beneficiary designation, a legal strategy can involve proving that you are the rightful beneficiary. This could include showing that the policyholder named you as the beneficiary in a valid and legally binding manner, or it might involve challenging the insurer’s decision if they wrongly named someone else as the beneficiary.
In all of these cases, having an experienced lawyer by your side can make a significant difference. Legal professionals can help you navigate the complex process of appealing a FEGLI denial, ensuring that your claim is handled correctly and that you are given the best chance at success.
Settlements & Verdicts
The Appeal Process for FEGLI Denials
Once your claim has been denied, you typically have the right to appeal the decision. The process for appealing a FEGLI denial can be time-consuming and complicated, but it is an essential step in getting the benefits you deserve.
The first step in the appeal process is to carefully review the denial letter you received. This letter will outline the reasons why your claim was denied and provide instructions on how to file an appeal. In some cases, you may be able to appeal directly to the insurance company. However, if the denial was based on a complex legal issue, it is often best to work with a lawyer who can help craft a compelling argument for why the denial should be overturned.
During the appeal, you may be asked to provide additional documentation, such as medical records or other supporting evidence. Your lawyer will help you gather this information and ensure that all necessary documents are submitted in a timely manner. In some cases, you may also be required to attend a hearing where you can present your case in person.
While the appeal process can be challenging, it is important to remain persistent. Many denials can be successfully overturned if the right legal strategies are employed. With the help of an attorney, you can navigate the process and increase your chances of securing the benefits that your loved one intended for you.
Let Us Help You Get the Results You Deserve
At the end of the day, you deserve to receive the benefits your loved one intended for you. If your FEGLI claim has been denied, it’s crucial to take action quickly and seek legal assistance. At Trief & Olk, we understand the emotional and financial strain that a denied claim can cause, and we are here to help you through every step of the process. Our team is dedicated to helping Massachusetts beneficiaries like you get the results they deserve.
If you’re ready to take the next step and challenge the denial of your FEGLI claim, don’t hesitate to reach out to our firm. We have the experience and the knowledge to guide you through the process and fight for your rights. Let us help you secure the benefits that are rightfully yours.
