What Is the FEGLI Program and Why Do Denials Happen?
The Federal Employees Group Life Insurance program is designed to provide life insurance benefits to federal employees, retirees, and their families. It’s a critical benefit that provides financial security for those who have dedicated their careers to public service. However, despite the importance of this coverage, there are instances when claims are denied. The reasons behind these denials can vary, and they are often tied to technicalities or misunderstandings about policy terms. One of the most common reasons for denial is failure to meet the necessary eligibility requirements. For example, if the deceased federal employee didn’t maintain continuous coverage or failed to properly enroll or update their beneficiary information, the claim could be denied. Another common issue is disputes regarding the cause of death. In cases where the cause of death is not covered under the policy or if the insurer questions the information provided in the claim, they may deny it. Understanding why a denial occurred is crucial for moving forward with your case. It’s important to remember that a denial doesn’t mean the end of the road. In many cases, the decision can be challenged, and a thorough review of the circumstances surrounding the claim can result in a favorable outcome.
What Are the Most Common Issues in FEGLI Denial Cases in New Jersey?
When it comes to FEGLI denials in New Jersey, several common issues tend to arise. These issues can often be resolved with the right legal strategy and careful attention to detail. One of the key issues that can lead to a FEGLI denial is the failure to maintain adequate records. It’s crucial to ensure that all documents, including medical records, beneficiary forms, and proof of continuous employment, are in order. In some cases, claimants may be unaware that they did not submit the proper forms or that their coverage lapsed for some reason. Without proper documentation, the insurer may have grounds to deny a claim. Another issue that frequently arises in FEGLI denials is the question of whether the insured person’s death falls within the scope of the policy’s coverage. For example, certain causes of death, such as suicide or death due to criminal activity, may be excluded from coverage. Insurers may dispute whether the death meets the criteria for benefits, leaving family members struggling to get the support they need. When facing this type of issue, it’s essential to work with a legal team that understands the nuances of FEGLI policies and can advocate on your behalf. A third issue involves disputes over the proper beneficiary. If there is confusion or conflict about who is entitled to receive the death benefit, it can lead to delays or denials. This issue can be particularly complicated in cases where the deceased person did not update their beneficiary designation or where multiple individuals claim to be the rightful beneficiary.
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
The Importance of Understanding Your Policy
If your FEGLI claim has been denied, it’s crucial to thoroughly understand the terms of the policy. Often, policyholders aren’t fully aware of the exclusions, limitations, and requirements that can impact their claim. These details can be buried in the fine print, and it’s easy to overlook them when you’re already dealing with the loss of a loved one or a family member. Understanding the policy will allow you to better assess whether the denial was justified. It will also help your attorney identify any areas where the insurance company may have been in error. Working with a legal professional can ensure that all aspects of the policy are carefully examined and that all necessary steps are taken to challenge an improper denial.How to Challenge a FEGLI Denial in New Jersey
If your FEGLI claim has been denied, don’t give up hope. There are several ways to challenge the denial and pursue the benefits that you or your loved one are entitled to. One of the first steps in challenging a denial is to request a detailed explanation from the insurer. This explanation will outline the specific reasons for the denial and give your attorney the information needed to determine the best course of action. In many cases, a legal professional can help you file an appeal with the insurer. The appeal process often requires submitting additional documentation or providing new evidence that could support your claim. This may include medical records, proof of continuous coverage, or other relevant documents.Life Insurance Denial Statistics
20%
The annual average number of life insurance claims denied.
$50 Million
The yearly average dollar amount of claims denied by life insurance companies.
.2%
The number of claims appealed annually by consumers.