Military Resource Center
Brochu Law provides legal services for servicemembers, veterans, and military families in a variety of legal matters: Camp Lejeune lawsuits, military life insurance (SGLI, VGLI, TSGLI), VA disability appeals, military lending, military housing, interpleader, injury cases, and consumer class action.
Military Life Insurance Basics
SGLI
(Servicemembers’ Group Life Insurance)
Overview
The Servicemembers Group Life Insurance (SGLI) is a life insurance policy that is designed to help ease the burden on family members when the servicemember passes on. Both servicemembers and families rely on this crucial life insurance policy – valued at up to $400,000 – to help pay for necessary expenses such as funeral expenses, medical bills, lost income, and other crucial bills, such as a mortgage, that a family shouldn’t have to worry about during a troubled time when they are focused on healing. However, these troubling times dealing with the loss of a loved one can get even worse when you have a denied SGLI life insurance claim.
Brochu Law can help fight any delayed or denied SGLI life insurance claims. Additionally, we can help with any SGLI interpleader cases.
Eligibility
Full-time SGLI coverage is available for any of the following:
- Active Duty – Army, Navy, Air Force, Marines, or Coast Guard
- Commissioned member of the National Oceanic and Atmospheric Administration (NOAA) or the U.S. Public Health Service (USPHS)
- Cadet or midshipman of the U.S. military academies
- Member, cadet, or midshipman of the Reserve Officers Training Corps (ROTC) engaged in authorized training and practice cruises
- Member of the Ready Reserve or National Guard scheduled to perform at least 12 periods of inactive training per year
- Service member who volunteers for a mobilization category in the Individual Ready Reserve (IRR)
Reasons for SGLI Delays
After submitting a death certificate and beneficiary claim form, you should receive payment from the life insurance policy within 30 days. If not, you should contact an attorney. Just because the payments are delayed, does not mean that they will not be paid. However, it also could lead to an eventual denial of the claim. Common reasons for SGLI life insurance delays are:
- Beneficiary disputes
- No beneficiary designation
- Incorrect claim submission (error or missing information on claim form)
- Information not received from the military in a timely fashion
- Undue Influence
- Duress
- Fraud
- Forgery
- Misrepresentation
- Incapacity
- Last-minute beneficiary changes
- Improper form information
- Beneficiary is a minor
- Beneficiary is a disabled adult
- Lapse
- Murder
- Manslaughter
- Criminal charges
- Ex-spouse listed
- Can’t locate a beneficiary
- Life insurance company files an interpleader
Reasons for SGLI Denials
SGLI claims can be denied for a wide variety of reasons. The situation surrounding each servicemembers, claim, and denial is unique. However, a denied claim can be appealed and the benefits recovered through litigation. The commons reasons for SGLI life insurance denials are:
- AWOL Status
- Inactive Duty
- Beneficiary Designation
- Incorrect Form Submission
- Coverage Reduction
- Ineligibility
- Failure to Convert Coverage
- Non-Payment of Premiums
- Beneficiary disputes
- No beneficiary designation
- Incorrect claim submission (error or missing information on claim form)
- Information not received from military in a timely fashion
- Undue Influence
- Duress
- Fraud
- Forgery
- Misrepresentation
- Incapacity
- Last-minute beneficiary changes
- Improper form information
- Beneficiary is a minor
- Beneficiary is a disabled adult
- Lapse
- Murder
- Manslaughter
- Criminal charges
- Ex-spouse listed
- Can’t locate a beneficiary
- Life insurance company files an interpleader
VGLI
(Veterans’ Group Life Insurance)
Overview
Must have met all eligibility requirements of SGLI AND within one year and 120 days from discharge, a Servicemember must apply to convert their SGLI policy to a VGLI policy.
Veterans that submit VGLI applications within 240 days of discharge do not need to submit evidence of good health. As a veteran, if you submit a VGLI application more than 240 days after discharge, VGLI requires you to answer a questionnaire about your health.
Eligibility
Must have met all eligibility requirements of SGLI AND within one year and 120 days from discharge, a Servicemember must apply to convert their SGLI policy to a VGLI policy.
Veterans that submit VGLI applications within 240 days of discharge do not need to submit evidence of good health. As a veteran, if you submit a VGLI application more than 240 days after discharge, VGLI requires you to answer a questionnaire about your health.
Reasons for VGLI Delays
After submitting a death certificate and beneficiary claim form, you should receive payment from the life insurance policy within 30 days. If not, you should contact an attorney. Just because the payments are delayed, does not mean that they will not be paid. However, it also could lead to an eventual denial of the claim. Common reasons for VGLI life insurance delays are:
- Beneficiary disputes
- No beneficiary designation
- Incorrect claim submission (error or missing information on claim form)
- Information not received from military in a timely fashion
- Undue Influence
- Duress
- Fraud
- Forgery
- Misrepresentation
- Incapacity
- Last-minute beneficiary changes
- Improper form information
- Beneficiary is a minor
- Beneficiary is a disabled adult
- Lapse
- Murder
- Manslaughter
- Criminal charges
- Ex-spouse listed
- Can’t locate a beneficiary
- Life insurance company files an interpleader
Reasons for VGLI Denials
VGLI claims can be denied for a wide variety of reasons. The situation surrounding each servicemembers, claim, and denial is unique. However, a denied claim can be appealed and the benefits recovered through litigation. The commons reasons for VGLI life insurance denials are:
- AWOL Status
- Inactive Duty
- Beneficiary Designation
- Incorrect Form Submission
- Coverage Reduction
- Ineligibility
- Failure to Convert Coverage
- Non-Payment of Premiums
- Beneficiary disputes
- No beneficiary designation
- Incorrect claim submission (error or missing information on claim form)
- Information not received from military in a timely fashion
- Undue Influence
- Duress
- Fraud
- Forgery
- Misrepresentation
- Incapacity
- Last-minute beneficiary changes
- Improper form information
- Beneficiary is a minor
- Beneficiary is a disabled adult
- Lapse
- Murder
- Manslaughter
- Criminal charges
- Ex-spouse listed
- Can’t locate a beneficiary
- Life insurance company files an interpleader
TSGLI
(Traumatic Injury Protection under Servicemembers’ Group Life Insurance)
Overview
TSGLI (also known as Servicemembers’ Group Life Insurance Traumatic Injury Protection) is a type of insurance coverage that compensates military service members who suffer certain traumatic injuries while serving in the military. TSGLI payments can range from $25,000 to $100,000 depending on the nature of the traumatic injury. The coverage applies no matter if a service member was injured on-duty or off-duty. TSGLI is retroactive so that it covers qualifying injuries incurred after October 7, 2001. A service member can receive benefits if he/she suffered a traumatic injury after this date and was covered by Servicemembers’ Group Life Insurance (SGLI).
The traumatic injury protection program/TSGLI program is supervised by the U.S. Department of Veterans Affairs and is administered by the Prudential Insurance Company of America.
If you file a TSGLI claim and it gets denied, you CAN appeal the denial. A service member who gets denied TSGLI payments will receive a denial letter from his/her branch of service. The letter will set forth the specific instructions on how the member can file the appeal.
Brochu Law is able to help a service member appeal a TSGLI claim denial in the following ways:
- gather medical evidence to support a TSGLI claim
- request medical records that form the basis of a TSGLI claim
- manage their ongoing medical care
- complete his/her TSGLI application
Eligibility
A service member may be eligible for TSGLI benefits if they meet certain criteria set by the U.S. Department of Veteran’s Affairs. The basic requirements for a TSGLI claim are:
- Your injury occurred after October 2001
- Your injury occurred prior to your separation from the Armed Forces
- Your injury directly resulted in one of the losses covered by the program
- You suffered this loss within 2 years of your traumatic injury
- You were insured by SGLI at the time of your injury
- If deceased: must have survived for a period of not less than seven (7) full days from the date of the traumatic injury
The U.S. Department of Veteran’s Affairs provides a schedule of losses covered, including, but not limited to:
- Loss of hearing, sight, and/or speech
- Burns
- Paralysis
- Amputation of or damage to limbs or genitourinary functions
- Facial reconstruction
- Traumatic brain injuries and/or comas
- Hospitalization due to traumatic injuries
- Limitations on Activities of Daily Living
If your traumatic injury resulted in limitations on performing two or more Activities of Daily Living (ADL) for at least 30 days, you may qualify for a TSGLI claim on those limitations alone. The ADL includes bathing, continence, dressing, eating, toileting, and transferring. If you require physical or verbal assistance to perform these tasks due to your injury or require someone to be within arm’s reach because of fluctuating ability, you may be eligible for a TSGLI benefit.
Loss of Activities of Daily Living (ADL)
TSGLI applications can get denied for many reasons. Some of the most common seem to revolve around the loss of activities of daily living (ADL). Typically, if a service member files a TSGLI claim for a loss of limb or severe injury, their TSGLI claim may be paid without the need for reconsideration and/or appeals. Unfortunately, one of the more difficult qualifying losses to prove revolves around ADLs.
There are six (6) ADL’s:
- Bathing
- Continence
- Dressing
- Eating
- Toileting
- Transferring
To establish a TSGLI claim, a service member must prove that he/she has suffered two of the six above-mentioned qualifying losses for a certain period of consecutive days. ADL loss requires assistance. The service member must be unable to independently complete at least two of the six ADLs. The qualifying loss period for ADLs is measured in intervals of 30-days, with a maximum of 120-days. Each consecutive amount of days is equal to $25,000, with a maximum payout of $100,000.
ADL Loss Period:
- 30-days – $25,000
- 60-days – $50,000
- 90-days – $75,000
- 120-days – $100,000
A service member must prove that he/she suffered a qualifying loss for at least two of six ADLs for a certain number of consecutive days. The challenging part about proving loss of ADLs is that many civilian doctors do not record a qualifying loss within their notes, even though the service member has been told orally that he/she needs assistance to perform certain ADLs and upon review, the doctor would agree that the servicemember suffered a qualifying loss. Doctors are paid to get you better, and sometimes, may not record the day-to-day of your injury and their instructions.
When a doctor fails to properly notate a servicemember’s medical records, the servicemember’s claim may be denied. The burden to prove a qualifying loss is on the servicemember. If the servicemember’s doctor does not describe the servicemember’s limitations in detail and establishes a certain loss period, the servicemember’s claim may be denied.
Excluded Conditions
There are certain injuries and conditions that can prevent a servicemember from claiming TSGLI benefits. Below is a list of several excluded conditions:
- Injuries caused by attempting suicide
- Injuries that are self-inflicted
- Injuries caused by medical or surgical treatment of an illness, disease, or condition
- Injuries received while under the influences of a controlled substance
- Injuries received while committing (or attempting to commit) a felony
Protecting Military Families
Live on 104.5 WOKV Jacksonville
Sunday from 6:30 to 7:30am
Attorney Christopher Brochu is currently featured on 104.5 WOKV Jacksonville each Sunday morning from 6:30-7:30am. The show discusses information surrounding delayed or denied military insurance claims such as SGLI, TSGLI, and VGLI.
F.A.Q.s
General
How much does a life insurance attorney cost?
We represent our life insurance claim clients on a contingency fee basis. There is no fee unless you win. We advance all costs on behalf of our clients.
Do you offer free consultations?
Yes! Each life insurance claim case is unique in its own ways. We would love to speak with you and provide the best strategy for your situation.
What life insurance companies have your clients made claims against?
- Metlife
- Prudential
- Transamerica
- AIG
- Pruco
- Minnesota Life
- Allstate
- Globe
- Independent Order of Foresters
- Primerica
- CMFG
Do I have to live in Florida for Brochu Law to take my case?
No. Brochu Law takes cases in all 50 states regardless of life insurance company or location of beneficiary. No matter where you live in the United States, Brochu Law can represent you. Christopher J. Brochu is licensed in the state of Florida. Brochu Law uses local counsel outside of Florida in accordance with state and federal law.
SGLI
What type of coverage is available for SGLI and how much are the premium payments?
A service member can purchase SGLI coverage in $50,000 increments. SGLI maximum coverage is $400,000. Currently, SGLI premium payments are 6 cents per $1,000 of coverage up to $400,000. For more information about premium payments, you can visit the Department of Veterans Affairs- Servicemembers’ Group Life Insurance (SGLI) page.
From the servicemember’s date of separation, covered members receive 120 days of free coverage. If the Servicemember is totally disabled at separation, coverage can be extended for up to two years. Reserve members who do not qualify for full-time coverage (members covered part-time do not receive 120 days of free coverage) if the Part-time coverage is also provided.
If a Servicemember is disabled at the time of separation (unable to work), a Servicemember can apply for an SGLI disability extension. The SGLI disability extension provides free coverage for up to two years from the date of separation. At the end of the extension period, the servicemember becomes automatically eligible for VGLI.
VGLI
How do I convert my SGLI policy to a VGLI policy?
Within one year and 120 days from discharge, a Servicemember must apply to convert their SGLI policy to a VGLI policy. Veterans that submit VGLI applications within 240 days of discharge do not need to submit evidence of good health. As a veteran, if you submit a VGLI application more than 240 days after discharge, VGLI requires you to answer a questionnaire about your health.
Some medical conditions may make it difficult or even impossible to obtain private insurance. If a servicemember has any present medical conditions, they should consider transferring to VGLI. Learn more about disqualifying conditions at the U.S. Department of Veterans Affairs.
TSGLI
How do I file for TSGLI benefits?
You can file for TSGLI benefits through the Department of Veterans Affairs by filling out the Application for TSGLI Benefits (SGLV 8600).
After filling out the application, you will need to fax, mail, or email the application to the appropriate branch. The branches and contact methods are listed on page 1 of the application.
Please note that Part B of the application must be filled out by a healthcare provider. You will need to provide medical documentation of the injuries as well as an explaination of how they occured.
How long will my TSGLI claim take?
It may take your branch of service up 120 days to process by your branch of service and make a decision.
If your claim is denied, you should recieve a letter that explains why the military has denied your claim. Your military branch’s denial letter while guide you on how to file an appeal.
How do service members' receive TSGLI benefits?
Since the benefits from a TSGLI claim are intended to provide short-term financial relief and security, TSGLI claim payments are often made in one lump sum.
If my claim is denied, how long do I have to appeal?
Typically, the time to appeal is within one year (365 days) from the date of the denial letter. However, you may appeal a denied claim with new evidence at any time.
Didn’t find your answer? Reach out to us with your questions or schedule a free consultation!