How Long Does a FEGLI Claim Take to Process?

Understanding a FEGLI Claim

The Federal Employees’ Group Life Insurance (FEGLI) program provides life insurance coverage to federal employees and retirees. When an insured individual passes away, a FEGLI claim is the formal process beneficiaries undertake to receive the death benefits.

The Office of Personnel Management (OPM) oversees the FEGLI program, but the actual claims processing is administered by the Office of Federal Employees’ Group Life Insurance (OFEGLI). Eligible claimants include designated beneficiaries, but if no beneficiary is named, benefits are paid according to a statutory order of precedence. This order prioritizes a surviving spouse, then children, parents, the executor of the estate, and finally, next of kin.

Preparing and Submitting a Claim

Initiating a FEGLI claim involves carefully gathering specific information and documentation. Key details include the deceased’s full name, Social Security Number, date of birth, and date of death, along with their employment history. Beneficiary information, such as names, addresses, Social Security Numbers, and relationships to the deceased, is also required.

The primary document for filing a death benefit claim is Form FE-6, “Claim for Death Benefits”. This form can be obtained from the OPM website or by contacting the deceased’s former federal employing agency or OPM directly. Along with the completed FE-6 form, a certified copy of the death certificate is a required supporting document. Depending on the specific circumstances and beneficiary relationship, additional proof, such as marriage certificates or birth certificates, might be necessary.

Once all required information and supporting documents are gathered, the completed claim package is ready for submission. The completed claim package should be mailed to OFEGLI. The standard mailing address is OFEGLI, P.O. Box 6080, Scranton, PA 18505-6080. For overnight deliveries, a physical address is available: OFEGLI, 10 Ed Preate Dr., Moosic, PA 18507. Sending the claim via a trackable method, such as certified mail, is advisable to confirm receipt and maintain a record of the submission.

The Claim Processing Timeline

After OFEGLI receives a complete claim package, the processing timeline involves several internal stages. These include an initial review to ensure all necessary forms and documentation are present, followed by verification of the insured’s coverage, validation of beneficiary designations, and the calculation of benefits. If the claim is straightforward and fully documented, OFEGLI aims to pay it within 10 working days once fully documented. However, the overall processing time for a FEGLI claim can vary, ranging from a few weeks to a few months. Claims that are not paid within 30 days of submission are considered delayed.

Several factors can impact the processing time for a FEGLI claim:
Incomplete or inaccurate documentation, such as a missing death certificate or insufficient supporting papers.
Disputes among beneficiaries or competing claims.
Issues with beneficiary designation, like an outdated form or no beneficiary on file.
Eligibility issues, such as whether coverage was active at the time of death or non-payment of premiums.
Administrative mistakes.
The need for OFEGLI to request additional information.

Beneficiaries can proactively monitor the status of their submitted claim. After waiting at least 30 days from the submission date, claimants can call OFEGLI directly to inquire about the claim’s progress. When calling, it is helpful to have the insured’s name, Social Security Number, the deceased’s name (if different), and the date of death readily available. This can help address any requests for additional information promptly, preventing further delays.

Receiving Claim Decisions and Payments

Once OFEGLI completes its review of a FEGLI claim, the decision is communicated to the claimant. This notification arrives through an official letter or electronic notification, detailing whether the claim has been approved or denied. If the claim is approved, the communication will also outline the benefit amount.

FEGLI benefits are disbursed as a lump sum payment. Beneficiaries have the option to receive the payment via a check or through electronic funds transfer (EFT) directly into their bank account. For benefit amounts of $5,000 or more, beneficiaries can choose to receive the funds through a MetLife Total Control Account (TCA), an interest-bearing account managed by Metropolitan Life Insurance Company.

In instances where a claim is denied, or if there are discrepancies with the payment amount, the denial letter will provide the specific reasons for the rejection. Claimants have the right to appeal these decisions. The appeal process begins with a request for reconsideration, involving submitting additional information or correcting any errors in the original claim. Strict deadlines apply to these appeals, and adhering to them is important.