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Life insurance claims denied, families of vets sue feds, Prudential p4

Thu Aug 2nd, 2012 on     Insurance Claims,    

Four families have something awful in common: Each lost a loved one to suicide. Those loved ones were all veterans who had recently separated from the service, and their families believe they all suffered from post-traumatic stress disorder when they died. The families were surprised when the U.S. Department of Veterans Affairs and Prudential denied the life insurance claims — they knew that the government carried life insurance for service members, so why would these claims fail?

It turns out that there are two classes of insurance for members of the military: one that covers active duty service members and one that covers veterans. (We discussed both of these in our last couple of posts.) When a serviceman or servicewoman separates from the military, the active duty SGLI coverage expires; the veteran must apply for the veteran’s coverage, known as VGLI. There is a 120-day grace period, but if that deadline is missed, neither policy is in force.

If, however, the veteran was disabled at the time he or she separated from the service, the active-duty policy remains in place for two years. At the end of that period, the 120 day grace period begins. In this case, the families believe this provision applies. Even if their loved ones weren’t diagnosed, it was clear to the plaintiffs that each suffered from PTSD.

In their argument to both the VA and Prudential, the plaintiffs cite other cases to support their argument. In one instance, the veteran had missed the conversion deadline and more than two years had passed by the time he died. On top of that, unlike any of the service members in this case, that veteran had held down a job for 15 months. In another case, the VA ordered Prudential to pay benefits for a veteran who had never been notified about the SGLI to VGLI conversion process.

To the plaintiffs, it makes no sense that the VA and Prudential Financial Inc. would deny their claims but grant others’ whose circumstances were substantially the same. They are asking for actual damages (the full benefit amount owed them) as well as damages for constitutional violations, breach of contract and breach of fiduciary duty.

There are other families in the same situation. The New York Times reported that “more than 4,000 former service members have died after returning home from Iraq and Afghanistan. Many of those returning veterans have died from self-inflicted wounds.” The outcome of this case could mean that other families wouldn’t have to go through the delays, denials and lawsuits these plaintiffs have endured.

Source: Courthouse News Service, “Prudential, USA Stiff Families of Suicidal Veterans, Kin Claim,” Cheryl Armstrong, July 12, 2012

Our firm handles similar situations to the one discussed in this post. If you would like to learn more about our practice, please visit our Miami life insurance claim page.

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