Frequently Asked Questions about TSGLI
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General Information
Coverage
Premiums
TSGLI Eligibility and Claims
Payment of TSGLI Benefits
Contact Information
TSGLI Year One Review
The Servicemembers' Group Life Insurance Traumatic Injury Protection program (TSGLI) is a traumatic injury protection rider under Servicemembers' Group Life Insurance (SGLI) that provides for payment to any member of the uniformed services covered by SGLI who sustains a traumatic injury that results in certain severe losses.
TSGLI coverage will pay a benefit of between $25,000 and $100,000 depending on the loss directly resulting from the traumatic injury.
Every member who has SGLI also has TSGLI effective December 1, 2005.
TSGLI coverage is automatic for those insured under basic SGLI and cannot be declined. The only way to decline TSGLI is to decline basic SGLI coverage.
No, TSGLI is not available to spouses and children under Family SGLI. It is available only to service members insured under SGLI.
No. TSGLI coverage is not available to VGLI policyholders.
Covered losses and payment amounts are listed in the TSGLI Schedule of Losses.
For example:
sight in both eyes or hearing in both ears |
$100,000 |
sight in one eye |
$50,000 |
one hand at or above the wrist or one foot at or above the ankle |
$50,000 |
thumb and index finger of same hand |
$50,000 |
Follow this link for a complete listing of all losses that are covered under TSGLI and how much will be paid for each loss.
Yes, certain injuries and conditions are excluded from coverage. For more information on these exclusions, please contact your service department points of contact.
The premium for TSGLI is a flat rate of $1 per month for most service members. Members who carry the maximum SGLI coverage of $400,000 will pay $29.00 per month for both SGLI and TSGLI.
The table below outlines the rates for various categories of SGLI coverage.
Active duty members |
$1.00 per month |
Reservists or National Guard members w/full time coverage |
$1.00 per month |
Reservists or National Guard members w/part time coverage |
$1.00 per year |
Funeral honors & 1 day muster duty |
No charge |
Note: These rates are determined by VA and are subject to change based on claims experience.
To be eligible for payment of TSGLI, you must meet all of the following requirements:
- You must be insured by SGLI.
- You must incur a scheduled loss and that loss must be a direct result of a traumatic injury.
- You must have suffered the traumatic injury prior to midnight of the day that you separate from the uniformed services.
- You must suffer a scheduled loss within 2 years (730 days) of the traumatic injury.
- You must survive for a period of not less than seven full days from the date of the traumatic injury. (The 7-day period begins on the date and time of the traumatic injury, as measured by Zulu [Greenwich Meridian] time and ends 168 full hours later).
Congress directed that TSGLI would be retroactive to October 7, 2001, for members who incur a qualifying loss as a direct result of injuries incurred on or after October 7, 2001, through and including November 30, 2005, in Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF). For the purposes of TSGLI only, "incurred in Operation Enduring Freedom or Operation Iraqi Freedom" means that the member must have been deployed outside the United States on orders in support of OEF or OIF or serving in a geographic location that qualified the service member for the Combat Zone Tax Exclusion under the Internal Revenue Service Code.
In order to make a claim for the TSGLI benefit, the member (or someone acting on his or her behalf) should:
- Download the TSGLI Certification Form GL.2005.261. You can also obtain this form from the your service department point of contact or from the Office of Servicemembers' Group Life Insurance by toll-free phone at 1-800-419-1473 or by email at osgli.claims@prudential.com.
- Contact your service department point of contact to begin the certification process.
The certification form has three parts:
- Part A is to be completed by the service member or, if incapacitated, by the member's guardian, or the member's attorney-in-fact.
- Part B is to be completed by the attending medical professional.
- Part C is to be completed by the Branch of Service.
Yes. There are certain situations when the member will have to file more than one claim.
- For losses such as coma or traumatic brain injury, the TSGLI benefit is payable in $25,000 increments on the 15th, 30th, 60th, and 90th consecutive days of the member's inability to carry out activities of daily living. A separate claim for TSGLI must be filed at each time interval. For example, if a service member suffers a traumatic injury that leaves him in a coma, a claim for TSGLI should be filed after the 15th consecutive day of the member being in a coma for which $25,000 is payable. If the member remains in a coma for 30 days after the traumatic injury, another claim should be submitted and another $25,000 will be paid.
- If a member files a claim for an incurred loss and then subsequently incurs another loss as a result of the same traumatic event, a new claim must be filed for the subsequent loss. For example, if a member files a claim for losing one leg as a result of an explosion and four months later has the other leg amputated as a result of that same explosion, the member must file another claim for the loss of the leg.
Yes, a service member may appeal if denied TSGLI.
- If the service member is appealing a decision based on eligibility criteria such as their loss or the circumstances surrounding the traumatic injury causing the loss, the service member should contact the appropriate service department point of contact.
- If the service member is appealing a decision based on whether they had TSGLI coverage at the time of the traumatic injury, the service member should contact the Office of Servicemembers' Group Life Insurance at 1-800-419-1473 to file an appeal.
All appeals must be in writing and must be filed within one year of the date of the denial.
The service member is the beneficiary of TSGLI. The member cannot name someone other than himself or herself as the TSGLI beneficiary. If the member is incompetent, the benefit will be paid to his or her guardian or attorney-in-fact.
If the service member dies as a result of the traumatic injury, TSGLI is still payable if the member survived for a period of not less than seven full days from the date of the traumatic event and died before the maximum benefit for which the service member qualifies is paid. (The 7-day period begins on the date and time of the traumatic event, as measured by Zulu [Greenwich Meridian] time and ends 168 full hours later).
No, payment of TSGLI has no impact on the amount of SGLI payable. For example, if a service member is insured for $400,000 of SGLI coverage and receives a TSGLI payment of $50,000 for a traumatic injury, that member is still insured for the full $400,000 of SGLI coverage, which will be paid upon the service member's death.
If the service member is deceased, the TSGLI payment will be made to the beneficiary or beneficiaries of the member's basic SGLI.
TSGLI payments will be made by one of the following methods:
- Electronic Funds Transfer (EFT) - Under this option, the TSGLI payment is electronically credited to the bank account specified by the service member. This option is available to the service member or the member's guardian or attorney-in-fact.
- Prudential's Alliance Account - Under this option, the service member will receive a checkbook for an interest-bearing account that gives the member ready access to the money. This option is available only to the service member. If the member is deceased, the member's SGLI beneficiary will receive payment via the Alliance Account.
- Check - Under this option, the service member's guardian or attorney-in-fact will receive a single check on behalf of the service member for the full TSGLI benefit payable. This option is available only to the service member's guardian or attorney-in-fact.
The IRS has determined that the TSGLI benefit is not taxable.
No. The member may use their TSGLI benefit payment or payments in any manner they choose.
Yes. TSGLI benefit recipients may take advantage of the Beneficiary Financial Counseling Services (BFCS) program, which is the same free counseling service to which SGLI or VGLI beneficiaries have access. Follow this link for more information on BFCS.
Some changes to the TSGLI program have been recommended. As part of a comprehensive review of the program at the end of one year of operation, recommendations to cover a number of new losses have been made. Also, the requirements on some existing losses covered by the program have been revised.
Follow this link to view the TSGLI Year-One Review Report which contains the full list of changes to the program, including the new losses.
IT IS VERY IMPORTANT TO KEEP IN MIND THAT THESE CHANGES ARE NOT FINAL. BENEFITS FOR THE NEW LOSES CAN’T BE PAID UNTIL REGULATIONS ARE PUBLISHED, WHICH WILL PROBABLY BE SOMETIME IN THE FALL.
The TSGLI Program can begin begin paying benefits on the program changes as soon as implementing regulations are published and the required public comment period has ended. These regulations are currently in process. Because they are subject to review, they cannot be considered final. If they are approved as is, we expect to begin paying benefits on the program changes by the end of this year.
When this happens information will be posted here on the VA website. You can also contact your branch of service point of contact for the status of the regulation. Keep in mind that the earliest we expect it to be published by is some time in the fall.
No, by law TSGLI does not cover mental or physical illnesses or diseases. This has not changed.
The TSGLI program is modeled after the dismemberment portion of commercial Accidental Death and Dismemberment (AD&D) policies, expanded to take into account the unique circumstances of military service. AD&D policies typically do not cover illnesses, diseases or minor injuries.
The recommended program changes and additions from the review must still meet the requirements of the original law. All new and changed losses would be retroactive to the earliest eligibility date of the TSGLI program, October 7, 2001. However, losses due to traumatic events from October 7, 2001 through November 30, 2005 must have been incurred in Operations Enduring Freedom or Iraqi Freedom, regardless of whether the member had SGLI coverage.
For TSGLI purposes only, DOD has defined this as the member must have been deployed outside the United States on orders in support of OEF or OIF or serving in a geographic location that qualified the service member for the Combat Zone Tax Exclusion under the Internal Revenue Service code.
For losses due to traumatic events incurred from December 1, 2005 forward, the loss can occur anywhere, regardless of OEF/OIF status, as long at the member is covered by SGLI. This applies to the proposed new losses as well.
Your branch of service TSGLI office will determine your eligibility for a TSGLI benefit based on the program changes, just as they currently do under the existing program criteria.
While you can file a claim at anytime, no claims for the new and changed losses can be paid until the regulation is published and the public comment period is over. This period will not be complete until the fall of 2008 at the earliest.
Additionally, a new claim form, which includes the new and changed losses, and has other important changes, will also not be available until the end of the regulatory process.
If you would like to file a claim based on the program changes prior to the completion of the regulatory process, you should contact your branch of service TSGLI office. They will be able to provide you with claim filing guidance and claims processing information for claims covered by the new and changed losses.
If you file a claim after the completion of the regulatory process, you should utilize the new claim form where you can document your loss under the program additions and changes. Your branch of service will determine your eligibility based on the program additions and changes. This claim form will be available on this website (www.insurance.va.gov) after the regulation process is complete.
Your branch of service TSGLI office is reviewing 100 percent of all denied claims to determine if any previously denied claimants would now be eligible for a TSGLI benefit if the program changes and additions are approved.
However, to be sure that your claim is being reviewed, you should contact your Branch of Service TSGLI office.
If the information that you provided with your original claim documents your eligibility based on the program changes and additions, your branch of service TSGLI office will authorize payment of a benefit without the need for you to refile a claim when the regualtions permit us to do so.
If the information that you provided with your original claim does not document your eligibility based on the program changes and additions, your branch of service TSGLI office may contact you for additional information to supplement your original claim. You can also call your branch of service TSGLI office to determine what additional information is needed.
In either situation, if your branch of service TSGLI office determines you are eligible for a benefit, you will be contacted to confirm your current address and banking information.
Your branch of service TSGLI office is reviewing 100 percent of all approved claims where the service member was paid less than the maximum TSGLI benefit of $100,000 to determine if there may now be eligibility for an additional TSGLI benefit if the program changes and additions are approved.
However, to be sure that your claim is being reviewed, you should contact your Branch of Service TSGLI office.
If the information that you provided with your original claim documents your eligibility for a higher benefit based on the program changes and additions, your branch of service TSGLI office will authorize payment of an additional benefit without the need for you to refile a claim. If the information that you provided with your original claim does not document your eligibility for a higher benefit based on the program changes and additions, your branch of service TSGLI office will contact you for additional information to supplement your original claim. You can also contact your branch of service TSGLI office to determine what additional information is needed.
In either situation, if you are determined to be eligible for a benefit, you will be contacted to confirm your current address and banking information.
No, the Combat-related Injury Rehabilitation Pay Program (CIP) was terminated on May 15, 2008 and has been replaced by the Pay and Allowances Continuation Program (PAC). Unlike CIP, the PAC program is not linked in any way to the TSGLI Program. The CIP Program payments of $430 per month ended when a service member received a TSGLI payment. The new PAC Program has no such limitation. All of a service member’s incentive pays, bonuses, or similar benefits, and the incidental and expense portion of the temporary duty allowance for members deployed in a combat operation or combat zone may continue or resume for up to one year following initial hospitalization for treatment of a wound, injury, or illness incurred in the line of duty while serving in a combat operation or combat zone, while serving in a hostile fire area, or while exposed to a hostile fire event.
You may contact your branch of service TSGLI office.
For more detailed information on the TSGLI benefit, you can refer to title 38, CFR, Part 9.20. You can also contact your service department point of contact or the Office of Servicemembers' Group Life Insurance by phone at 1-800-419-1473 or by email at osgli.claims@prudential.com.
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