Application for VA Life Insurance (VALife)
You have any service-connected disability rating (even 0%) and want affordable permanent life insurance without medical underwriting.
Gather before you start
Attach with the form
Section I - Veteran Identification
Blocks 1-5Name, SSN, DOB, address, phonePII
Your identifying information. VALife is managed by the Veterans Benefits Administration Insurance Center in Philadelphia.
(legal name, SSN, DOB, address)
- Waiting more than 2 years after receiving your SC rating - the 2-year window is strict; after it closes, VALife requires medical underwriting.
- Not knowing 0% SC ratings qualify - even a 0% service-connected rating qualifies for VALife.
Section II - Coverage
Block 6Coverage amount desired (up to $40,000)
Choose a coverage amount from $10,000 to $40,000 in $10,000 increments. Premiums are fixed for life based on your age when you enroll. Younger enrollment = lower lifetime premium. Coverage is permanent whole life with no expiration.
e.g., $40,000 maximum coverage
- Not enrolling at the maximum amount at young ages - premiums are age-locked; the monthly premium for $40,000 at 30 is far lower than at 50.
- Confusing VALife with VGLI - VGLI is for transitioning SMs only; VALife is for SC veterans specifically.
Section III - Beneficiary Designation
Block 7Primary and contingent beneficiary(ies)
Name who receives the death benefit. Primary beneficiary receives if surviving. Contingent beneficiary receives if primary predeceases you. You can split among multiple beneficiaries by percentage.
e.g., Primary: Jane Smith (spouse, 100%). Contingent: Emily Smith (daughter, 50%), Michael Smith (son, 50%).
- Naming only a primary beneficiary without a contingent - if the primary beneficiary predeceases you, proceeds go through probate.
- Naming your estate as beneficiary - insurance proceeds pass outside probate only if named individuals are designated.
Section IV - Premium Payment
Block 8Payment method and bank information for automatic premiumPII
VALife premiums can be paid monthly via electronic funds transfer. Set up automatic payment to prevent lapse. Premium rates are published at benefits.va.gov/insurance.
(bank routing/account numbers for automatic payment)
- Not setting up automatic payment - policy lapses if premiums are missed.
- Not keeping beneficiary information updated after marriage, divorce, or death of named beneficiary.
Section V - Certification
Blocks 9-10Veteran signature and datePII
Sign and date. Apply online at benefits.va.gov/insurance/valife.asp if possible.
(signature/date)
- Missing the 2-year enrollment window - set a reminder when you receive your rating decision.