Claim for Death Benefits (SGLI/VGLI)
You are the designated SGLI or VGLI beneficiary and the insured has died.
Gather before you start
Attach with the form
Section I - Claimant Identification
Blocks 1-5Beneficiary name, SSN, DOB, address, relationship to insuredPII
Your information as the SGLI/VGLI beneficiary. Must match the designation on file.
(your legal name, SSN, relationship)
- Not knowing your beneficiary designation status - VGLI policy documents and SGLV 8286 show who is designated.
Section II - Insured Information
Blocks 6-10Insured name, SSN, date of death, SGLI/VGLI policy/coverage amountPII
The deceased service member or veteran. Include the date of death and the SGLI or VGLI coverage amount for which you are claiming.
(insured legal name, SSN, date of death, coverage amount)
- Not knowing the coverage amount at time of death - check the SGLV 8286 for SGLI or annual VGLI statement for VGLI amount.
Section III - Death Documentation
Block 11Cause and circumstances of death
Provide the cause of death as shown on the death certificate. Most causes of death are covered. Note: suicide IS covered by SGLI/VGLI (unlike some private policies); SGLI/VGLI coverage is very broad.
(cause of death per death certificate)
- Not claiming because of suicide cause of death - SGLI/VGLI covers suicide deaths; claim should be filed.
Section IV - Payment Information
Blocks 12-13Bank account for direct deposit of death benefitPII
VA pays SGLI/VGLI death benefits by direct deposit to the beneficiary's bank account.
(bank routing and account numbers)
- Incorrect bank information - causes payment return and delay.
Section V - Claimant Certification
Blocks 14-15Beneficiary signature and datePII
Sign and date. Mail to Prudential Insurance Company (SGLI/VGLI administrator): OSGLI, P.O. Box 70173, Philadelphia PA 19176.
(your signature/date)
- Mailing to VA instead of Prudential - SGLI/VGLI is administered by Prudential on behalf of VA.