What happens if you have a fatal accident or one that results in the loss of eyesight or a limb? If you are an employee enrolled in by Basic or Option A-Standard insurance under the Federal Employees’ Group Life Insurance program, you’re covered. You receive accidental death and dismemberment (AD&D) coverage at no additional cost.
AD&D insurance is often a source of additional money if something terrible happens to you. To refresh your memory, Basic insurance is equal to your base salary rounded up to the nearest $1,000 plus $2,000. Option A-Standard insurance is worth a flat $10,000. These are your Principal amounts of coverage. If you lose your life as a result of an accident, your survivors will receive the Principal amount of your insurance coverage plus an equal amount of AD&D. For example, if you were covered by Basic insurance in the amount of $80,000, the total payment from FEGLI would be $160,000 ($80,000 plus $80,000). If you were enrolled in Option A-Standard, the payable amount would be $20,000 ($10,000 plus $10,000). If you have both kinds of coverage, you’ll get both payments.
If you were fortunate enough to have survived that accident and lost a hand, foot or the sight in one eye, you would receive half the amount of your Principal coverage. For example, in the above example, if you lost one limb you would receive $40,000 if covered by Basic insurance and $5,000 if covered by Option A. If you lost two or more limbs, you would receive the full amount, $80,000 or $10,000 (or both, if you have both kinds of coverage).
Of course, the death or loss must meet certain criteria. First, it must occur within 90 days of the accident and second, it must be a direct result of injury sustained in that accident, not from other causes. Further, there is an upper limit to what can be paid under AD&D. For all eyesight or limb loses resulting from any one accident, you may receive no more than an amount equal to the Principal. Note: There is no lifetime limit on coverage. If you suffer a loss in a subsequent accident, payment may be made again.
While AD&D is generous in its coverage, there are some limitations. For example, the Office of Federal Employees’ Group Life Insurance (OFEGLI) will not pay AD&D benefits if your death or loss is in any way the result of, is caused by, or is contributed to by one or more of the following:
- physical of mental illness;
- the diagnosis or treatment of physical or mental illness;
- ptomaine or bacterial infection, unless it is caused by an accidentally sustained external wound;
- hernia, no matter how sustained;
- a war (declared or undeclared), any act of war, or any armed aggression against the United States, in which nuclear weapons are actually being used;
- a war (declared or undeclared), any act of war, or any armed aggression or insurrection in which you are in actual combat at the time the bodily injuries are sustained;
- suicide or attempted suicide;
- injuring yourself on purpose; or
- illegal or illegally obtained drugs that you administer to yourself.
For information about a specific case, call OFEGLI at 1-800-633-4542.