Claims Settlement

... I want to express my disappointment that the DoD <Department of Defense> decided not to participate in today’s hearing.

  • This is the second time that the DoD has refused to testify at one of our Subcommittee hearings and I am hoping that this does not become a customary response from DoD.
  • For this hearing, I invited DoD to provide views on high rate of denials for TSGLI claims and I am frustrated because I wanted the department to explain why the Armed Services denied 44 percent of TSGLI claims in fiscal year 2017.
    • This denial rate could be due to any number of factors, such as applications not being eligible for—applicants not being eligible for the benefits.
  • However, we don’t know whether this is the reason.
  • I was hoping the DoD would provide insight as to whether the
    servicemembers may not understand the TSGLI requirements or if they may be inadvertently filing improper claims, or are the Armed Services incorrectly denying benefits that servicemembers are paying for?

    DoD’s expertise would certainly have been helpful here
    today as we consider these programs and any improvements to them.

-- Mike Bost, Chairman

2018 - GOV - Review of VAs Life Insurance Programs CHRG-115hhrg35470 34p

    • The States do little with respect to life insurance regulations for many reasons, mainly because there are very few  problems with complaints over claims.
    •  Most of the staffs are involved with complaints relating to automobile insurance and health insurance.
    • Life insurance is sort of the stepchild of many, if not most, insurance departments.  (p1501)
    • As a starting point, there is little regulation of the life insurance industry by the States.

    --   John A. Durkin, New Hampshire Insurance Commissioner

    1973 - GOV - The Life Insurance Industry - Part 2 - Hart

The insurer must remember that offices have unjustly refused, at the time of the death, to pay either the amount assured or to return the premiums, on the ground of error in the description of age—although no fraud was intended or reasonably suspected.


Legal objections of a technical nature have frequently succeeded in inducing claimants to forego a part or the whole of their demands, without the office injuring itself by appearing to be of a litigious character.


And I have heard of an office the trustees of which boasted of their power to litigate a claim for three years.



Mr. Adkins (CIR) added that in the center's study, 12 provisions in the Unfair Trade Practices Act and 15 provisions in the Unfair Claims Settlement Practices Act were analyzed.


1996-1, NAIC Proc.