27 Feb Traumatic Injury Protection Under SGLI (TSGLI)
If you are covered under SGLI, it means that you also have TSGLI. This type of cover that includes National Guard, reservists, active duty, and one-day muster duty and funeral honors duty members.If you received extreme damages due to traumatic losses (from Oct 7th 2001 to Dec 1st 2005) you may also be eligible for this benefit, if the damage was acquired while in Operations Enduring Freedom/ Iraqi Freedom.
If you are under TSGLI, you will get a benefits pay from 25,000 USD to 100,000 USD, which will be determined according to the loss endured after the injury incurred. The table below will provide you with the type of loss, and how much you can receive.
- Sight: complete damage to your eyesight, which has lasted for 120 days (for both eyes) – 50,000 USD
- Hearing: complete damage and loss of hearing. One ear – 25,000 USD, both ears – 100,000 USD
- Speech: complete loss of speech – 50,000 USD
- Quadriplegia: entire paralysis of all 4 limbs – 100,000 USD
- Hemiplegia: full paralysis on lower and upper limbs (all side of the body) – 100,000 USD
- Paraplegia: complete paralysis of lower limbs – 100,000 USD
- Uniplegia: entire paralysis of just one limb. Note- one cannot have uniplegia payment combines to a loss at number 9, 10 or 14, for the same hand. Uniplegia also cannot be paid together with loss, 11 to 13 and 15. – 50,000 USD
- Burns: if you get second-degree burns/ burns of not more than 20% of the entire body (includes face/20 %of the face) – 100,000 USD.
- Amputation of hand: amputating of the arm at the wrist or above. Each hand (Note: loss of 9 can not be combine with that of 10) – 50,000 USD.
- Dismemberment of the thumb/four fingers: amputating above/at the metacarpophalangeal joint. Each hand – 50,000 USD.
- Amputation of foot: dismemberment at the ankle or above. Each foot. Loss 11 cannot be combined with loss 12/13.– 50,000 USD
- Amputation of all toes( inlcudes big toe): if the amputation is done above/on metatarsophalangeal joint. Each foot (note: loss 12 can not be combined with loss 13) – 50,000 USD.
- Dismemberment of big toe/ 4 toes on one foot: amputated at/above metatarsophalangeal joint. Each foot- 25,000 USD
- Limb salvage of arm: restoration of the arm where the amputation was done. Note: loss 14 cannot be combined with loss 9/10. Each arm – 50,000 USD
- Limb salvage of leg: restoration of the leg where the amputation was done. Note: loss 15 can not be combined with loss 11 to 13. -50,000 USD.
- Facial reconstruction: Surgery to fix face or jaw that will cause discontinuity effects.
Jaw- surgery to fix jaw (loss of upper or lower jaw) – 75,000 USD
Nose- surgery to fix nose (50% or more loss) – 50,000 USD
Lips – surgery to fix lips (loss of 50% or more on either upper or lower lip)
One lip – 50,000 USD
Both lips – 75,000 USD
Eyes- surgery to correct eyes (30% or more loss of the periorbita) each eye – 25,000
Facial Tissue – surgery to fix the loss of 50% or more of the facial tissue, which includes: temple, chine, infraorbital, zygomatic or mandibular. Note1: injuries related to facial injury may be combined together, with the max benefit not exceeding 75,000 USD. Note2: injuries under facial reconstruction may be combined with other injuries in part one, only if all injuries were acquired due to a single event, with the total payment not exceeding 100,000 USD.
Each facial subunit – 25,000 USD
- Coma caused by awful injury or/and brain damage causing disability to do not less than two activities of daily living (ADL) 25,000 USD an additional
- At 15th contiiuing day of coma/ ADL loss – 25,000 an aditional
- At 30th continuing day of coma/ADL Loss – 25,000 an aditional
- At 90th continuing day of coma/ADL loss
- Brain dmage that leads to hospitlaization
At the 15th continuing day of hospitilization – 25,000 USD
Note1: benfits for hospiilization will replace loss 17 (only 1st payemnt)
Note2: the period fo hospitilization inlcudes days on which the memebr was tranpoarted from the accidnet area to a hospital, as esplained in §9.20(e) (6) (xiii), admission, transfers between facilities and discharge.
- Traumatic injury that leads to disability to do not less than two ADL (Activities of Daily Living) – 25,000 USD an additional
- At 30th continuing day of ADL inability – 25,000 USD an additional
- At 60th continuing day of ADL inability – 25,000 USD an additional
- At 90th continuing day of ADL inability – 25,000 USD an additional
- At 120th continuing day of ADL inability
- Traumatic injury that leads to hospitalization
- At 15th continuing day at hospital – 25,000 USD
Note1: Hospital benefits replace the 1st payment in loss 19
Note 2: the period fo hospitilization inlcudes days on which the memebr was tranpoarted from the accidnet area to a hospital, as esplained in §9.20(e) (6) (xiii), admission, transfers between facilities and discharge.
If you have severe brain damage or coma, TSGLI cover max pay is up to 25,000 USD, with additional on the 15th, 30th, 60th and 990th continuing day, of the members ADL inability. You will need to make a separate clam when it comes to TSGLI, after each interval. Example: if the member receives a severe injury, the TSGLI claim should be filed after the fifteenth continuing day of the member being injured, with the payable amount being 25,000 USD. If they stay for another fifteen days (30 in total), another claim should be made, with another additional 25,000 USD payable.
If you have filed a claim for an injury or loss, and get another injury due to the same cause, then a new claim should be filed for the second injury. Example: If you file a claim for loss of one leg due to an explosion, and the other leg is dismembered due to the same explosion, you are required to file another claim for the loss do the other leg.
Cost of TSGLI
The prime of TSGLI is a constant rat of one dollar every month for almost every member. If you are a member and have a cover of SGLI with a cover of max 4000,000 USD, you will end up paying 27 USD every month, which will be for TSGLI and SGLI. The table below summarizes the rates on the different categories of SGLI covers:
- Members who are active on duty – 1 USD every month
- National Guard or Reservists (all-time coverage) – 1 USD every month
- National Guard or Reservists (part-time coverage) – 1 USD annually
- Funeral honor and one-day muster duty – no fee
TSGLI Qualification and Claims
In order to qualify for TSGLI you will need to fulfill all the necessary requirement:
- If you get an injury as from 1st Dec 2005, you need to be covered by SGLI during the occurrence of the injury. If you incur you injury from 7th Oct 2001 to 30th Nov 2005, you do not require SGLI to qualify for TSGLI.
- You will need to receive a scheduled loss, a loss that will be directly caused by a severe injury.
- You need to have received a severe injury before 12 am of the day you separate from the military services.
- You need to incur a scheduled loss not more than 2 years of the severe injury.
- You need to survive for a duration of seven days or more, from the day you received your severe injury. (the 7-day duration starts on the traumatic injury day, according to Zulu [Greenwich Meridian] time and will stop a68 hours later)
If you are a service member and you have received a severe injury during active duty and you are under SGLI, you can apply for the benefit, which also applies if you were discharged.
To file a claim to get the TSGLI benefit, the service member will need (or someone representing the member) to download the SGLV-8600, Application for TSGLI benefits. One can obtain this form from the service department area of contact or they can get it from the offices of Servicemembers’ Group Life Insurance, or via email: firstname.lastname@example.org.
The Application for TGSLI come in two sections:
- Part A – this section needs to be filled by the service member (if disabled, should be filled by the member’s guardian or attorney-in-fact).
- Part B – Should be filled by the attending medical practitioner.
After both sections have been filled, the application should then be sent to the necessary department of service TSGLI office, which should be on the first page on the application.
Payment of TSGLI Benefits
The member of military service is the recipient of TGSLI. As a member, you cannot name anyone to be the beneficiary of TSGLI. If the member is incapable, the benefit will be given to their guardian or the attorney-in-fact. If the member does die due to the severe injury, TSGLI will still pay the benefit only if the member survived for a duration of seven days or more from the day they got the injury and die before the max benefit (which member is qualified for) is paid for.
The TSGLI payment does not in any way affect the amount to be paid by SGLI. Example: if you are a service member and you insured for 400,000 USD under SGLI, and you get a 50,000 USD from a TSGLI payment (for severe injury), you will still get the 400,000 USD from SGLI, which will be paid once the service member dies. If the member has died, the TSGLI benefit will be paid to the recipient(s) of the member’s basic SGLI.
The payments of TSGLI will be made using either of the following ways:
- EFT (Electronic Funds Transfer) – with this method, TSGLI payment will be made directly to the bank account of the service member, which will be automated. This method is available to the service member, guardian or the member or power of attorney.
- Prudential’s Alliance Account – The Alliance Account is an account that will be opened under the member’s name, which is an interest-bearing draft account and the member will have a draft book. As owner of the account, you will be able to write drafts (checks) of any amount, until the total amount of the proceeds. This will give the member the chance to make vital financial decisions with their funds secure and earning interest. The account has no monthly service fees or any check fees, plus the checks can be requested for free, although there are fees for specific services, including stop payment orders, returned checks and copies of check or statements.
- Check – with this method, the member’s guardian or attorney-in-fact will get one check on behalf of the member, which will be the full TSGLI benefit to be paid. Check option is allowed to the guardian or power of attorney.
The member can use their TSGLI benefits in any manner that they desire. If you are a TSGLI beneficiary you may decide to take benefit of the BFCS (Beneficiary Financial Counseling Services) program, which is a free counseling service. The service is offered to all SGLI and also VGLI beneficiaries.