(fillable), Use this form to reinstate your insurance policy if it has lapsed for more than 6 months. AfO%7s$XMwBnb?Svg ;mv0NCd\]k)f#be!v) Note:Supplemental S-DVI also stopped taking new applications after December 31, 2022. Find out if youre eligible for VALife and how to apply. Note:VALife doesnt offer premium waivers. Stand with your phone camera directly over the document looking down, not at an angle. You must pay premiums for both policies during the 2-year waiting period. Use this form to designate or change the beneficiary for your VGLI policy. Use this form to claim FSGLI proceeds for a deceased spouse or dependent. Veterans Crisis Line: You will now be able to tab or arrow up or down through the submenu options to access/activate the submenu links. 0000064418 00000 n 3. If you have a question about your government life insurance policy or a general question about government life insurance, please complete as much of the information in the form below as possible. 988 (Press 1). visit VeteransCrisisLine.net for more resources. Sign up to pay your Veterans' Group Life Insurance premium automatically from your bank account. Get VA life insurance About VA insurance options and eligibility U@.\(}{$LjbL{2}Ln%=6g9~w':+_sLuK~j"5z 0000007788 00000 n <]/Prev 281345/XRefStm 1822>> 8.WESyr&?saUbi3oPtaS6U{6SE 6m%7*lQ(lX. <iframe title="Intentionally Blank" src="https://www.googletagmanager.com/ns.html?id=GTM-MBGXM55" height="0" width="0" aria-hidden="true" style="display:none . 0000004982 00000 n An official website of the United States government. You can call the VA Life Insurance Center at 800-669-8477 (TTY: 711). Watch our new video following a user, Andrea, as she uses the Benefit Finder on Benefits.gov to discover medical assistance programs such as Medicaid. You can access your Servicemembers Group Life Insurance (SGLI) orFamily Servicemembers Group Life Insurance (FSGLI) policy online through milConnect. 2. If you think we may owe you funds from a VA insurance policy, search our unclaimed funds records by the qualifying Veteran's name. (fillable), Use this form to request an automatic monthly premium deduction from your VA compensation check. Keep the information up to date about who you want to receive your insurance proceeds. You have 4 options to get life insurance as you transition out of service, but they have time limits. Use this form to request an advance insurance payment for a Servicemember or veteran that is terminally ill. Information about increasing VGLI Coverage. %IH^``1uyHs2=md rDXiF 0 "7 2900-0068 Respondent Burden: 40 minutes Expiration Date: XXXXXXX APPLICATION FOR SERVICE-DISABLED VETERANS INSURANCE IMPORTANT INFORMATION S-DVI provides up to $10,000 of life insurance for eligible veterans. 1. The .gov means its official. Yes. Use this form to enroll in direct deposit or change your direct deposit information. Request your military records, including DD214. 0000007619 00000 n (fillable). The https:// ensures that you're connecting to the official website and that any information you provide is encrypted and sent securely. Life Insurance Online Policy Access: Home Access My Policy Online Do you have a VGLI Control Number? Q[s7+^YMP^^GV'U^nf 2^S(!gQ{3wG)Jf'9)/z(499HB6yh5p.}V'9A:[vlD!on8NMSU*PR 9e0Re\ 7az=VRId.3[s-DlUlq/lqqE+vl04O1HJZ_cWR_\GOhKb)gAABm97eaS:' 8~9`2Bp^=5G>(KCv,crouLW4k./Us^icAR|Lw'qK0MV.`l&ii&!9syn)eW>k0QMc6QwxV-9m4c =Prca9 zUVRV#>J&VQtHouC-nf/R%.N$bX-:0hnB5aB{R&f1I Place the document on a flat surface, like a desk or table. 198 0 obj <> endobj Under certain conditions, the basic S-DVI policy still provides a premium waiver for Veterans who are totally disabled. You can also try using the flash to eliminate shadows, but make sure it is not adding glare that makes parts of the document unclear. VA Life Insurance If your file number begins with a V, RH, J, RS, K or W, access your policy at this link: VA Life Insurance Online Policy Access Veterans' Group Life Insurance (VGLI) If you have a VGLI control number, access your policy through eBenefits or at this link: VGLI Online Policy Access return to top How Much Life Insurance Do You Really Need? Upload Documents Cancel <>stream Box 7208 Philadelphia, PA 19101 10. Or mail to the Department of Veterans Affairs at the address shown on the reverse. To access the menus on this page please perform the following steps. Use this form to claim SGLI or VGLI proceeds for a deceased policyholder. IF YOU HAVE ANY QUESTIONS CONCERNING . This is the fastest and most secure way to send your claim, Office of Accountability & Whistleblower Protection, Training - Exposure - Experience (TEE) Tournament, Outreach, Transition and Economic Development Home, Warrior Training Advancement Course (WARTAC), Staff Appraisal Reviewer (SAR) Information, How to Apply for Nonsupervised Automatic Authority, VALERI (VA Loan Electronic Reporting Interface). Veterans Crisis Line: 0000002194 00000 n This form is used by military casualty and personnel offices only. Before sharing sensitive information, make sure you're on a federal government site. But if you already have S-DVI, you can keep it. Federal government websites often end in .gov or .mil. Home Find a VA form About VA Form 29-4125 About VA Form 29-4125 Form name:Claim for One Sum PaymentGovernment Life Insurance Related to:Life insurance Form last updated:June 2022 Downloadable PDF Download VA Form 29-4125 (PDF) You dont have to do anything to keep your coverage. [~`\0;i4f d yDE2(| msKI?D(%9s-HCnAL@}X8 Yz-U[!r6hTnS /WgzP2AiKE{]|w4q88z%Q$ We began accepting applications for VALife on January 1, 2023. BOX 7208 PHILADELPHIA, PA Before sharing sensitive information, make sure you're on a federal government site. Find out how to claim VA life insurance benefits under your policy. BOX 42954 PHILADELPHIA, PA 19101 VAROIC-DD P.O. Learn about VALife, our new life insurance program for Veterans with service-connected disabilities. https://insurance.va.gov/home/IDU. 1. Whether you pay once each month or once each year. Use our life insurance needs calculator to help decide how much life insurance you need. Use this form to request an automatic monthly premium deduction from your checking account. Prudential works with us to provide VGLI benefits to Veterans. Center, Vocational Rehabilitation The form can then be printed out with your entries already completed. Learn about the law requiring us to pay all benefits by electronic funds transfer. 0000194545 00000 n https://insurance.va.gov/home/IDU. If you've received a denial letter for Traumatic Injury Protection Life Insurance benefits that instructs you to use this form, file your appeal by the date provided in your letter. Center, Vocational Rehabilitation Complete form SGLV 8283, Claim for Death Benefits and fax it to 1-877-832-4943 or mail it to the following address with a copy of the death certificate:Office of Servicemembers' Group Life Insurance (OSGLI)PO Box 70173Philadelphia, PA 19176-9912. 0000116941 00000 n 0000006441 00000 n (fillable), use this form to surrender your VA insurance policy for its cash value or to request a loan against the cash value of your policy. trailer How Does VGLI Compare to Other Insurance Programs? designate or update the beneficiary on a SGLI policy, restore or increase SGLI coverage when it has previously been reduced or declined, restore or increase Family SGLI coverage when it has previously been reduced or declined. 3. You may fill out the form online or download the form to your hard drive and fill it out from there. Using the Benefit Finder, Andrea will find the resources she and her family need and automatically compare her eligibility for over 1,000 state and federal benefit programs. They cannot be used for VA Compensation, VA Disability, Servicemembers' or Veterans' Group Life Insurance.Document Upload - Did you know you can send your form to VA Life Insurance using ourDocument Uploadweb page? Your response is required to obtain or retain this benefit. Hostname Summary Authoritative Information for the .gov Top-Level Domain Delegation 0000014414 00000 n ET. 0000002900 00000 n You may only apply for VMLI if you have been approved for a, General information about the Veterans Mortgage Life Insurance Program. www.sheridan.Va.gov - Va Sheridan Currently only limited information about the hostname www.sheridan.va.gov is available. The .gov means its official. (if any) and address of minor or incompetent beneficiary. No insurance deduction may be made unless a completed authorization has been received (38 CFR 8.8). We can help answer questions about these policies: Already have VA life insurance? endstream endobj 199 0 obj <>/Metadata 19 0 R/Pages 18 0 R/StructTreeRoot 21 0 R/Type/Catalog/ViewerPreferences 200 0 R>> endobj 200 0 obj <> endobj 201 0 obj <>/MediaBox[0 0 792 612]/Parent 18 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 202 0 obj <>/BS<>/F 4/Rect[33.75 162.05 232.83 181.22]/StructParent 1/Subtype/Link>> endobj 203 0 obj <>/BS<>/F 4/Rect[33.75 141.65 221.12 162.05]/StructParent 2/Subtype/Link>> endobj 204 0 obj <>/BS<>/F 4/Rect[285.75 461.54 503.12 481.95]/StructParent 3/Subtype/Link>> endobj 205 0 obj <>/BS<>/F 4/Rect[285.75 441.13 503.12 461.54]/StructParent 4/Subtype/Link>> endobj 206 0 obj <>/BS<>/F 4/Rect[329.65 250.56 434.19 270.97]/StructParent 5/Subtype/Link>> endobj 207 0 obj <>/BS<>/F 4/Rect[285.75 217.74 434.21 238.15]/StructParent 6/Subtype/Link>> endobj 208 0 obj <> endobj 209 0 obj <> endobj 210 0 obj <> endobj 211 0 obj <> endobj 212 0 obj <> endobj 213 0 obj [278 0 0 0 556 0 0 0 333 333 389 0 278 333 278 278 556 556 556 556 556 556 556 556 556 556 278 0 0 0 0 0 0 667 667 722 722 0 611 778 722 278 500 0 556 833 722 778 667 0 722 667 611 0 667 0 0 667 0 0 0 0 0 0 0 556 556 500 556 556 278 556 556 222 0 500 222 833 556 556 556 556 333 500 278 556 500 722 500 500] endobj 214 0 obj <> endobj 215 0 obj [278 0 0 0 0 0 0 0 333 333 0 0 0 333 278 278 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 611 0 722 722 722 722 667 611 778 722 278 0 0 611 833 722 778 667 0 722 667 611 722 667 944 0 0 0 0 0 0 0 0 0 556 611 556 611 556 333 611 611 278 0 556 278 889 611 611 611 0 389 556 333 611 556 778 0 556] endobj 216 0 obj <>stream 0000000016 00000 n 0000129214 00000 n |UBCPdk:VInrgjuUk=xhu-2 h0XQD@{+-LJR%/lj\VI]ab %A4LF`.hG"(0Dl%V)ZT}8s.3z| f K.da,Ka2 82"3`WyVwVyUpn,yWa?^Nb,d05 VOP*:2d0E\v6y"~0&/XL7\LYR {Y~3ffUT0 prXIyvblCrjrp{$pRIV^2R9 The information requested is required to obtain or retain benefits and will be used by VA employees and your authorized representatives in the maintenance of Government insurance programs. https://insurance.va.gov/home/IDU. BYObY._S5i*p"H\}' 0BT3KQ;L_f^ggJ Y}V[2UK,UCVsENQMQMS,fQ,iDlKQ-7AiL#A!") rAa*fUK&YR(hAB/%*K[Vf ~T|Y%mE"0i9%1rIJj7+SdtK$guh{nN):ctN2/EAwvAG>"LzA :K&|dsfj- Q\Q!TX T $Op,S#NRBi LDQm Name and Mailing Address for Insurance Purposes. Choose Documents Select Files to Upload OR Drag and drop files here Selected Documents: 3. Any VA life insurance policy that starts with a V, J, RS, or W. 8DkqL-5c=7v%J`)19_.RW]+;Af}zCqX8 VA Collections Address: PO Box 4019 Portland, OR 97208-4019. The https:// ensures that you're connecting to the official website and that any information you provide is encrypted and sent securely. 0000084414 00000 n The Veterans Mortgage Life Insurance (VMLI) program is designed to pay up to $200,000 on the home mortgages of eligible This pamphlet gives Service-Disabled Veterans Insurance (S-DVI) premium and plan information. Use this pamphlet when applying for S-DVI. This is the fastest and most secure way to send your form. Right-click on the form title and choose "Save Target As" or "Save Link As" in the sub-menu. This will make it easier for your family members to file a claim in their time of need. You may submit payments to VA Life Insurance through your preferred banking institution online Bill Pay feature. Nr_'8$,sXlQtN~QdCi$+bD`yXiY :%Q}|SIB8p*z }oJe1C5$lt`L?_*7=Hp W Use this page to securely send documents to VA Life Insurance. It also provides a list of commercial insurance companies that will accept a conversion. How Does VGLI Compare to Other Insurance Programs? Use this form to apply for waiver of policy premiums if you become totally disabled before your 65th birthday. (fillable). 0000063712 00000 n File claim electronically online-This is the fastest and most secure way to send your claim.or,2. These forms are to be used for National Service Life Insurance only. Find out how to reach out to ask a question about your policy or file a claim for benefits. To file a claim for VA Life Insurance online, you will need to complete VA Form 29-4125e, Claim for One Sum Payment and attach a photocopy of the Veterans death certificate and any other documents listed under required documentation. Please have a look at the full domain report for va.gov for extended statistics about the Va.gov website. Use this form to authorize the disclosure of VA Life insurance information to a third party. 0000116695 00000 n The site is secure. If you are in crisis or having thoughts of suicide, Applications, eBenefits Employment The .gov means its official. Use this form to apply for Veterans Mortgage Life Insurance. Please note, original copies of death certificates are not required. 0 Find out if you're eligible for tax-free monthly payments as a wartime Veteran or surviving spouse or child. 0000117369 00000 n If you're enrolled in a VA life insurance plan, find out if you can get free financial planning and online will preparation services. What you can do when you access your policy Check your policy's status to make sure it's up to date Pay your premium (the amount you pay each month or each year to keep your coverage) We can help answer questions about these policies: VALife S-DVI Any VA life insurance policy that starts with a V, J, RS, or W More information about your benefits Access your policy online VA FORM SEP 2021. 0000064701 00000 n Use this form to convert all or part of your term insurance to a permanent plan of insurance. Track the status of your life insurance appeal. This program stopped taking new applications after December 31, 2022. 0000084437 00000 n Hit enter to expand a main menu option (Health, Benefits, etc). Support for WWI, WWII, and Korean War era programs: Support for the VGLI program, SGLI claims, and FSGLI claims. VA FORM XXXX Were here from 8:30 a.m. to 6:00 p.m. Document Upload is located at https://insurance.va.gov/Home/IDU. An official website of the United States government. hb``f``c`c` B@Q5:00\e .:=bTXII) ,F+[ED?2,fz&2 F=",7&3LbfHc`a,c~4L0bdhfT1t gjw1f`3a Select "VA Life Insurance" as the Payee and enter your Insurance File Number as the Account Number. Use this form to reinstate a lapsed VGLI policy. 0000063471 00000 n Use this form to authorize the disclosure of VA Life insurance information to a third party. 0000008070 00000 n More information about Life Insurance for Veterans Choose one of the links below for more information about Life Insurance for Veterans Veterans Affairs Life Insurance (VALife) HWn}GaFJKnQD&i$jFwkz3E0&~Jo ?Bw" Yes, in some cases. & Protections, Life Insurance Online Use this form to apply for VGLI insurance. Attention A T users. Many of our forms can be filled out using the Adobe Acrobat Reader. Before using this form, please refer to the denial letter you received from your branch of service. 0000004154 00000 n To enter and activate the submenu links, hit the down arrow. Use this form to reinstate your insurance policy if it has lapsed for less than 6 months. %PDF-1.7 % & Protections, Life Insurance Online Eliminate shadows by using bright, direct lighting on your document. More information about Life Insurance for Veterans, Choose one of the links below for more information about Life Insurance for Veterans, Veterans Crisis Line: 0000002002 00000 n Use this form to request an advance insurance payment for a Servicemember or Veteran that is terminally ill. Use this form to apply for a free extension (up to two years) of SGLI coverage if you are a totally disabled at time of discharge. Left-click on the form title to view the form in your browser. You will now be able to tab or arrow up or down through the submenu options to access/activate the submenu links. 0000009493 00000 n 0000007449 00000 n Learn how to access your VA records, benefit letters, and documents online. The .gov means its official. Complete form SGLV 8283A, Claim for Family Coverage Death Benefits and contact your Branch of Service Casualty Assistance Office for assistance in submitting the form to the Office of Servicemembers Group Life Insurance (OSGLI). Learn about our new online process for enrolling in Servicemembers' Group Life Insurance. 0000064032 00000 n h{)W_Gk7F !U$XLs8(s:p~1ko; How Much Life Insurance Do You Really Need? 0000002714 00000 n 0000002151 00000 n HWYoF~'0} hj+5T aEITSwfIJCfoWxp {\pLz^beqy^iNd=9 tUoG^R%@ Get S-DVI RH Information and Premium Rates (VA Pamphlet 29-9) to download. 0000014484 00000 n FSGLI: Family Servicemembers Group Life Insurance, Schedule of Payments for Traumatic Losses, S-DVI: Service-Disabled Veterans Life Insurance, Beneficiary Financial Counseling and Online Will, Lesbian Gay, Bisexual & Transgender Veterans, Download TSGLI Form or Conversion Information, Download Life Insurance Forms for Service-Disabled Veterans (VALife and VMLI), Download All Other VA Life Insurance Forms, SGLV 8284 Servicemember/Veteran Accelerated Benefits Option Form, SGLV 8715 Application for SGLI Disability Extension, SGLV 8286A Family Coverage Election (SGLI), SGLV 180 Application for Reinstatement of Coverage (VGLI), Frequently Asked Questions about increasing your Veterans' Group Life Insurance, How to Convert Your SGLI/FSGLI/VGLI Coverage to an Individual Policy, 29-10 Veterans Affairs Life Insurance Information and Premium Rates, 29-9 Service-Disabled Veterans Insurance RH Information and Premium Rates, 29-8636 Application for Veterans Mortgage Life Insurance (VMLI), calculate the premiums which would be paid under VMLI, 29-0975e Authorization to Disclose Personal Information to a Third Party (Insurance). 0000117396 00000 n If you have S-DVI, you have these 2 options: If you apply for VALife by December 31, 2025,you can keep your S-DVI during the 2-year waiting period for VALife benefits. or, 3. U.S. Department of Veterans Affairs | 810 Vermont Avenue, NW Washington DC 20420. 0000003449 00000 n You can call the VA Life Insurance Center at 800-669-8477(TTY: 711). If the document is folded, smooth it out as much as possible. To enter and activate the submenu links, hit the down arrow. 0000001485 00000 n Access your VA life insurance policy online If you have VA life insurance, find out how to access and manage your policy online. 0000117210 00000 n If your file number begins with a V, RH, J, RS, K or W, access your policy at this link: If you have a VGLI control number, accessyour policy througheBenefits or at this link: Veterans Crisis Line: One moment please. Administration. Find out how to apply for and manage your VA health care benefits. 2. & Employment, Veterans Benefits Follow this link to Access your VGLI Policy Online. To ensure your security and privacy, when using a shared or . If the beneficiary is a minor or incompetent, the person having custody of the beneficiary should complete the form and give his/her address in Item 8A. If you disagree with a decision on your application for life insurance benefits, you can request a decision review. %PDF-1.7 % If you have supplemental S-DVI, youll need to pay premiums for this supplemental coverageeven if you have a waiver for your basic S-DVI premiums. If you have questions about Government Life Insurance, you can call us toll-free at 1-800-669-8477 or visit our website at: www.insurance.va.gov. APPLICATION FOR SERVICE-DISABLED VETERANS INSURANCE IMPORTANT INFORMATION. Go to milConnect and select Manage my SGLI. 0000005281 00000 n To enter and activate the submenu links, hit the down arrow. Or mail to: VA Insurance Center P.O. U.S. Department of Veterans Affairs | 810 Vermont Avenue, NW Washington DC 20420. 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