Filing a Accidental Dismemberment Claim

If you are an employee enrolled in the FEGLI Program and lost a limb or eyesight, you would follow the process below.

• Carefully complete the " Claim for Dismemberment Benefits" form FE-7 that is located on the OPM website (Click here) 
• The employee enrolled in the FEGLI Program completes Part A of the form.
• Once Part A is complete, the employee’s physician or other healthcare provider completes Part C.
• IMPORTANT: please have copies of all medical reports from treatment you received for this accident. Also attach any police, traffic, or other reports about this accident.
• If you need help completing this form, contact your human resources office or call the Office of Federal Employees’ Group Life Insurance (OFEGLI) at 1-800-63-4542

Please mail the completed form and all documents to your human resources office. The human resource office will complete Part B, the Agency Certification and forward the documentation to the Office of Federal Employees’ Group Life Insurance Team.