Milpersman 1770-250

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MILPERSMAN 1770-250

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NAVY DEPENDENTS: CASUALTY REPORTING AND THE SUBMISSION OF CLAIMS FOR FAMILY SERVICEMEMBERS' GROUP LIFE INSURANACE (FSGLI)

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PURPOSE

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PROCEDURES FOR REPORTING THE DEATH OF A SAILOR'S DEPENDENT AND GUIDANCE FOR THE SUBMISSION OF A CLAIM WHEN A DEPENDENT IS COVERED BY FAMILY SERVICEMEMBERS' GROUP LIKE INSURANCE (FSGLI)

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MILPERSMAN 1741-030

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GOVERNMENT LIFE INSURANCE

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PCR

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PERSONNEL CASUALTY REPORT

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REPORTING REQUIREMENTS

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PCR MUST BE SUBMITTED AS SOON AS POSSIBLE ONCE THE COMMAND IS NOTIFIED OF A DEPENDENT DEATH

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HOTEL

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ANY REMARKS REQUIRED, OR DESIRED, BY COMMAND.

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SUBJECT LINE

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THE SUBJECT LINE SHOULD CONTAIN THE SAILOR'S RANK, NAME, SERVICE AFFILIATION (USN OR USNR), LAST FOUR OF THE SSN, THE OFFICER DESINGATOR

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ALPHA

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DEPENDENT’SNAME, LAST 4 OF SSN (XXX-XX-234), RELATIONSHIP TO SAILOR, AND DATE OF BIRTH.

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BRAVO

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COMMAND POINT OF CONTACT (POC): RANK, NAME, PHONE, FAX, ANDE-MAIL ADDRESS.

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CHARLIE

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SPECIFY“DEPENDENT DEATH”

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DELTA

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DATE (LOCAL TIME OF CASUALTY INCIDENT), PLACE, CIRCUMSTANCESOF INCIDENT, AND CAUSE OF DEATH

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ECHO

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LOCATION OF REMAINS (I.E. FUNERAL HOME’S NAME, ADDRESS ANDPHONE NUMBER). IF UNKNOWN, STATE “UNKNOWN”.

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FOXTROT

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SPECIFY IF THE DECEASED DEPENDENT WAS INSURED UNDER THEFSGLI PROGRAM. IF THE DECEASED DEPENDENT WAS A SPOUSE, SPECIFY THE AMOUNT OFSERVICEMEMBERS’ GROUP LIFE INSURANCE (SGLI) COVERAGE THE SAILOR MAINTAINED. IFUNKNOWN, STATE “UNKNOWN”.

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GOLF

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DATE/TIME SAILOR WAS NOTIFIED OF DEPENDENTS DEATH

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REQUIRED DOCUMENTATION

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FORM SGLV-8283A

NAVPERS 1070-602

DEATH CERTIFICATE