38 C.F.R. § 9.22

VA's access to records maintained by the insurer, reinsurer(s), and their successors

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(a) In order to perform oversight responsibilities designed to protect the legal and financial rights of the Government and persons affected by the activities of the Department of Veterans Affairs and its agents and to ensure that the policy and the related program benefits and services are managed effectively and efficiently as required by law, the Secretary of Veterans Affairs shall have complete and unrestricted access to the records of any insurer, reinsurer(s), and their successors with respect to the policy and related benefit programs or services that are derived from the policy. This access includes access to:

(1) Any records relating to the operation and administration of benefit programs derived from the policy, which are considered to be Federal records created under the policy;

(2) Records related to the organization, functions, policies, decisions, procedures, and essential transactions, including financial information, of the insurer, reinsurer(s), and their successors; and

(3) Records of individuals insured under the policy or utilizing other related program benefits and services or who may be entitled to benefits derived through the Servicemembers' and Veterans' Group Life Insurance programs, including personally identifiable information concerning such individuals and their beneficiaries.

(b) Complete access to these records shall include the right to have the originals of such records sent to the Secretary of Veterans Affairs or a representative of the Secretary at the Secretary's direction. The records shall be available in either hard copy or readable electronic media. At the Secretary's option, copies may be provided in lieu of originals where allowed by the Federal Records Act, 44 U.S.C. chapter 31.

[79 FR 48072, Aug. 15, 2014. Redesignated at 88 FR 15912, Mar. 15, 2023]

Notes of Decisions

Cited in 4 cases, 1969–1980 · leading case: Annie Lenora Shannon v. United States of Am. & Prudential Ins. Co. of Am., 417 F.2d 256 (5th Cir. 1969).

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Annie Lenora Shannon v. United States of Am. & Prudential Ins. Co. of Am., 417 F.2d 256 (5th Cir. 1969). “Under 38 C.F.R. § 9.22 the Veterans Administration has broad power to make administrative decisions which conclusively determine the serviceman’s coverage and the right to proceeds, including whether he is a “member” and “whether or not he is covered at any point in time under…”

Allison v. United States, 426 F.2d 1324 (6th Cir. 1970). “The policy, as well as the Regulations adopted by the Administrator (38 C.F.R. 9.22), provide that the determination by the Veterans’ Administration as to coverage is conclusive, but original jurisdiction is vested in the District Court of any civil action or claim against the…”

Allison, Sr. v. United States, 426 F.2d 1324 (6th Cir. 1970). “6 The policy, as well as the Regulations adopted by the Administrator (38 C.F.R. 9.22), provide that the determination by the Veterans' Administration as to coverage is conclusive, but original jurisdicti is vested in the District Court of any civil action or claim against the…”

Nowinski v. Servicemen's Grp. Life Ins., 484 F. Supp. 1060 (E.D. Pa. 1980). “§ 211 (a) (1979), and 38 C.F.R. § 9.22 (a)(1), determinations by the Administrator of Veterans’ Affairs as to coverage under the policy are not reviewable in the courts.”

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