Long-Term Care Insurance
Perhaps you or a loved one has recognized the need for long-term care insurance (LTC). This type of insurance is not just “nursing home” coverage. It’s insurance that helps assure you of continued independence in your later years, and protect the personal assets you’ve acquired. Long term care insurance helps to pay for medical care for an extended period of time, whether that be in a nursing facility, rehabilitation facility, or providing in-home assistance to those who need help with Activities of Daily Living (ADLs). For the benefit to become payable, the person insured by the policy usually must show an inability to perform two or more of the ADLs, such as dressing, bathing, toileting, cleaning, cooking, incontinence and transferring from a bed.
As the population ages, more and more people will require long-term care, necessitating the increased need for long-term care insurance, and the likelihood of an increased percentage in LTC insurance denials. But the LTC insurance industry has suffered numerous financial problems over the years. Many companies sold policies providing too great of coverage for the premium they charged. These companies simply did not anticipate the inevitable, and significant, increase in health care costs experienced over the past decade and more. Several of these companies have gone out of business. Many others ceased selling LTC policies altogether.
Has Your LTC Claim Been Denied?
Long term care insurance companies deny claims for a variety of reasons. When this happens, the policyholders—often a senior citizen—can be financially ruined. The cost of nursing home or other assisted facility care is extremely expensive (costing as much as $10,000 per month for some facilities). A denied claim can be disastrous for the person and his or her family who were expecting to have the financial security promised by the insurance company.
Denials come in many forms. Some of the more frequent reasons are:
- Coverage for an approved nursing home but the facility where the claimant now resides is an assisted living facility
- Lack of medical necessity for treatments or benefits
- A lapse in coverage due to unpaid premiums (many older insureds simply forget to pay their premiums)
- The chosen Care Provider is not covered by the policy (most policies exclude family members from being the caregiver, even if qualified to do so)
- Lack of compliance with a confusing claim process
- Requirement to first be hospitalized
If you purchased long-term insurance coverage, you or your parent may find yourself having a difficult time collecting on an LTC policy These companies are now in a position of not being able to pay what they agreed upon. The way to solve that problem is to deny or delay your claim. Common LTD insurance companies in business today are:
- Bankers Life & Casualty
- Genworth Financial
- MassMutual Financial Group
- Mutual of Omaha
- New York Life
- Northwestern Mutual
- State Farm
- Colonial Penn
Our Long-Term Care Insurance Attorneys are Available to Talk to You
Insurance companies will deny payment of these benefits for various reasons. The pursuit of a denied claim can be incredibly overwhelming for many people who need long-term care, as well as for their families. If you or someone you know has fallen victim to a long-term care insurance company, contact the bad faith insurance attorneys at McDermott Law.