How to Take Action When Your Long Term Care Claim Has Been Denied

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Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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UPDATED: Jun 19, 2018

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Many long term care policyholders are finding that their claims are being denied. Insurance companies sold billions of dollars in long term care insurance in the mid- 1980’s and 1990’s to aging baby boomers that sought coverage should they need assistance in their twilight years.

Unfortunately, insurance underwriters had little experience underwriting these types of policies back then and underestimated the costs now associated with nursing homes, assisted living facilities and in-home care. As a result, many insurers are denying long term care claims and seeking to drastically increase premiums at the discretion of state insurance commissioners.

Who Can Really Help You?

Here are some ways you can receive help if your long term care policy has been denied:

Seek the advice of an attorney with experience in bad faith insurance claims. A qualified attorney can assist you when your long term insurer has wrongly denied your claim and when you’ve had enough and wish to take legal action. Unfortunately, many general practice attorneys don’t understand the nuances of how insurance companies operate, so make sure you find an attorney that specializes in bad faith litigation.

Complain to your state’s insurance commissioner. All states have an insurance commissioner who oversees the insurers licensed to practice in their state. A complaint may result in the state contacting the insurer on your behalf and may bring some results but it also recommend that you contact a long term care attorney.

Help yourself. The best way to help yourself is to be organized. Make sure you have your records in order and write down who you spoke with, when you spoke with them and what they told you. And when they don’t do what they said they would, contact them again.

There’s no reason for policyholders to accept the fact that their claim has been denied. If your long term insurance company isn’t responding to your long term care complaint – take action.

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