5 Steps To Ensure You Are Not Denied Long-Term Care Insurance
Long-term care (LTC) is costly compared to many other insurance payments. Private care in a nursing home or long-term care setting can cost as much as $83,000 per year. Therefore, insurance companies and insurance carriers must analyze these statements critically. Individuals can be denied long-term care insurance if they do not meet the insurance company’s requirements.
You may think there will be no difficulties when you, a parent, or a loved one files for a LTC insurance claim. When you need assistance with daily living, an LTC policy could be beneficial to pay for the cost of assisted living, nursing home care, or at home care.
However, it is not guaranteed the insurance company will compensate your claim. Before filing your claim, it is essential to be aware of the factors that could prevent your insurer from providing necessary benefits. Here are five steps to ensure you are not denied long-term care insurance!
1. Read Your Policy!
First and foremost, read your policy thoroughly. This will assist you in submitting the claim correctly. Analyzing every detail is important because relevant information often seems to be hidden in the policy.
2. Specify Your Needs!
You must include all of the required information to support your claim. Do not restrict yourself to only the questions that have been posted. It is beneficial to submit documentation from your doctor stating you require a specific form of treatment or care. If it helps support your claim, providing additional information is favorable.
If you’ve decided to stay at home, but require the assistance of a care assistant, investigate what paperwork the assistant will need to provide to the insurer. This is a requirement for many insurance companies.
3. Making it Clear That You Need Help
If a parent or elderly loved one files a claim, you must be present for any assessment the insurer performs. Older individuals frequently refuse to accept they require assistance with daily activities. This refusal can often lead to claim denials. It is beneficial to assist the assessor in determining your loved one needs help.
The benefits could be denied if they do not meet the insurance company’s concept of being primarily reliant and requiring significant physical assistance. For example, a doctor could fail to make the diagnosis of cognitive impairment.
If you are submitting a claim on behalf of a parent or loved one, you will almost certainly need that person to sign a paper authorizing you to manage any policy disagreements. Inform them if you are their power of attorney or health care substitute.
If a claim is denied, make sure any correspondence with the company is dealt with or followed up with in writing. Always request any queries or reasons for denial for the insurance company.
4. Consult With a Lawyer!
You might benefit from seeking legal counsel. Long-term care claims necessitate careful examination and advanced legal strategy. Rather than battling your claim alone, seek the advice of a professional attorney.
Attorneys who have dealt with denied insurance claims understand how to work with insurers and assist clients in getting the benefits they are entitled. You can still fight legally even if your insurance claim has been denied or even terminated.
5. Don’t Be Late With the Payments!
People occasionally miss or make late payments. In such cases, the insurance company may claim your policy has expired and you are no longer entitled to benefits. Nevertheless, there are rigorous rules governing how insurance companies should act when a payout is missed. Even if they do not take the required steps, you might qualify for long-term care benefits.
Most policies allow up to 60 days before they lapse due to nonpayment. If you can obtain a physician’s declaration proving your family member is cognitively impaired during that time, the carrier could reinstate the policy. If your elderly parent suffers from cognitive impairment or the initial phases of dementia, be sure to consider filing a claim.
