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Long Term Care Claims Experiences

A question we are frequently asked here is in regards to claims history of the companies.  Many Americans are familiar with long term care insurance plans owned by their parents.  Many of these older plans had tricky claims processes and some policyholders were burned.

Recent Claims Experience Data 

The fact is, modern long term care insurance policies satisfy the majority of Americans.  In fact, a recent study conducted by the U.S. Department of Health and Human Services found that a large majority of long term care insurance policyholders who filed claims reported that they were satisfied - 97 percent - with how their claims were handled.

Another thing that I like to tell our clients is that in the past few years, our carriers, and all health insurers, worked closely with the National Association of Insurance Commissioners to develop a protocol of industrywide standards.  The idea was to ensure that consumers have all the information they need when purchasing a long term care policy, as well as the freedom and flexibility to adjust policies to meet changing needs, and, most importantly, protection against arbitrary rate increases.

An article in today's San Francisco Chronicle solidifies the point:

A comprehensive survey of long-term care insurance companies found that nationwide only 3.3 percent of claims are denied, typically because the policyholder hadn't met the policy deductible or sought services or providers not covered by their policy. That's in line with California policyholders' experience. A recent analysis by the California Department of Insurance confirmed that about 3 percent to 7 percent of claims are denied (with the percentage depending on how the denials are calculated: as a percent of claimants or the number of services involved).

 

 

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