Common Causes of Delays or Denials in Long-Term Care Insurance Claims

Filing a long-term care insurance claim is never easy. There are often many requirements that must be met both on the claim and in long-term care. It’s a burden that many families shouldn’t have to face alone. When you hire a skilled Chicago long-term care insurance attorney, you’ll have an advocate on your side who knows how to handle these claims and hold the insurance companies accountable to their claimants. With the ever-rising costs of long-term care, families need and deserve the benefits they are entitled to receive. 

Far too many long-term care insurance companies are unfairly failing to pay claims. They often delay processing a claim, hoping the claimant might forget and leave them alone. Or they will deny a claim to keep more of their profits. Claimants are given many reasons as to why their claim is being delayed or denied.

Requesting More Information

It’s common for long-term insurance carriers to delay payments or processing claims under the premise that they need more information. For example, you might receive multiple requests for more information before the claim is approved. To avoid some of this, be sure to include all the paperwork and information required under the plan with your initial claim. Suppose you continue to receive further requests for information, and your claim is delayed. In that case, it’s in your best interest to consult an experienced Chicago long-term care insurance lawyer. 

Assessment Related Denials

Sometimes a long-term care insurance carrier will send someone out to evaluate the policyholder to determine their need for long-term care services. The policyholder should have a family member or reliable friend present them when they are evaluated. Often, seniors are unsure of how to respond to the evaluator’s questions. For some policyholders, pride is a factor, as they may be hesitant to acknowledge their need for long-term care. Unfortunately, these insurance investigators are trained to document statements during the assessments that can be used as a basis for the insurance company to deny claims.

Failure to Pay Premiums

Many seniors deal with cognitive impairments like Alzheimer’s disease. As such, they may innocently overlook paying their premiums. As such, they should request that the insurance company send any lapse/late payment notices to someone close to them, such as a family member. Most insurance companies give long-term care policyholders time to make up these payments if they take action in time. However, once the premiums haven’t been paid in a while and the policy terminates, there isn’t much that can be done. If the policy is canceled, the policyholder won’t be able to receive the benefits due to them. However, it’s still imperative for them to contact a Chicago long-term care insurance attorney to determine what rights they might have.

Talk to an Experienced Chicago Long-Term Care Insurance Attorney Today

The experienced Chicago long-term care insurance lawyers at Bartolic Law understand what it feels like to attempt to receive benefits from a long-term care policy and how expensive this type of care can be. They know that policyholders and families alike count on receiving this benefit to provide necessary care. If your claim is being delayed or denied or you want help filing your initial claim, contact our office today. We will meet with you free of charge to help determine your next steps.