Getting your LTC Insurance claim paid
Posted by Dorothy at 5/7/2009 10:33 AM 
Categories: Basics
Tags: long-term care long-term care insurance claims
Categories: Basics
Tags: long-term care long-term care insurance claims
The May 2, 2009 issue of Kiplinger's Personal Finance magazine includes an article on the topic of Long-Term Care claims (click here to read: Make Sure Your Insurer Pays Up).
It’s a decent piece of work, and as the author says, "getting a long-term-care claim approved is the easy part." Here I'd like to offer a few observations and pointers based on 20-plus years experience as a Long-Term Care Insurance professional.
Making a claim on your Long-Term Care Insurance (LTC) should be no more difficult or complicated than making a claim on a homeowners, auto or disability insurance and there are many things you can do at claim time to simplify and speed the process.
If you're just now buying LTC insurance, buy from a knowledgeable agent who cares about his or her clients. An agent can be a tremendous help at claim time. The agent should be intimately familiar with your policy and can often help you avoid miscommunications and other problems during what can be a highly emotional time.
At claim time, your first phone call should be to your agent. He or she can often guide you through the claims process and help eliminate needless frustration and delays.
Since many years typically pass between when a policy is purchased and when a claim is made, you likely would benefit from reviewing your policy, paying attention to these points:
Also, pay attention to the process
A report by the National Association of Insurance Commissioners said the Long-Term Care insurance industry has no systemic issue in regards to claims payments. However, there are many things you can do to simplify and speed the process of making a claim.
Long-Term Care doesn't have to be a complicated and unpleasant subject. In fact, taking responsibility for your own health and welfare can help you avoid years of poverty or substandard care. Everyone must have a Long-Term Care plan in place that will fit their lifestyle and budget.
Dorothy McMahon, president of McMahon and Associates in Bloomfield Hills, is a specialist offering “Straight Talk about Long-Term Care Insurance.” She has brought her program to professional associations, family support groups, meetings, and conferences. Contact her at (248) 844-9787 or LTCINSUSA@AOL.COM and visit www.mcmahonltcins.com.
It’s a decent piece of work, and as the author says, "getting a long-term-care claim approved is the easy part." Here I'd like to offer a few observations and pointers based on 20-plus years experience as a Long-Term Care Insurance professional.
Making a claim on your Long-Term Care Insurance (LTC) should be no more difficult or complicated than making a claim on a homeowners, auto or disability insurance and there are many things you can do at claim time to simplify and speed the process.
If you're just now buying LTC insurance, buy from a knowledgeable agent who cares about his or her clients. An agent can be a tremendous help at claim time. The agent should be intimately familiar with your policy and can often help you avoid miscommunications and other problems during what can be a highly emotional time.
At claim time, your first phone call should be to your agent. He or she can often guide you through the claims process and help eliminate needless frustration and delays.
Since many years typically pass between when a policy is purchased and when a claim is made, you likely would benefit from reviewing your policy, paying attention to these points:
- Deductible: Review how the deductible, usually called an ‘elimination period’ is covered.
- Licensing requirements: Pay attention to the caregiver’s licensing requirements to make sure you maximize the benefits from your policy.
- Proof of licensing: Make sure your claim paperwork includes copies of any required proof of licensing, or the claim could be delayed. Call your claims representative with any questions to make certain your claim is not delayed due to insufficient documentation.
Also, pay attention to the process
- Start a file: Dedicate a spiral bound notebook to the claim. Keep a record of any and all phone conversations with the claims representative, care coordinator and caregivers. Include date, time, who initiated call and who you spoke with. Keeping everything in one place will make it easier if there is a problem.
- Send all claims forms via return receipt mail so you know when they have been received at the insurance company. Give the insurer several days to process the paperwork before you call and ask for a status. Proof of receipt is important in the event of a claims appeal, since your contract will state the number of days the insurer has to respond to your appeal (day one is the date they receive your paperwork to respond).
- Keep your policy handy, not in a safe deposit box. Give a complete photocopy of your policy to a close relative or friend in case you are unable to find your policy at claim time.
- Name at least one person in the third-party notification section of your application. That person will be notified if your policy is ever in danger of lapsing. Whether the danger is from an extended trip, an oversight, or because of a lapse in cognitive ability, this safeguard is designed to make sure your policy is in force at claim time! If you don't name someone during the application process, you can do it any time after the policy is issued.
A report by the National Association of Insurance Commissioners said the Long-Term Care insurance industry has no systemic issue in regards to claims payments. However, there are many things you can do to simplify and speed the process of making a claim.
Long-Term Care doesn't have to be a complicated and unpleasant subject. In fact, taking responsibility for your own health and welfare can help you avoid years of poverty or substandard care. Everyone must have a Long-Term Care plan in place that will fit their lifestyle and budget.
Dorothy McMahon, president of McMahon and Associates in Bloomfield Hills, is a specialist offering “Straight Talk about Long-Term Care Insurance.” She has brought her program to professional associations, family support groups, meetings, and conferences. Contact her at (248) 844-9787 or LTCINSUSA@AOL.COM and visit www.mcmahonltcins.com.
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