Here’s a link to a PBS NewsHour story from January 9, 2015. The story is about a wildly successful long-term care insurance claim. But this is not what was emphasized.
The PBS story portrays long-term care insurance (LTCi) as a mysterious, super-complicated product. It describes the elimination period and Activity of Daily Living triggers as onerous. This is false. If the LTCi credentialed insurance agent who sold the described policy had the barest trace of competence, I am nearly certain the couple was probably well-educated about how their LTCi policies worked when they purchased them. LTCi is not as complicated as portrayed in this story. The couple chose and understood the elimination period. The Activity of Daily Living (ADL) and Cognitive Impairment triggers are straightforward and very easy to satisfy.
Here are comments about this story I posted online:
“Why does Ms. Santhanam wish to place emphasis on the LTC carrier not offering assistance in the selection of care? The best care is found on local recommendation. This is a trivial complaint. The job of insurance is to pay claims. The reporter does not think it is satisfactory enough that this couple paid $1700/yr x 2 x 4 years = $13600 total in premium and collected $700K? Why was this fact not emphasized instead? This is the true story. Legal intervention to get the policy to pay was most likely unnecessary. If I can re-submit valid claims as a completely non-legal person and always get them paid, this is great business for lawyers. Besides, what is more fun than trashing the big bad insurance company? Just talking with the carrier and finding out what they want has been sufficient in my extensive experience. But at claim time, people are often pressed and panicked, and sometimes the agent is not present, unfortunately. Out of 300+ LTCi claims I’ve seen, not a single valid claim has been denied. We have had to re-submit quite a few. According the AALTCi and other sources, aprox 98% of all LTCi claims get paid. The 2% that don’t are just not valid claims. Insurance companies do not impede claims. On the contrary, most are extremely helpful, but they have rules and it is up to the claimant to find out what they want, then provide it. Please do more responsible reporting. Proper research would cause media to stop casting a bad shadow over LTC insurance. This would help the public greatly. As it stands, a huge number of Baby Boomers use articles like this to deny the genuine, urgent need to plan for LTC, NOW! Instead they spend what should have been their LTC premiums on immediate gratification items. When they need LTC they may be in very tragic circumstances. This is reality. It’s about time mainstream media starts putting the correct slant on this powerful, transformative insurance.”