Brain Decline + Failure to Communicate = Failure Formula

If you are a regular reader of my weekly blog posts, you’ll notice the recurring theme of Brain Loss. While the condition isn’t avoidable, many of the resulting consequences can be prevented. It just takes a little planning and some open conversations. Otherwise, you are building a path to failure.

Here’s an email I recently received from a concerned service provider:

“Hi Honey,

You have been so helpful in the past and I always think of you when a question about LTC comes up! 

We have a former patient who just moved to New York to be closer to her daughter.  She is 91 years old and has dementia.  She has had a LTC policy, but without her daughter knowing, she let her policy lapse.   The LTC insurance company is asking for documentation of her mental status.  Our doctor only saw her for general medical ailments and never formally evaluated her memory, so we have no test scores to provide.  He wrote a letter of incapacity but the insurance company is not accepting that. 

This woman stands to lose hundreds of thousands of dollars of coverage.  Do you have any suggestions for them?”  

I receive emails and distressed phone calls like this too often and they are heartbreaking. The families reaching out to me are in a state of emergency and dealing with unbelievable levels of stress. A lot of this stress is a result of failure to plan properly.

I’m assuming that the mother’s health has seriously declined, since the family had her moved at 91 years old to a new state. She like has, at minimum, mid-stage dementia. This means her dementia is at a point where it’s obvious and she needs lots of supervision.

Avoiding the Preventable Failure

Fortunately, most long term care insurance (LTCi) policies now include language allowing policyholders to reinstate their coverage and get their claim paid within 6 months of policy lapse. If she’s lucky, the mother qualifies for reinstatement and her claims can be paid.

The mother will need to have neurological testing to prove her dementia. Once proven, her choice to cancel her coverage could be reversed, as she was not mentally capable of making this serious decision.

Some Reasonable Questions

• Does the daughter have a copy of her mother’s LTCi policy? When monitoring the health and care of our parents, it is critical to have the documentation and be familiar with the terms. Understand what options are available before you need to use them
• If the policy lapsed from nonpayment, does the insurance company know to automatically notify the daughter? This is a standard part of every LTCi application. Pay attention and remember to complete it. There is good news: this appointment can be added or changed at any time, as long as the policy is in good standing.
• Did the family ever have the conversation with their mother about what kind of care she wanted to receive once she was unable to make these decisions on her own?

This tragedy occurred because of the family’s failure to explore and document their mother’s wishes and desires ahead of time, in a frank manner.

Take a moment to explore how you can plan for an easier future for yourself or someone you love. Click here to receive your free, no-obligation quote for long term care insurance.