An article by Trevor Thomas in the October 11, 2010 National Underwriter entitled “Life Plans: LTC Carriers Botch Few Claim Denials” reports on the LTC insurance claim determination review that was delivered in April and commissioned by the U.S. Department of Health and Human Services (HHS).
This report shows that long-term care (LTC) insurance claims are getting paid fairly.
An audit team of registered nurses from LifePlans examined about 1,200 claims submitted in 2007 and 2008 to seven LTCi insurers.
The auditors concluded that they would have denied roughly the same proportion of claims as the carriers did, LifePlans researchers say. In fact the auditors concluded that they would have approved 5% fewer cases than the insurance carriers approved.