The American Association for Long-Term Care Insurance reports that approximately 8 million people in the U.S. have long-term care coverage.  Approximately half of the claims made under long-term care policies are filed by policyholders that are at least eighty-years-old.  The purpose of this form of coverage is to pay for those expenses not covered by Medicare.  

Minimum Coverage Typically Includes In-Home Coverage

If an insured needs in-home care, certain minimum requirements must be satisfied before in-home care services can be provided.  Typically, the insured must be unable to perfrom at least three types of his or her daily needs, such as personal hygiene and meal preparation.  If the insured suffers from dementia or Alzheimer’s disease, the insured can qualify for in-home care that is not provided by Medicare.  

Denial of Long-Term Coverage

When an elderly loved one needs long-term care in his or her residence or a nursing home, a long-term care policy can provide critical coverage.  Many policyholders in this situation find that their claims are denied.  If this happens, policyholders should seek legal advice from an experienced long-term care insurance attorney.  Your attorney can take on the insurance company and protect your interests.  Because the fundamental function of long-term care policies is to defray the costs of skilled nursing care or in-home care, a denial can mean going without critical supportive care.  This inability to obtain proper care can result in a threat to the insured’s health and safety.  

There are a number of key facts you should be aware of if you need to file a claim under your long-term care insurance:

Delays in Filing Can Damage Your Claim: As a general rule, you should not procrastinate in terms of filing a claim under your long-term care policy.  Delays may be construed as evidence that you do not need assistance.  The insurer will contend that if you required assistance you would have filed your claim earlier.

Terms/Deductibles: Policyholders should carefully review their policy, so there are no surprises in term deductibles, exclusions, or limitations on coverage.

More Than Nursing Home Coverage: Although some people think long-term care policies only apply to nursing home care, these insurance policies also provide coverage for assisted living and in-home care.

You can reach Miami Insurance Claims Lawyer J.P. Gonzalez-Sirgo by dialing his direct number at (786) 272-5841, calling the main office at (305) 461-1095, or Toll Free at 1 (866) 71-CLAIM or email Attorney Gonzalez-Sirgo directly at [email protected].

J.P. Gonzalez-Sirgo
J.P. Gonzalez-Sirgo, P.A.
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