Long-Term Care Insurance: Filing a Claim

Learn about important long-term care insurance (LTCI) policy considerations and the process of filing claims for benefits. Stress to your clients the critical nature of properly asserting a claim. Whether representing insureds or insurers, properly filing a claim is a condition precedent to an insurer's obligation to pay benefits. Gain insight on the claim filing and claim evaluation process from the LTCI insurer's standpoint. Learn about the critical steps required to properly assert an LTCI claim that do not exist with other kinds of insurance claims. Educate your clients on understanding the requirements of their individual policies, as they will specify the procedures to be followed.

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Related Content

• Long-Term Care Insurance Fundamentals Checklist
  Consult this checklist to understand the principles underlying LTCI, which is designed to pay for custodial care that government programs (e.g., Social Security, Medicare, and Medicaid) do not cover. This checklist outlines LTCI policy thresholds—the inability to function independently or with various assistance—that must be met for policyholders to receive policy benefits. This checklist addresses LTCI benefits, distinguishes the types of care covered versus not covered, and compares LTCI to government programs that furnish benefits to groups of people who may have comparable demographics and needs.
• Long-Term Care Insurance: Filing a Claim Checklist
  Advise your clients on the proper steps to follow when filing claims under LTCI policies. Identify key considerations and processes that must be followed to assess policies accurately and either obtain benefits for policyholders or deny claims in good faith on behalf of insurers.
• Long-Term Care Insurance: Litigation Checklist
  Review the principal steps individuals insured under LTCI policies should take to file claims for benefits. Because of their inherent complexity, the market to which they appeal, and how they can be financed through other insurance products, LTCI policies commonly generate litigation. In addition, this checklist outlines the litigation considerations that relate to disputes over LTCI.

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