Long-term care insurance can be a lifesaver. After all, the chances that you or a loved one will end up needing long-term care are pretty high. But even if you’ve felt a sense of security by carrying long-term care insurance for years or even decades, the tragic reality is that many claims filed under these policies are denied. Therefore, before moving forward with your claim you might want to consider a few things.
- Know the terms of your policy: When it comes to long-term care insurance, the devil really is in the details. If you look closely at your policy, you might see that there are numerous limitations. These restrictions can apply to the types of facilities and services that will be covered, as well as extensive waiting periods that must be met before a claim will be paid out.
- Be diligent in filing your claim: Filing a long-term care claim under your policy might feel daunting. There are usually a lot of forms to fill out and you’ll have to submit your medical records, but the claims process doesn’t end there. You’ll probably also have to speak with representatives from the insurance company and provide any other information they request. Be prepared for this process so that you don’t make a statement that could jeopardize your claim.
- Be prepared for the next step: If your claim is paid out, then you’ll hopefully have the financial resources necessary to secure the long-term care that you need. However, many long-term care insurance claims are denied. Be prepared for this given that you have the right to appeal that determination. There’s usually a short appellate window, though, so make sure that you’ve done everything that you need to prepare for your appeal.
A daunting task
This might all sound daunting, and we understand. But law firms that are skilled in insurance law can help you protect your interests, especially if your claim has already been denied and you’re looking to appeal that decision. Here are a few things that you can do to better position yourself on appeal.
- Adhere to the process: You don’t want a claim denial to be upheld simply because you failed to follow the processes. So, familiarize yourself with the appellate requirements and be prepared to stick to them.
- Gather all the documents that you need to support your claim: You probably should have done this before filing your claim, but if you missed something, then now is the time to get it. This might include securing additional medical records and perhaps even obtaining an affidavit from your doctor that specifies how you meet the policy’s requirements from a medical perspective.
- Keep all communications: Emails, voicemails, and phone call records can all be critical to your case, especially if the insurance company is dragging its feet in paying out your claim. In other words, these records may help you show that the insurance company is acting in bad faith.
- Know how to articulate your position: It’s one thing to present records and say that you’re entitled to an insurance payout. It’s another thing altogether to argue from a legal standpoint that your claim should’ve been granted. Therefore, it’s hugely beneficial to know the law and how to craft persuasive legal arguments.
You don’t have to navigate the process alone
We know that dealing with insurance companies can be confusing or even infuriating. But don’t let these frustrations cause you to give up on your claim. Instead, consider working closely with a legal team that will know how to advocate for you or your loved one. Only then can you ensure that you maximize your chances of obtaining the result that you or your loved one deserves.