Standing Up For You When A Long-Term Care Insurance Claim Gets Denied
Long-term care insurance has been one of the fastest-growing types of insurance sold in recent years. These policies are typically purchased privately outside of the employment setting and are governed by state laws, which usually provide a broader array of damages for policyholders than do policies governed by the Employee Retirement Income Security Act (ERISA). If an insurer unreasonably and without proper cause denies a long-term care insurance claim by engaging in bad faith conduct, a policyholder may sue for benefits due under the policy, “consequential damages” (damages that are caused by the bad faith conduct), emotional distress damages, punitive damages, attorneys’ fees and interest on past-due benefits (typically at the legal rate of 10%).
Regardless of your specific coverage, insurers have a financial incentive to collect premiums and pay out less in benefits, which will increase their profits. This conflict of interest can motivate insurance companies to improperly deny your long-term care insurance claim. McKennon Law Group PC in Newport Beach, California, is an experienced long-term care insurance attorney team of insurance litigation attorneys prepared to represent you.
Ready to Handle Your Long-Term Care Insurance Denial
Typically, long-term care policies contain technical language that specifies coverage for specific treatments and requirements. Claimants must prove that they cannot perform a certain number of “Activities of Daily Living,” which typically means any of the following:
- Bathing: Washing oneself by sponge bath or in either a tub or a shower
- Dressing: Putting on and taking off all items of clothing and any required braces, fasteners or artificial limbs
- Transferring: Moving into or out of a bed, chair or wheelchair
- Toileting: Getting to and from the toilet, getting on and off the toilet
- Continence: Ability to maintain control of bowel and bladder function
- Eating: Feeding oneself by getting food into the body from a receptacle or by a feeding tube or intravenously
These types of claims are similar to long-term disability insurance claims, and insurance companies will often follow similar practices in denying long-term care and disability insurance claims. These practices include taking medical evidence out of context, hiring biased doctors to evaluate claims, conducting an inadequate or biased investigation, using surveillance and other methods to assert that an insured does not qualify for long-term care benefits. Moreover, insurance companies delay paying claims, in part by requiring an unreasonable amount of documentation to establish entitlement to long-term care benefits.
Our Long-Term Care attorneys will not let insurance companies push you around. Since 1986, we have negotiated and litigated cases involving long-term care insurance. We are among the nation’s top law firms in working with long-term care insurance claims. For more information, please see our Long-Term Care FAQs.
Schedule a Meeting Now With a Dependable Attorney
If you or a loved one has been denied a long-term care insurance claim, you can rely on the skills and experience of McKennon Law Group PC in Newport Beach, California. For more than three decades, we have guided clients from throughout California, including the Orange County / Los Angeles area and Northern California. We offer free initial consultations, so please contact us via this free consultation form or by calling 1-800-682-4137.