Turned Down for Long Term Care Ins

[Go Bolts]

I’m just in the process of trying to claim LTC for my mother, and I have to say the experience has made me very loath to get coverage myself. Of course I understand that insurance companies need to make a profit and so don’t like to pay out but I really wonder whether the premiums wouldn’t have been better simply invested! I’d never advise that for ordinary medical or home insurance, but the definitions of what “care” means and the policy insistence on getting her to some mythical base level rather than an actual ability to take care of herself makes me wonder if the wording on these policies is particularly loose in the favor of the company. She is with MetLife which no longer even writes LTC so perhaps it is a function of their running down the unit but I’ve found it stressful and irritating! At least with medical insurance we can all agree what a doctors visit is or what an xray is; in home insurance a theft is pretty clearly a theft and a fire is pretty obvious as well. But LTC seems... squishy. And not in a good way. Probably they will pay in the end, but the cost to my mental health is ... uncovered!

Sorry to hear. As I was reading along, I thought it was CNA since they aren’t too good with claims, many lawsuits over the years, etc. My mother has CNA and many years ago after a severe fall, we established a claim for a while. She eventually recovered from her TBI thankfully.

Since her policy has a one time 90 day waiting period, I submitted information to CNA to show them she had satisfied the 90 days by virtue of her stays in acute hospital, rehab hospital, skilled nursing facility and home health care.

It took me about a whole year to get them to understand all of this. I had to teach them how to read EOBs and remittances. I wrongly expected them to know these basics.

I did eventually receive a letter from them stating the waiting period was satisfied. This should preclude having to go through the same BS should a future claim occur.

Anyone else with CNA have good/bad experiences?

PS I have another story about waiver of premium debacle and may share that another time.