The LTC rider that I have is pretty clear on when payments start. They are called ADL’s, Activities of Daily Living and are very common in medical insurance. They involve the ability of the patient to bath or use the bathroom, eat, etc. Once any one of the seven cannot be performed, payments can start.
They've been known to play with that one too. Like medical insurance. You need a drug or procedure but the insurance company thinks you don't. Can't eat? Eat slower. Have meals delivered. We think you can do it if you tried harder, so we won't pay. I still wouldn't trust them even if "you get it in writing" because the writing always A) favors their position and B) Is left up to their interpretation. Or at least that's how they'll stonewall it even if they know eventually they'll have to pay.