Mother's Long Term Care Insurance Company Giving Me the Run Around

[harllee]

I'm so glad things are starting to go your way. Now that you're in the habit of writing to the insurance company, I'd be submitting claims for 1) the waiver of premiums AND 2) the professional fees. I'd threaten them with informing FIRE Forum (heh, heh, we already know, but that might scare them as much as AARP!)


Blessings on you and your mom! Keep us posted on further developments.

Definitely going to try to get the premiums she paid after she qualified refunded, that is over $3000 and that has been promised. As for the $2000 consultant and attorneys fees, I don't have the energy for that. Actually I found AARP very helpful-- they wrote a letter to MetLife and I do think that helped.

 

[Dreamer]

I am so glad to hear that the company has finally started paying. Your mother is lucky that you were willing to go to bat for her. Great job.

 

[harllee]

OP here with an update. As earlier reported, after 6 months of work, Metlife finally made a large back payment to my mother. I had hoped that once they started paying things would go smoothly going forward. Unfortunately it has not. Metlife still drags on paying. Mother's CCRC sent her bill for the month of December on January 5, Metlife is required to make payment within 10 days of receiving the bill according to the policy. I called Metlife today to check on the status of the payment and Metlife claims they never got the bill. The CCRC is resending (the CCRC says this type of delay is typical of all long term care companies). I will probably have to deal with these crooks for the next 3 years (it is a 3 year policy). Grrr.

 

[sheehs1]

Harlee, that is truly disheartening. One, to have paid in for the "peace of mind of Long Term Health. Two, to have had to fight for 6 months to get them to pay. Three, to have to stay on them so they continue to pay. Where is the "peace of mind"?

 

[harllee]

Harlee, that is truly disheartening. One, to have paid in for the "peace of mind of Long Term Health. Two, to have had to fight for 6 months to get them to pay. Three, to have to stay on them so they continue to pay. Where is the "peace of mind"?

There is no peace of mind. In my opinion LTC insurance is a rip off. My mother would have been much better off putting the premiums in a savings account.

 

[Happyretired]

There is no peace of mind. In my opinion LTC insurance is a rip off. My mother would have been much better off putting the premiums in a savings account.

Sadly some LTCi insurance companies are going to do everything they can to get out of paying at the time one needs it the most. I’m not a fan of LTCi. I agree money would be better placed elsewhere.

 

[target2019]

It's surprising that your State was not more helpful. In any event, I'm glad this is working out and somewhat resolved.

My wife just reminded me of the hoops she had to jump through for LTC payments for mother-in-law. It was an old USAA/John Hancock policy, and the terms were pretty good. I don't have the specifics, but the policy paid for a substantial amount of the care in Assisted Living for him, and full-time care for her in the memory unit.

At that time, more than 5-10 years ago, they used well over 500K in benefits. There is nothing like that coverage today, as I understand it.

I chalk this up to declining Consumer Protectionism, and care costs gone insane.

We're self-insuring. She will probably live into her 90's. My daughter will be fully capable and funded to provide assistance needed.

 

[LateToFIRE]

There is no peace of mind. In my opinion LTC insurance is a rip off. My mother would have been much better off putting the premiums in a savings account.

MIL had LTC insurance. Reached the same conclusion - would have been better off investing the premiums. Had to jump thru many of the hoops you are describing. I would never purchase LTC insurance for these reasons. I know it has worked for some folks, but clearly its a role of the dice - and what is insurance for, but to eliminate uncertainty. No thanks! Sorry for your suffering - hope it goes better from here on out.

 

[MarieIG]

I'm certainly sorry to hear about Harlee's ongoing problems. This is certainly not a ringing endorsement for that "provider."

 

[harllee]

I'm certainly sorry to hear about Harlee's ongoing problems. This is certainly not a ringing endorsement for that "provider."

Yes Metlife has been awful but the person at mother's CCRC who deals with LTC insurance claims say Metlife is no worse than the rest of the insurance companies--they all deny and delay in the hopes that the insured will die or the family will give up.

 

[Koolau]

Sadly some LTCi insurance companies are going to do everything they can to get out of paying at the time one needs it the most. I’m not a fan of LTCi. I agree money would be better placed elsewhere.

I'm sure that's true - unless you need it. I've mentioned before that my mom had a policy (too long ago to recall the company name.) She absolutely needed that policy when she went into memory care. Without it, there would have been much more hassle than chasing payments from the LTCi company (and we never had to do that.) They had a very responsive phone service. I always talked to the same person. I forget why I needed help, but it wasn't to get them to pay. Maybe those days are long gone.


I feel so sorry for harllee that she must go through this now, but I'm guessing it is "worth it" when you consider the alternative. But, YMMV.

 

[Sunset]

Yes Metlife has been awful but the person at mother's CCRC who deals with LTC insurance claims say Metlife is no worse than the rest of the insurance companies--they all deny and delay in the hopes that the insured will die or the family will give up.

I saw the same thing with life insurance for my "Uncle" , and later worked with an ex-insurance worker, who said they got bonus/recognition for the delay/deny of benefits.

Obviously delaying or denying payments increases the profitability of an insurance policy.

 

[harllee]

I saw the same thing with life insurance for my "Uncle" , and later worked with an ex-insurance worker, who said they got bonus/recognition for the delay/deny of benefits.

Obviously delaying or denying payments increases the profitability of an insurance policy.

This is just criminal

 

[Closet_Gamer]

I would like to see a whole new class of consumer protection law related to the elderly.

People like the OP's mom are completely incapable of protecting themselves from predatory (or simply incompetent) execution by big companies. They either get away with making money through incompetence or a loved one has to step in and advocate that companies do what they signed up to do. This is particuarly critical with insurance as the money involved can be quite large, but I would apply it to other services as well.

I would raise my hand in a heartbeat for 100x (or even 1000x) penalities, paid to the customer, for "errors" in processing. It would clean these issues up in about a week. You "accidentally" didn't pay grandma back for $500 of LTCI? That will be $50K please.

 

[harllee]

I would like to see a whole new class of consumer protection law related to the elderly.

People like the OP's mom are completely incapable of protecting themselves from predatory (or simply incompetent) execution by big companies. They either get away with making money through incompetence or a loved one has to step in and advocate that companies do what they signed up to do. This is particuarly critical with insurance as the money involved can be quite large, but I would apply it to other services as well.

I would raise my hand in a heartbeat for 100x (or even 1000x) penalities, paid to the customer, for "errors" in processing. It would clean these issues up in about a week. You "accidentally" didn't pay grandma back for $500 of LTCI? That will be $50K please.

When someone like my 94 year old mother with Alzheimers needs to make a claim on LTC insurance she has to rely on a family member and the insurance company knows this. My mother worked with an agent when she bought the policy in 1986 but that agent is dead and his company is long gone. Most family members would just give up rather than go through what I have been through to make the insurance company pay and the insurance company knows this.

 

[LateToFIRE]

I would like to see a whole new class of consumer protection law related to the elderly.

People like the OP's mom are completely incapable of protecting themselves from predatory (or simply incompetent) execution by big companies. They either get away with making money through incompetence or a loved one has to step in and advocate that companies do what they signed up to do. This is particuarly critical with insurance as the money involved can be quite large, but I would apply it to other services as well.

I would raise my hand in a heartbeat for 100x (or even 1000x) penalities, paid to the customer, for "errors" in processing. It would clean these issues up in about a week. You "accidentally" didn't pay grandma back for $500 of LTCI? That will be $50K please.

Yes! Having dealt with aging, failing parents I can vouch for the extraordinary level of unethical and criminal behavior that constitutes a multi-billion dollar industry of ripping off the elderly. Even stuff as simple as magazine subscriptions - ever wonder why you get reminded/billed so often - because they know elderly subscribers can't keep track and pay the bill multiple time over. Charitable solicitations - even some of the most legit charities will repeatedly send harassing begging letters for precisely the same reason. TV shopping networks - sure you thought you were tracking your mom's credit cards, but you didn't know she could get instant credit elsewhere where they are happy to take ten orders for the same exact thing in one day.

Everything from big companies to international crime rings have set their predatory sights on the elderly. And the consumer protections are absolutely dismal. This is a national shame. Makes me very concerned about our future. i don't understand why this isn't a bigger societal priority given older folks comprise a larger proportion of voter participation.

 

[Dreamer]

I would like to see a whole new class of consumer protection law related to the elderly.

People like the OP's mom are completely incapable of protecting themselves from predatory (or simply incompetent) execution by big companies. They either get away with making money through incompetence or a loved one has to step in and advocate that companies do what they signed up to do. This is particuarly critical with insurance as the money involved can be quite large, but I would apply it to other services as well.

I would raise my hand in a heartbeat for 100x (or even 1000x) penalities, paid to the customer, for "errors" in processing. It would clean these issues up in about a week. You "accidentally" didn't pay grandma back for $500 of LTCI? That will be $50K please.

+100. I don't understand why something isn't being done either.

 

[Koolau]

All together now:


CLASS ACTION LAWSUIT!

 

[aja8888]

All together now:


CLASS ACTION LAWSUIT!

Where's the class members?

 

[Koolau]

Where's the class members?

Well, we all know one!


I'm sure harllee's mom is not the only one - especially if the buzz is correct (that all the LTCi companies delay, delay, deny, deny.) YMMV

 

[youbet]

Harlee,

Remind me please, is you DM residing in the memory care section of the CCRC? Or is she still in her independent living apartment with extra services being delivered to her there?

 

[harllee]

Harlee,

Remind me please, is you DM residing in the memory care section of the CCRC? Or is she still in her independent living apartment with extra services being delivered to her there?

My mother is still in Independent Living with caregivers 6 to 8 hours per day. It is the cost of the caregivers that the LTC insurance is suppose to be paying but they have not paid the December bill, claiming they have never received it even though it has been faxed to them twice. I am sure mother will eventually need to move to memory care or skilled nursing, right now skilled nursing is being recommended because her main issue now is heart failure and she does not wander which would necessitate memory care.

 

[RetiredHappy]

My mother is still in Independent Living with caregivers 6 to 8 hours per day. It is the cost of the caregivers that the LTC insurance is suppose to be paying but they have not paid the December bill, claiming they have never received it even though it has been faxed to them twice. I am sure mother will eventually need to move to memory care or skilled nursing, right now skilled nursing is being recommended because her main issue now is heart failure and she does not wander which would necessitate memory care.

Did you sign an assignment of benefits to the CCRC? If not, it is a good thing to do. Once assigned to the CCRC, it is their responsibility to co-ordinate with the LTCI company to get necessary paperwork to them and get paid.

 

[youbet]

My mother is still in Independent Living with caregivers 6 to 8 hours per day. It is the cost of the caregivers that the LTC insurance is suppose to be paying but they have not paid the December bill, claiming they have never received it even though it has been faxed to them twice. I am sure mother will eventually need to move to memory care or skilled nursing, right now skilled nursing is being recommended because her main issue now is heart failure and she does not wander which would necessitate memory care.

My prediction is that once she is in either memory care or skilled nursing, your issues having the folks at Met Life pay will improve as that is a much more straight forward situation.

I hope things go as smoothly as possible for you both.

 

[harllee]

Did you sign an assignment of benefits to the CCRC? If not, it is a good thing to do. Once assigned to the CCRC, it is their responsibility to co-ordinate with the LTCI company to get necessary paperwork to them and get paid.

I asked the CCRC about that and they will not do it. They will file the paperwork and it is up to me to get the payment