Long Term Disability Insurance

1,125 Views | 5 Replies | Last: 2 yr ago by Tecolote
Tecolote
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AG
I know many will say "read the contract" but before I spend endless time over fine print, I wanted to see if anyone has personal experience or is in the insurance business. So, my situation/question:

My father passed away a couple months ago and had been a nursing home for about 18 months. He was always the type to pay things well in advance. So, I just got a refund check for partial premiums (seems they monitor SSN of deceased to match with clients) on a long term care insurance policy that would have paid for much of his nursing home and also the in-home health care worker I hired before he went into a home.

Unfortunately, I did not even know he had this policy so I was not aware to file for payment of his care. Is there any way to go back and submit documentation from his doctor, receipts, etc. in hopes of any reimbursement? or is it just "**** happens" and SOL. The policy was paid up and in effect at the time of his care and before his death.
SquareOne07
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AG
Long term care and disability insurance are 2 different things.

Who is the policy through?
Tecolote
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AG
SquareOne07 said:

Long term care and disability insurance are 2 different things.

Who is the policy through?
Bankers Life

My cursory review of the policy has it specifically indicating nursing home for elderly - so probably long term care is a better reference?
one safe place
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Yes, it sounds like you are dealing with long-term care. I would bet that buried in all the fine print for the policy it will address the deadline for submitting a claim. I am speculating but if you get anything at all, it will only be for the most recent two or three months.

Insurance companies are quite efficient at taking premiums and known to delay and fight paying out claims but in this case, I bet the policy documents specify the time frame. Good luck.
Stive
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AG
Like one-safe-place said, some carriers have claim submission limits but many actually don't and the state's insurance boards frown on them. It's definitely worth reaching out to the company to see if a claim would be possible. If it's a "nursing home only" policy, then your caretaker at home situation wouldn't fit the policy but the later months of the nursing home would. Depending on the structure of the policy the waiting period on it could be anywhere from 30 days to 1 years (most common is 90 days). After that point a claim could have been possible and if it wasn't too long ago, might still be payable.

Long-term care policies typically work on reimbursement protocols so you're going to need to keep the bills/receipts from that stay in the nursing home to use as a evidence in filing the claim. They'll also want medical records to show loss of cognitive abilities or physical limitations where the activities of daily living are concerned.

For sure give it a try and see what happens.
Tecolote
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AG
Thank you both - sounds like it's worth a shot to look into!
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