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Long term care insurance affects Florida’s elderly population in many ways; unfortunately, most of them aren’t in good ways. Claim denials and stalling tactics are commonplace, according to Dan Thornburgh, a Florida attorney whose firm represents long term care policyholders, and they have an emotional and physical effect on many.

How do insurance company denials affect the elderly as a whole?

That’s the first question we asked Thornburgh in a recent interview. He told us:

It’s really quite sad. The elderly who purchase these insurance products are thinking ahead. They don’t want to become a burden on their family should they ever become chronically ill. It really has an emotional and physical effect on these people because their claim is suddenly denied and they either have to divert resources from their own funds or get their families to help. A wrongful denial also has consequences to tax payers. When a claim is denied, Medicaid often ends up paying for the care of the insured.

Minimizing claims issues

There are certain things that policyholders can do to minimize problems in the claims process. Thornburgh explained, “Regarding the claims process, it’s best to act as soon as possible. Once a doctor has determined that you are functionally incapacitated, you really need to make the claim right away. Be as thorough as possible and provide all the forms and documents that are required. Always keep copies of everything for your file as well. That way you have proof that you sent those forms and that you did it on a certain date.”

When to seek outside assistance

Even the most organized and persistent policyholders can find themselves with their backs against the wall when trying to get their claims paid. When that happens, it may be time to seek outside assistance. Thornburgh explained:

The most important reason to contact a lawyer who handles these types of cases is that he or she has experience, knows what to look for and knows how to get the company to pay the claim sooner rather than later. I think you need somebody who isn’t scared to go up against some of these multi-billion dollar insurance companies and fight them until the consumer gets the relief that they’re entitled to based on the insurance contract.

Documentation tells your story

Most policyholders will be able to resolve claims issues with their insurance carriers. However, in those cases that simply cannot be resolved, Thornburgh says that documentation regarding the claim tells your story. “Every document that an insured receives from the insurance company should be saved or preserved somewhere, either electronically or in a file somewhere, so that we have all the documentation we need and proof of the case. The things I look for is the insurance policy itself and all the correspondence that was sent to and from the insurance company. All of those documents are going to tell me a story about the case, about the delay tactics that may have been used and about the denial of the claim.”

If your long term care insurance company has denied your rightful benefits, it may have acted in bad faith and you might want to contact an attorney whose practice focuses in this area of the law. Consultations are strictly confidential, free of charge and without any obligation. To contact a qualified attorney, please click here. We may be able to help.