Anecdotal issue with receiving LTCi benefits

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Anecdotal issue with receiving LTCi benefits

Postby TomatoTomahto » Sun Mar 24, 2013 11:07 am

This is different from the back and forth about the wisdom of Long Term Care insurance we've already had on the forum. I found this Haggler article in the NYT interesting, as it discusses the difficulty one family has had in receiving benefits. After being contacted by the Haggler, the insurance company agreed to re-open the case.

http://www.nytimes.com/2013/03/24/your-money/a-winding-road-to-benefits-from-long-term-care-insurance.html?ref=todayspaper&_r=0
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Re: Anecdotal issue with receiving LTCi benefits

Postby Honobob » Sun Mar 24, 2013 11:34 am

I'm sure the family was happy to get the $24,000+ for the care as they had no other plan. My LTCi has a third party concierge service through Univita Living that will take care of things like this. It even provides for a "circle of friends" named by me that will be my advocate if I'm unable. i'm sure these insurers will encounter many attempts at fraud and unfortunately claims will be scrutinized same as any other insurance claim.
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Re: Anecdotal issue with receiving LTCi benefits

Postby TomatoTomahto » Sun Mar 24, 2013 11:39 am

Honobob wrote:I'm sure the family was happy to get the $24,000+ for the care as they had no other plan.


I'm confused. $24,000+???
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Re: Anecdotal issue with receiving LTCi benefits

Postby Honobob » Sun Mar 24, 2013 11:43 am

TomatoTomahto wrote:
Honobob wrote:I'm sure the family was happy to get the $24,000+ for the care as they had no other plan.


I'm confused. $24,000+???

$4,000 a month for care times 5-6 months. If it's a legimitate claim the insurer will have to back pay to the eligible date.
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Re: Anecdotal issue with receiving LTCi benefits

Postby TomatoTomahto » Sun Mar 24, 2013 11:49 am

Honobob wrote:
TomatoTomahto wrote:
Honobob wrote:I'm sure the family was happy to get the $24,000+ for the care as they had no other plan.


I'm confused. $24,000+???

$4,000 a month for care times 5-6 months. If it's a legimitate claim the insurer will have to back pay to the eligible date.

As the Haggler notes, the company has reopened the case. It does not mean that any money has been paid, nor that it necessarily will. Even the Haggler, who has the public spotlight of the NYT to shine on the matter, was surprised not to be blown off by an insurance company.
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Re: Anecdotal issue with receiving LTCi benefits

Postby nisiprius » Sun Mar 24, 2013 11:55 am

I believe "do they pay" is a very legitimate and important question about LTCi.

Before I read the article, I am going to ask the question: is this a company I consider "reputable?" Then I will go and read the article. Companies I consider "reputable" include John Hancock, Genworth, Metlife, and TIAA-CREF--I don't know which if any are still writing LTCi insurance. "Reputable" means they may be sleazy with regard to raising rates but they behave as expected with regard to claims. The only "disreputable" company I know by name is Conseco.

Now I am going to read the article.

OK, it's CNA, I didn't have any pre-existing impressions one way or another about CNA.

With regard to the issue as described, I simply can't tell what I think. The big mystery to me is how "Dr. Visekruna" came to be involved, and whether Mr. Kotz was aware of the contents of her report. It seems reasonable to me that if the insurer had paperwork from a medical professional that translated into "not covered," the key thing needed to resolve the situation was to make sure the insurer got paperwork from a medical professional that translated into "covered."

If Dr. Visekruna was an "independent" doctor sent by the insurer--independent like the "independent" optometrist whose office is conveniently colocated on the premises of the national eyeglass chain--well, then, one wonders.

The other big unanswered question is, in the course of that five months, could Mr. Kotz have arranged for an evaluation by another "independent" doctor and would that have done anything... or was the intervention of the press really required.

The take-home might be... at the point where an LTCi claim is being considered, it might be a good idea to pay for a doctor of your own choice to make an evaluation... or then again maybe it wouldn't help.
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Re: Anecdotal issue with receiving LTCi benefits

Postby BruDude » Sun Mar 24, 2013 12:12 pm

CNA was probably the worst-run insurance company ever, so this is not surprising. There are a lot of articles like this about getting CNA LTCi claims paid. From the article it sounds like this is not a tax-qualified policy where benefits are triggered when two of the six ADL's cannot be performed, or where dementia is an automatic trigger.
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Re: Anecdotal issue with receiving LTCi benefits

Postby OldWetHen » Sun Mar 24, 2013 12:35 pm

My mother was insured through Genworth- supposedly one of the better insurers. An obvious issue is that the insurer needs to cover their costs- their lovely buildings, many minions, independent agents, phone calls, and so on. They can't afford to pay out anything near what folks pay in- so, like any insurance scam, they're set up not to do so. First, they only start paying when you can't take care of yourself. Someone else has to be your advocate. If you're paying that person to do so, you've already lost the battle. Second, anything they don't understand immediately, they don't pay. After explaining about 10 times they might start paying, but then you have to convince them to pay retroactively. That can take years. Third, they have a list of what they do and don't cover, which must make sense to them. Bottom line, my mother could have invested the same money in a fund she could access as needed, without proving anything to anybody. She then could have taken out everything she put in, instead of needing to cover various expenses herself. My take-away lesson- yes, set aside money for long term care expenses, but skip the insurance business. You're much better off being self-insured. Now if I can only get Genworth to cough up the last $6000 they owe us. My mother's been gone over a year, and I guess it's time to make phone call #25 about this claim. Maybe the claims analyst's boss's boss will help?
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Re: Anecdotal issue with receiving LTCi benefits

Postby Honobob » Sun Mar 24, 2013 1:12 pm

OldWetHen wrote: You're much better off being self-insured.

Yeah, but how would you accomplish a plan that would pay out over $200,000 each and every year say 20 years from now, or needing $70,000 a year today?
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Re: Anecdotal issue with receiving LTCi benefits

Postby TomatoTomahto » Sun Mar 24, 2013 4:40 pm

Honobob wrote:
OldWetHen wrote: You're much better off being self-insured.

Yeah, but how would you accomplish a plan that would pay out over $200,000 each and every year say 20 years from now, or needing $70,000 a year today?


I'm no genius, but I managed such a plan, which mainly consists of saving a lot :D

That said, it is because we fall outside the "sweet spot" for LTCi, which Consumer Reports says might work for people not poor (because they can't afford the premiums) nor rich (because they can self-insure). I can't say that I'm rich, but we have enough to substitute for LTCi payments.
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Re: Anecdotal issue with receiving LTCi benefits

Postby Honobob » Sun Mar 24, 2013 5:03 pm

TomatoTomahto wrote:
Honobob wrote:
OldWetHen wrote: You're much better off being self-insured.

Yeah, but how would you accomplish a plan that would pay out over $200,000 each and every year say 20 years from now, or needing $70,000 a year today?


I'm no genius, but I managed such a plan, which mainly consists of saving a lot :D

That said, it is because we fall outside the "sweet spot" for LTCi, which Consumer Reports says might work for people not poor (because they can't afford the premiums) nor rich (because they can self-insure). I can't say that I'm rich, but we have enough to substitute for LTCi payments.

Would you share your plan? What assumptions are you making? From what age did you have "coverage? It looks like one would need $5,600,000 per person in their portfolio 20 years from now to have a 4% withdrawal rate to cover basic LTC coverage of $225,000 a year.
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Re: Anecdotal issue with receiving LTCi benefits

Postby donall » Sun Mar 24, 2013 5:09 pm

Yes, this article and similar stories are what always stops me from going out and buying LTC insurance. I'd love to buy LTC insurance but am leery of having to work with the LTC insurance to pay valid claims. I've set aside a LTC fund and will be taking my chances.

So this brings me to today, where I am the advocate for a relative who has two LTC policies. One, in the Penn Treaty group, is in rehabilitation, while the other policy was taken over by CNA. :oops: :oops:

A lot has happened since this relative purchased these policies. Although the relative dodged a big one this month with a successful surgery and rehabilitation, I hope there will be no need to use either policy.
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Re: Anecdotal issue with receiving LTCi benefits

Postby Honobob » Sun Mar 24, 2013 5:33 pm

donall wrote: I've set aside a LTC fund and will be taking my chances.

So roughly, you'd need $1,300,000 TODAY at 60 and count on 8% compounded growth for the next 20 years and if you die at 79............? Meanwhile, I'll have spent maybe $70,000 (and spent my earnings on my $1,300,000 of $104,000 each and every year!) for LTCi and have 30 years of coverage.
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Re: Anecdotal issue with receiving LTCi benefits

Postby TomatoTomahto » Sun Mar 24, 2013 5:46 pm

Honobob wrote:
TomatoTomahto wrote:
Honobob wrote:
OldWetHen wrote: You're much better off being self-insured.

Yeah, but how would you accomplish a plan that would pay out over $200,000 each and every year say 20 years from now, or needing $70,000 a year today?


I'm no genius, but I managed such a plan, which mainly consists of saving a lot :D [snip...]

Would you share your plan? What assumptions are you making? From what age did you have "coverage? It looks like one would need $5,600,000 per person in their portfolio 20 years from now to have a 4% withdrawal rate to cover basic LTC coverage of $225,000 a year.

As I said, the plan consists mostly of saving a lot. No particular assumptions, other than that Financial Engines and ESPlanner are reasonably accurate when fed conservative inputs. I guess we've been "covered" from around age 35 or so (first through disability insurance and then with our portfolio).
The policies I've seen don't pay out $225k per year, unless you're talking inflated dollars. Most seem to pay a couple-few hundred per day.

Anyway, we're getting off topic (I.e. rehashing prior threads). I started this thread to point out an additional risk: whether or not a claim will be deemed legitimate and how apparently the decision is in the hands of the insurance company. How does your third-party advocate work? I'm not familiar with it; perhaps that's something to consider.
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Re: Anecdotal issue with receiving LTCi benefits

Postby mickeyd » Sun Mar 24, 2013 5:47 pm

I've worked for enough insurance companies over the years to realize that the best way to keep money from flying out the door is to close the door for as long as possible.
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Re: Anecdotal issue with receiving LTCi benefits

Postby TomatoTomahto » Sun Mar 24, 2013 5:52 pm

donall wrote: I've set aside a LTC fund and will be taking my chances.

Why would you have an LTC fund? I don't have one, any more than I have a groceries fund, or an automobile fund. My retirement income can be given to a care provider, or can be spent on groceries or cars. The wonderful thing about money is that it's fungible.
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Re: Anecdotal issue with receiving LTCi benefits

Postby OldWetHen » Sun Mar 24, 2013 6:07 pm

One last comment- my mother signed up over 20 years ago, and her final benefits were a max of $165K total, maximum $150 per day. I don't know where you're getting your expectation of millions in payment, and newer policies are only going to get less favorable. And, of course, the insurance companies get to decide what and if they want to pay.
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Re: Anecdotal issue with receiving LTCi benefits

Postby donall » Sun Mar 24, 2013 6:08 pm

Honobob wrote:
donall wrote: I've set aside a LTC fund and will be taking my chances.

So roughly, you'd need $1,300,000 TODAY at 60 and count on 8% compounded growth for the next 20 years and if you die at 79............? Meanwhile, I'll have spent maybe $70,000 (and spent my earnings on my $1,300,000 of $104,000 each and every year!) for LTCi and have 30 years of coverage.


Honobob, not sure why I need 1.3 million today to fund possible LTC. $80K X 2.5 years = $200K in today's dollars
Invest $200K and keep separate for future LTC or if not used, have some happy relatives. :D
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Re: Anecdotal issue with receiving LTCi benefits

Postby donall » Sun Mar 24, 2013 6:15 pm

TomatoTomahto wrote:
donall wrote: I've set aside a LTC fund and will be taking my chances.

Why would you have an LTC fund? I don't have one, any more than I have a groceries fund, or an automobile fund. My retirement income can be given to a care provider, or can be spent on groceries or cars. The wonderful thing about money is that it's fungible.


I agree, money is fungible. If I need LTC, then $$ will not be spent on groceries or a car. If you are setting aside money for LTC, then your calculation can be offset by pensions, SS, etc. See my previous post where if LTC fund is not used, then I predict happy relatives.

On the other hand, I think it is wise to have a capital outlay fund, where money is set aside for future cars, future major repairs, etc. This can be done the same way home associations have monthly assessments for future repairs.
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Re: Anecdotal issue with receiving LTCi benefits

Postby nisiprius » Sun Mar 24, 2013 6:20 pm

donall wrote:Honobob, not sure why I need 1.3 million today to fund possible LTC. $80K X 2.5 years = $200K in today's dollars
Invest $200K and keep separate for future LTC or if not used, have some happy relatives. :D
Where did you get "2.5 years" from? You're not making the mistake of thinking you don't need insurance if you can pay for the "average" event, are you? My circle of two-degrees-of-separation acquaintances includes several late people who had nursing-home stays with lengths in the vicinity of eight years. As well as half-a-dozen for whom it was less than six months. An insurance company gets to play the averages; an individual doesn't.
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Re: Anecdotal issue with receiving LTCi benefits

Postby TomatoTomahto » Sun Mar 24, 2013 6:24 pm

Donall, we're on the same page, separated only by semantics :D

Good for you to be an advocate for a relative. It is, however, sad that it's necessary, and even worse, for some (because of their particular circumstances),it's not even an option.

If you don't mind sharing, what resources are available for getting reimbursed and how much friction is there?
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Re: Anecdotal issue with receiving LTCi benefits

Postby donall » Sun Mar 24, 2013 6:36 pm

nisiprius wrote:
donall wrote:Honobob, not sure why I need 1.3 million today to fund possible LTC. $80K X 2.5 years = $200K in today's dollars
Invest $200K and keep separate for future LTC or if not used, have some happy relatives. :D
Where did you get "2.5 years" from? You're not making the mistake of thinking you don't need insurance if you can pay for the "average" event, are you? My circle of two-degrees-of-separation acquaintances includes several late people who had nursing-home stays with lengths in the vicinity of eight years. As well as half-a-dozen for whom it was less than six months. An insurance company gets to play the averages; an individual doesn't.


Nisiprius, yes I am basing my calculation on the average, because if I bought LTC insurance that is what I would buy. I would not buy eight years worth of LTC insurance.
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Re: Anecdotal issue with receiving LTCi benefits

Postby Professor Emeritus » Sun Mar 24, 2013 6:39 pm

nisiprius wrote:
donall wrote:Honobob, not sure why I need 1.3 million today to fund possible LTC. $80K X 2.5 years = $200K in today's dollars
Invest $200K and keep separate for future LTC or if not used, have some happy relatives. :D
Where did you get "2.5 years" from? You're not making the mistake of thinking you don't need insurance if you can pay for the "average" event, are you? My circle of two-degrees-of-separation acquaintances includes several late people who had nursing-home stays with lengths in the vicinity of eight years. As well as half-a-dozen for whom it was less than six months. An insurance company gets to play the averages; an individual doesn't.
Image



Most LTC insurance programs have 2-3 year benefit periods and specific benefit amounts. $150 a day for 3 years is about 160,000. that is all the insurance you are buying.
You are correct that a disaster will exhaust all savings, but insuring or not will not will not change that fact. It is rational to save and invest the equivalent of the payout from LTCI
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Re: Anecdotal issue with receiving LTCi benefits

Postby donall » Sun Mar 24, 2013 6:46 pm

TomatoTomahto wrote:Donall, we're on the same page, separated only by semantics :D

Good for you to be an advocate for a relative. It is, however, sad that it's necessary, and even worse, for some (because of their particular circumstances),it's not even an option.

If you don't mind sharing, what resources are available for getting reimbursed and how much friction is there?


TomatoTomahto, so far I have not gotten to the point of working with the relative's LTC insurance. I've read the contracts, filled out forms, and paid the premiums. I know I have a bad attitude about LTC insurance, but now learning that the second LTC insurance company is going to be a chore, I am discouraged. The worst part is that there is no way this relative could ever, ever get the LTC insurance to work. Why do we have long contracts that control the lives of our seniors?
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Re: Anecdotal issue with receiving LTCi benefits

Postby Honobob » Sun Mar 24, 2013 7:39 pm

donall wrote:
Honobob wrote:
donall wrote: I've set aside a LTC fund and will be taking my chances.

So roughly, you'd need $1,300,000 TODAY at 60 and count on 8% compounded growth for the next 20 years and if you die at 79............? Meanwhile, I'll have spent maybe $70,000 (and spent my earnings on my $1,300,000 of $104,000 each and every year!) for LTCi and have 30 years of coverage.


Honobob, not sure why I need 1.3 million today to fund possible LTC. $80K X 2.5 years = $200K in today's dollars
Invest $200K and keep separate for future LTC or if not used, have some happy relatives. :D

What do you think LTC will cost in 20 years? My 5% inflation policy will pay $226,000 a year but my understanding is that LTC is actually increasing about 7% per year. Your $200,000 invested today will cover you for about 22 months!
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Re: Anecdotal issue with receiving LTCi benefits

Postby donall » Mon Mar 25, 2013 9:08 pm

Honobob wrote:
donall wrote:
Honobob wrote:
donall wrote: I've set aside a LTC fund and will be taking my chances.

So roughly, you'd need $1,300,000 TODAY at 60 and count on 8% compounded growth for the next 20 years and if you die at 79............? Meanwhile, I'll have spent maybe $70,000 (and spent my earnings on my $1,300,000 of $104,000 each and every year!) for LTCi and have 30 years of coverage.


Honobob, not sure why I need 1.3 million today to fund possible LTC. $80K X 2.5 years = $200K in today's dollars
Invest $200K and keep separate for future LTC or if not used, have some happy relatives. :D

What do you think LTC will cost in 20 years? My 5% inflation policy will pay $226,000 a year but my understanding is that LTC is actually increasing about 7% per year. Your $200,000 invested today will cover you for about 22 months!


Honobob, not sure what $200K invested will cover in two years

Nisiprius, I know what you are saying with your graph. I remember reading what Steven Jay Gould wrote about cancer statistics
http://csn.cancer.org/node/213889
No matter how small a chance according to statistics, you may still be the unlucky one and then statistics really don't matter.
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Re: Anecdotal issue with receiving LTCi benefits

Postby robebibb » Tue Mar 26, 2013 10:14 am

nisiprius wrote:Image

This chart is useful but does not tell the whole story. Many people will spend some time in an assisted living facility before entering a nursing home. While cheaper than nursing homes, assisted living facilities are quite expensive and durations are lengthier. For example my grandfather was in assisted living for 2.5 years followed by 0.5 years in a nursing home. If he didn't have my grandmother to care for him he would have spent several additional years in the assisted living facility or in the home of a child with a paid caregiver.
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Re: Anecdotal issue with receiving LTCi benefits

Postby jeffyscott » Tue Mar 26, 2013 10:41 pm

Honobob wrote:
OldWetHen wrote: You're much better off being self-insured.

Yeah, but how would you accomplish a plan that would pay out over $200,000 each and every year say 20 years from now, or needing $70,000 a year today?


Who is selling a policy with unlimited coverage like that? As was mentioned in some previous posts the policies that can now be purchased all have limits of one kind or another. Then on top of that, they apparently won't pay anything without a fight. No thanks, not a product I am willing to buy.
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Re: Anecdotal issue with receiving LTCi benefits

Postby bluemarlin08 » Tue Mar 26, 2013 11:09 pm

Who is selling a policy with unlimited coverage like that?


Genworth, through AARP.
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Re: Anecdotal issue with receiving LTCi benefits

Postby dhodson » Wed Mar 27, 2013 8:28 am

But only through AARP
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Re: Anecdotal issue with receiving LTCi benefits

Postby john94549 » Wed Mar 27, 2013 10:46 am

Any insurance with a subjective trigger is difficult to administer. Experts can disagree as to whether someone is disabled, suffering from PTSD, unable to work, needing LTC, etc. What strikes me with all these anecdotal accounts is the total lack of empathy by either side for the other. It's almost as if "combat" is assumed as normal.

I would be happy to purchase a product which did not involve this hassle. Other than the obvious (which is to self-insure), any suggestions?
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Re: Anecdotal issue with receiving LTCi benefits

Postby bluemarlin08 » Wed Mar 27, 2013 10:59 am

One must remember that problem claims will always get the headlines, the overwhelming amount of claims are hassle free. The clients I see that have issues with claims is always due to the claimant not submitting the correct information.
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Re: Anecdotal issue with receiving LTCi benefits

Postby Sam I Am » Wed Mar 27, 2013 11:57 am

Message deleted.
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