Long Term Care Insurance Litigation
Long Term Care Insurance (LTC) is part of responsible financial planning for many. You purchase insurance and pay premiums for years to protect your savings in the event that you or a loved one require expensive medical care.
Insurance companies have convinced us that we must have such protection with increased life expectancy the associated risks of Alzheimer’s, stroke, Parkinson’s and other disabling conditions. However, insurers do not always hold up their end of the bargain when it comes time to pay. When these benefits are wrongfully denied or terminated, we have the experience and expertise to even the playing field, even if litigation is necessary to resolve the dispute.
Employer Provided LTC Insurance
Similar to disability policies, if LTC insurance is employer-provided and therefore governed by ERISA, an individual must first file an appeal directly to the insurance company. Our firm handles these appeals on a national basis. If the appeal is denied, we will file a lawsuit on your behalf, normally in federal court. Even if the policy was purchased privately and is not ERISA governed, the companies will often consider an internal appeal in lieu of filing in Court. We can assist you during any appeal.
Why do I need a lawyer for an appeal?
The vast majority of appeals are denied. Think about it, you are appealing to the company that denied your claim or terminated your benefits. The only way to convince the insurer to reverse their denial is to convince them that you will win when you go to Court. We place a lot of attention and focus on the appeals process. This is due to the fact that we understand how important it is to any given case because:
- It greatly increases chances that the insurance company will reverse their denial and grant benefits; and
- If the case ultimately goes to court, the court will look heavily upon evidence submitted to the insurance company during the administrative appeals process. So it is to your advantage to submit as much relevant information as possible for the record.
COMMON ISSUES IN LONG TERM CARE INSURANCE DENIALS/TERMINATIONS
The following are common issues that arise in LTC disputes with insurance companies:
- Whether you qualify for benefits and how much
- Whether your benefits are limited or excluded by policy language
- Your right to choose your care and providers
- Whether your LTC policy covers home health, transportation, etc.
- Whether your LTC policy covers prescribed treatment or equipment
- Whether you are entitled to round-the-clock care
- Whether you can choose to remain in your home vs. assisted living
« Return to the ERISA & Insurance Litigation Resource Center
- What Do You Do If Your Benefits Have Been Wrongly Denied?
- How Will I Pay for My ERISA Disability Lawyer?
- Do You Qualify for Long Term Disability Benefits?
- What Is a Social Security Offset?
OUR CLIENTS LOVE US, AND SO WILL YOU. SEE WHAT CCK CLIENTS HAVE TO SAY.
- It has been one of the best legal experiences that I have personally encountered. Their follow up and their follow thru has been on perfect terms. Wow, they have given me a celebrity experience! Impressive! Read More »
- These people are FANTASTIC!!! I highly recommend this firm to Veterans everywhere. Honest Legal Help like this is priceless and they are extremely skilled. So Satisfied with the results...5 stars!! Read More »
- I cannot begin to say how grateful I am to this Firm. From the Class A staff to the Lawyers, there are no complaints. Everyone treated me fantastic!! After 30 yrs of fighting on my own, they were able to win my case in less than 15 months. Read More »
- My case was initially rejected by the VA but with the thorough review by CC&K , the VA agreed with the case that CC&K made and awarded my initial rating of 30% retroactive to 1975. Read More »
- We had struggled for eight plus years, with the VA, and got nowhere. Our case was sent to CC&K and in less than one year, we were they won all his back pay and 100% rating. We could not be more pleased. We highly recommend this firm for anyone struggling with the VA. Read More »
- I thought I could go it alone. I filed several disability claims through the VA only to be denied over and over again. I knew I needed help. I found that help with the law firm of Chisholm Chisholm & Kilpatrick. They filed for me and won. Read More »
- I'm so glad we sought the help of CCK on my husband's VA claim. We had been going back and forth with the VA for 5 years on his claim without seeing any progress. Then we found CCK and the case was resolved in about a year! Read More »
- I was fighting for my VA disability compensation for 10 years. I was ready to give up and then CCK took my case. I immediately felt at ease because they kept me informed every step of the way and there was so much less stress for me. Read More »