A friend of mine told me of the problems that he had with a carrier.
They did everything my USMail. He had to request a form and then
have the doctors fill it out and USMail it. They had no e-mail or FAX.-
at least that is what they said at the time.
They then had 30 days to respond, again by mail; and at one point
they had to refer it up to management- another 30 days.
And if they did not approve of the facility you were intending to enter,
they would deny payment and you would have to find another one-
yes with a 30 day delay. They did not give you a list of "approved" facilities ahead of time in your area.

So I just wonder, if you have a waiting period of 90 days and then another
90 days of delays, just how good would a LTHC plan be. Most do not survive in a facility much beyond a year.

Is this common. There seems to be little on the internet to discuss the ease or problems in getting the insurance companies to pay. And if they are not doing well- as is the case now- this delaying tactic might become the norm.

Any insight would be appreciated.

I guess I can't speak for your friend or his experience, but let me share my personal experience with you. My mother-in-law is currently in a rehab facility. I called the carrier with whom she has her LTC insurance. They e-mailed me the claim form. We completed it and faxed it back. Within 4 days of my initial phone call, the carrier had started the claims process, contacted the physician involved, and has spoken with the facility where my mother-in-law is currently residing. She has a 90-day deductible. The claim will be approved well before she satisfies her deductible.

I have one client who has no surviving family members, no personal representative, she's in a facility with advanced Alzheimer's disease, and her LTC carrier - who no longer actively sells long term care insurance - is sending the benefit check to the facility, every month, month after month after month.

My mother in law, and the client I mentioned here, chose good, reputable companies. I have a sneaking suspicion that your friend is / was dealing with one of the industry's notorious, second tier carriers. There are companies, as there are with any line of insurance, that are less user-friendly. They sell their product at a lower price, and you run into this sort of thing at claim time. If you buy insurance from a credible carrier, you'll be treated well. If you cut corners and use a second rate carrier, you may not. I hope your friend gets his issues resolved.

If you want to know which companies are easy to work with at claim time, and which aren't, all you need to do is call nursing homes in your area and ask them if they've had experience with this. They'll tell you which companies put up road blocks, and which don't. You'll get the same answers every time.

Kerry,
You've supplied tpoto with a good answer to a very "questionable inquiry".

First of all, his post about his friend is hearsay. I'm not sure if what he says makes sense and the proof of that is his statement:
His friend says "they did everything my USMail. He had to request a form and then have the doctors fill it out and USMail it. They had no e-mail or FAX".

You & I have been in this business for a while. In all of the years dealing with a carrier (I started in 1995) have you EVER heard about an insurance company that does not have a either a fax machine or email account?

Personally I think this is a bogus post.
Arthur

Tsk, tsk... are you implying, Arthur, that someone might post falsely on this board, in hopes to incite some sort of damaging rant from an agent? I'm shocked. Shocked, I say...

I'm a bit suspicious as well, but the answer's the same, even if it is bogus. Our industry helps a lot of people, every day, and I'll never pass up an opportunity to let people know about it. Besides, maybe the fax machine just wasn't working that day, or the claims "department" was busy cleaning the men's room.

That's it!
I stand corrected.

Arthur