When you file a long-term care insurance claim, remember that insurance companies train their claims examiners to thoroughly analyze every aspect of it. One little misstep on your application can cause your long-term insurance claim to be delayed, or worse yet, denied. And, insurance companies have legions of lawyers who will fight for them on their behalf to limit your payout.
At Leader & Leader, our Ft. Lauderdale insurance attorneys are on your side. We will make sure your insurance company treats you ethically and fairly and does not take advantage of your inexperience with insurance laws. As long-term insurance attorneys, we represent individuals whose claims have been denied or delayed and, if necessary, we will file a lawsuit to recover benefits. At Leader & Leader, we never represent insurance companies.
What Are Some Reasons Long-term Insurance Claims Are Denied?
Insurance companies have many reasons for denials of long-term insurance claims. Some of the reasons you may hear include:
- Your paperwork is filled out incorrectly or got lost.
- Your long-term care services were not appropriately documented.
- Your nursing assessment shows you are not “cognitively impaired” or don’t require assistance in your daily living.
- You are no longer qualified for long-term benefits because you are able to perform too many activities of daily living.
- Your long-term insurance policy was cancelled due to non-payment.
- The long-term care services that were provided to you are not covered under your policy.
- Your long-term care services were not provided by an “approved” medical professional.
- Your long-term care services were provided by a family member who was not a qualified professional under the terms of your policy.
- The long-term care services that were provided to you were not provided by a nursing home or home care provider that was certified by Medicare.
- The insurance company hired its own doctor or nurse to review your claim or examine you who says you do not qualify for long-term care benefits, even though your doctor says you do.
- Your condition is pre-existing.
- Your condition was excluded by a rider on your policy.
- Your medical condition is not covered because it is the result of mental illness, substance abuse or drug addiction.
Appealing the Wrongful Denial of Long-Term Care Insurance Claims
Just because your long-term care insurance claim has been denied, does NOT mean you should give up hope. Our skilled insurance attorneys are familiar with appealing wrongful denials and will use either negotiation or litigation to get you the long-term care benefits that are rightfully yours.
As insurance attorneys, we have the knowledge to respond to your insurance company in language it understands. Most long-term care insurance policies contain complex and confusing contractual language. Our job will be to read your long-term care insurance policy thoroughly and prepare an effective response to their denial of your claim.
Our job is to hold the insurance companies accountable for their actions and enforce the contractual rights of our clients. We understand that a significant portion of your financial future is dependent on our legal representation. We have earned the trust of many clients throughout Ft. Lauderdale and the surrounding communities and get excellent results for our clients.
If you need help filing or appealing a claim, or understanding your long-term care policy, trust the Ft. Lauderdale insurance attorneys at Leader & Leader to help maximize your benefits and protect your rights. Call 954-523-2020 today to let us help speed up your long-term insurance claims or denial process.