Long Term Care Insurance

How To Fight For Your Benefits

New York Life long term insurance claim denials are common.  New York Life Insurance Company has a long history of improperly denying long-term care (LTC) insurance claims. Across the country, policyholders are repeatedly being forced to file lawsuits against the company in order to recover the long-term care benefits that they are owed under their New York Life long-term care policy.

It’s not uncommon for insurance companies like New York Life to deny claims with an eye toward maximizing their profits. In many cases, insurers will not properly investigate a long-term care claim until legal action is brought against them. That’s where Donahue & Horrow long term care insurance lawyers can help.

Our team has extensive experience advocating for policyholders like you. After all, you’ve paid your insurance premiums and New York Life should honor the policy. Sadly, this is not always the case.

New York Life is not the only company that has a pattern and practice of improperly denying long-term care insurance claims. Many insurance companies deny claims without a legitimate investigation or reason. Do not let New York Life or any other insurance company bully you into accepting their explanation as to why you are not entitled to benefits under your policy. You can always fight for your insurance proceeds. After all, you held up your side of the contract. The insurance companies should to do the same.

 

How You Can Qualify for Long-Term Care Insurance Benefits

While every insurance policy is different, most LTC policies state that you will qualify you for long-term care benefits if you need assistance with two of six activities of daily living (also referred to as ADLs). These are ADLs include:

• Getting dressed
• Eating and feeding oneself
• Continence
• Using the restroom
• Daily hygiene and bathing activities
• Transferring (getting out of bed or chair)

For instance, you would qualify for LTC benefits if you have difficulty or need help with bathing and also getting dressed. In most situations, a cognitive impairment would also qualify for you for benefits.

Insurance companies, like New York Life, always require that you provide written proof from your doctor or a licensed healthcare professional that you need assistance with any two of the ADLs. Other documentation to help your case could include a daily journal that records the time and place of your specific challenges. A video record of your daily life that proves your need for assistance is a powerful way to tell your story.

 

The Key Is To Know Your Policy

It’s important to know precisely what you qualify for under the terms of your policy. If New York Life denied your long-term care claim, take another look at the policy to see if you believe the denial was consistent with the terms of the policy.

For example, many LTC policies have a set limit of reimbursement per day. It could between $100 to $500 per day. And, these daily expenses add up fast. If denied, you or your loved one could be forced to pay from your estate assets. Your incentive to fight a denial couldn’t be stronger. You should be familiar with these details prior to filing a claim

Other things to know about your policy benefits include:

– Who can be a caregiver? A family member, or a professional caregiver?

– Do you have to live in a care facility to receive benefits? Or can you live at home?

We understand that insurance policies can often seem long and confusing. The attorneys at Donahue & Horrow have reviewed thousands of different insurance policies, and if you are confused, will be able to explain the ins and outs of your long-term care policy to you.

 

Contact Us

Donahue & Horrow attorneys will treat you with compassion and respect. We understand that you or your family member are facing significant physical, emotional and financial challenges. It’s impossible to fight the combined strengths of a huge insurance company while continuing to face your daily challenges. By working with us, we will handle the insurance company so you can take care of yourself and your loved ones.

We take all of our cases on a contingency basis – you do not need to pay us anything unless and until we recover insurance benefits for you. If your claim has been denied, or even if it hasn’t been denied yet, call us today for a free consultation.

Our firm is based in  Los Angeles, but we travel and litigate cases throughout California, and even the entire United States. We can schedule a date and meeting location that’s convenient for you.

Phone: 310-322-0300
Toll Free: 877-664-5407
Fax: 310-322-0302

Donahue & Horrow LLP
1960 E. Grand Avenue, Suite 1215
El Segundo, CA 90245

Long-term care insurance explanation.