When filing a claim on a Long-Term Care Insurance (LTCI) policy, it is critical that your client’s full needs are represented accurately to the insurance company. Unfortunately, policyholders frequently sabotage their own claim approval by over-asserting their independence beyond their own capabilities, often reporting that little or no help is needed when in truth there are safety concerns. Claims documentation must accurately demonstrate these true needs.

Often, the information provided by client, family and caregivers does not fully represent the true impairment according to unique qualifications of the policy (especially with older policies written when LTCI was evolving). Older policies that have differing definitions may create unique challenges to claims approval and maximum claims payment. A Claims Advocate is the most valuable asset you can have when going through this process.