Long Term Health Care Insurance Benefits . . . Runaround

LilacTree · ‎03-25-2012

I spent the entire day yesterday on the phone with about 15 different companies and individuals regarding what is taking so long for me to get my benefits, which I applied for well over six weeks ago. Long Term Health Care is insurance for which I have paid over $1,000 per year for 20 years, first at my employment, and since retirement nine years ago as an individual.

I fulfilled all of my obligations in filling out their application and providing them with all of my health care providers, including doctors, hospital, rehab, etc. I filled out the forms according to the copies of the records I received from these entities. I was advised that it would take four to six weeks for them to corroborate my information and then make a "decision" regarding my claim.

I thought insurance was insurance. You pay for life insurance and when you die your beneficiaries get the insurance. All they have to provide the insurance company with is a death certificate Car insurance, they send an estimator out, he/she makes a report and you get your money.

Long term care insurance? Obviously one has to "prove" one is sick. Okay, I even accept that. So I've waited and waited. I was supposed to get weekly updates on their progress with all of these entitities sending my records. I called a couple of times and was told they were "working on it."

In the meantime I received a bill for my new premium payment to the LTC insurance company, which has doubled from $1,000 to $2,000 per year, first payment due at the end of December. I called about that, advising them that my claim for benefits is still being "worked on" and whether I still had to pay the premium if they had not approved my claim yet. Of course, the answer was "yes," that I would get a refund again the word, if, the claim was approved.

Yesterday I had had it. I called the LTC insurance comapany and raised he*l. "Who is holding this up?" and a whole lot of other questions. In short, they gave me the job of calling each of the entities myself and pushing them to get the records in. There were eight of them, and they each had subcontractors who scanned the records for them, they don't do the work themselves. So that made 15 individuals I had to call, sometimes several times each to get to the person working on my claim. Most of them said they had the records ready, but couldn't send them to the LTC insurance company because their invoices hadn't been paid yet.

I then again called the guy at the LTC insurance company and gave him the status of each and every one of the entities and their advice to me that they had not been paid yet. He proceeded to trip all over his words because obviously that had been true. More phone calls back and forth (I had started at 8:30 in the morning, and by this time it was 4 PM). It seems all invoices will be paid today. So I figure by Monday of next week the records should go out. Then I have to wait for the "approval process" which he said would take five days "unless the records don't match my application, which would then require further investigation." I told him the records would match, because I took the information from the same records he would be getting.

Am I getting a runaround, or is this just the way things are done when the time comes to "pay up?" Also, would you pay the $2,000 premium at the end of December if this is not settled by then? I'm afraid not to because actually, I'm suspicious that they would cancel the policy for non-payment if I don't.

Formerly Ford1224
We must always take sides. Neutrality helps the oppressor, never the victim. Silence encourages the tormentor, never the tormented. Elie Wiesel 1986

SharkE · ‎08-19-2010

Hope she had a happy ending....

LilacTree · ‎03-25-2012

On 1/4/2014 Sharke said:
Hope she had a happy ending.... ${#emotions_dlg.biggrin}$

I did, Sharke. Thank you. My first benefit check is in the mail.

Formerly Ford1224
We must always take sides. Neutrality helps the oppressor, never the victim. Silence encourages the tormentor, never the tormented. Elie Wiesel 1986

SharkE · ‎08-19-2010

Oh wow ! that's great !!!!!!!!! I am really happy for you ! your dedication paid off ! We just now after 3-4 months got accepted by John Hancock and we were scared that maybe all those policies were just a pie in the sky when it came to payouts. You have restored my faith !!!

Thank you for letting us know and I wish you the best of health for the future !

glb613 · ‎03-09-2010

On 1/5/2014 Sharke said:
Oh wow ! that's great !!!!!!!!! I am really happy for you ! your dedication paid off ! We just now after 3-4 months got accepted by John Hancock and we were scared that maybe all those policies were just a pie in the sky when it came to payouts. You have restored my faith !!!

Thank you for letting us know and I wish you the best of health for the future !

You need to read you policy if you have one. Just because her policy paid doesn't mean yours will.

terrier3 · ‎03-10-2010

On 1/5/2014 Ford1224 said:
On 1/4/2014 Sharke said:
Hope she had a happy ending.... ${#emotions_dlg.biggrin}$

I did, Sharke. Thank you. My first benefit check is in the mail.

I so happy you were able to use your years of expertise working with companies to press your own case.

I feel badly for people not as savvy and tenacious as you are!

SharkE · ‎08-19-2010

Mine is from my financial consultant who has one too, so, I feel reasonably confident and he is younger then we are. LOL Everything we do in life is a c*ap shoot, but, I'm glad that her story had a happy ending as I'm sure we all are.

LilacTree · ‎03-25-2012

On 1/5/2014 terrier2 said:
On 1/5/2014 Ford1224 said:
On 1/4/2014 Sharke said:
Hope she had a happy ending.... ${#emotions_dlg.biggrin}$

I did, Sharke. Thank you. My first benefit check is in the mail.

I so happy you were able to use your years of expertise working with companies to press your own case.

I feel badly for people not as savvy and tenacious as you are!

After getting pretty beat up a few years after my divorce as a single working mother with four children, I learned I had to become relentless when I needed to. It didn't make me popular, but it allowed us to survive.

Society still wanted women to be fragile and feminine in those days, to sit back and wait to be rescued. I was a departure from that, and my girls learned to be independent and strong because they watched me. The friends I did have called me "feisty."

Thank you Sharke and Terrier for being happy for me.

Formerly Ford1224
We must always take sides. Neutrality helps the oppressor, never the victim. Silence encourages the tormentor, never the tormented. Elie Wiesel 1986

kdgn · ‎03-09-2010

Ford, I was subjected to that "little woman" routine when attempting to get my first car loan. Mom was with me. She stared at the guy, said very loudly "If this was my son you wouldn't demand that!" and we walked out the door. I admit to being embarrassed at the time but boy was she right! Same thing happened when I got my first mortgage-the company required more paperwork out of me than my married friends who had used the same company, same office. That was in the mid-80's. I played their game and got the mortgage, then I let them have it.

pitdakota · ‎03-16-2010

On 1/6/2014 Ford1224 said:
On 1/5/2014 terrier2 said:
I so happy you were able to use your years of expertise working with companies to press your own case.

I feel badly for people not as savvy and tenacious as you are!

After getting pretty beat up a few years after my divorce as a single working mother with four children, I learned I had to become relentless when I needed to. It didn't make me popular, but it allowed us to survive.

Society still wanted women to be fragile and feminine in those days, to sit back and wait to be rescued. I was a departure from that, and my girls learned to be independent and strong because they watched me. The friends I did have called me "feisty."

Thank you Sharke and Terrier for being happy for me.

Ford, I am also very happy to read this. Good for you!

And ITA about learning to be tenacious. Years ago when DH and I bought our house I went to purchase a washer & dryer. I opted at the time to do what was then very popular....the 90 days same as cash option. I had the cash, but decided to spread the payments out over 90 days. The very day before the washer/dryer was scheduled to be delivered they called me and told me they couldn't deliver them until DH came into to cosign the papers. ${#emotions_dlg.sneaky}$ I was working as a nurse, had a full time job....say what? I told them to stuff it. I promptly went someplace else and purchased a washer/dryer without any problems. Needless to say, I never took my business back to that company again.