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FAQ - Long-Term Care Insurance Disputes



A: The rising cost of long term care, compared to the total premium costs, makes this type of insurance worthwhile. An out-of-pocket long-term care commitment can lead to quick financial depletion and eventual bankruptcy. Home health care and facility care are among the highest in the health care industry, especially if needed long term. It is wise to purchase long-term care, especially for older individuals, as statistics show your odds of needing long term care increase greatly as you age. It is important to remember the need for long-term care can happen to anyone, at any time.

A: Although each individual policy may define the parameters of "long term care" differently, it is generally recognized as a condition in which the policyholder is unable to perform activities of daily living without assistance. Serious physical limitations and severe cognitive impairment are grounds for receiving long-term care, either in an accredited facility, or at home with licensed medical visitation.

A: You may be entitled to partial or full coverage, depending on the provisions of your policy. An experienced long-term care insurance lawyer can help you unravel the language of your policy to determine the exact amount of benefits you are entitled to.

A: These types of contracts can be very convoluted and contain numerous hidden loopholes. Policyholders depend on the security of a long-term care contract, but are left facing a mountain of long-term care bills when a claim is denied. Because long term claims usually mean substantial and ongoing benefit payouts, insurance companies may try every angle to deny benefits. Unfortunately, many times the policyholder is not adequately informed of the provisions of his or her policy upon purchase. Getting a lawyer to stand up for your rights, and expose the inconsistencies in the contract, may help you get the benefits you need.

A: Long-term care insurance does not cover hospital or temporary medical expenses, psychological disorders, addictive diagnoses, self-inflicted injuries, doctor's office visits, rehabilitation and surgery expenses.

A: David Share Associates does not require a down payment or retainer from its critical care insurance clients. Our lawyers operate on a contingency fee basis, where all costs are covered up front by our firm, and the lawyer collects his or her fee only in the event of a recovery.

A: There are time limits to all long-term disability insurance claims and any delay in proceeding may be subject to a deadline. You should not delay in proceeding with your claim or obtaining legal advice to clarify these deadlines.

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