Los Angeles Long-Term Care Insurance Attorney

Los Angeles Long-Term Care Insurance Attorney

Struggling to find safe, comfortable, and affordable care for yourself or an aging loved one? You’re not alone. Long-term care insurance may seem like the solution to this financial challenge, but all too often, it fails to deliver the promised security. 

At Monahan Tucker Law, we understand this challenge. We concentrate our practice on helping people with denied insurance claims. Our Los Angeles long-term care insurance attorney can help you navigate these difficult situations. If your claim has been denied, contact us today to see how we can assist you.

The Growing Problem with Long-Term Care Insurance Claims

As life expectancy has continued to rise, so has the number of long-term care claims from an aging population, leaving insurers in a tight financial spot. 

Take UNUM Group, for example, based in Maine. It recently faced scrutiny from the Maine Department of Insurance due to its unprecedented premium deficiency reserve amounting to billions of dollars. In order to mitigate their losses, insurers like UNUM have a vested interest in denying long-term care claims.

These financial constraints have made it increasingly difficult to obtain benefits under a long-term care policy, but it is possible with help from an experienced Los Angeles long-term care insurance attorney. 

Qualifying Conditions

In order to qualify for LTC benefits, one of the following kinds of conditions or concerns must affect the recipient:

• A chronic disease
• A physical or mental disability 
• A serious cognitive impairment, such as dementia

Additionally, qualification can hinge on the inability to address two or more primary activities of daily living (ADLs), which include:

• Continence and toileting need
• Personal hygiene
• Meal preparation
• Eating on one’s own
• Dressing oneself
• Ambulation and getting in and out of bed or a chair

Suspected Fraud: Challenging Unjust Insurance Decisions

One common issue in long-term care insurance disputes arises when the insurance company subjectively determines that the policyholder doesn’t actually require assistance and accuses them of intentionally providing false information. When a claim is made for long-term care benefits, insurers often send investigators to monitor the policyholder’s activities. However, it’s important to remember that a person’s capabilities can vary throughout the day due to factors such as medication or simply having a good or bad day.

Unfortunately, some insurers use a single moment captured by their investigators to argue that the policyholder is providing false information. This can be devastating for the policyholder and their loved ones, who feel wrongly accused of trying to take advantage of fleeting moments of better health during their declining years.

At Monahan Tucker Law, we’ve encountered instances where investigators have violated privacy rights and manipulated footage to make it seem like the policyholder was active at a time when they claimed they couldn’t function. With our extensive experience, we’ve successfully fought against these baseless allegations and compelled insurers to acknowledge their mistakes.

Contact an Experienced Los Angeles Long-Term Care Insurance Attorney for the Help You Need Today

The seasoned Los Angeles long-term care insurance attorneys at Monahan Tucker Law have the focus and legal insight to help build your strongest long-term care claim – in skilled pursuit of a favorable outcome that affords you the care you need to continue living your life on your terms. The benefits of LTC are considerable, but receiving the full range of benefits to which you’re entitled is complex, and we’re standing by to help. Learn more by contacting us today.