LTC INSURANCE: PROBLEMS COLLECTING
What to do when your provider doesn't pay
BY:ROBERT EDELSTEIN
If your long-term-care insurance provider has been reluctant to pay claims and elusive in your attempts to make contact to resolve the situation, there are steps you can take. Try following the advice below.
The first step would be to seek out your insurance agent. “But if you’re having trouble with an insurance company and you don’t have an agent you trust, you should get in touch with the state insurance department,” advises Sandy Praeger, a commissioner for and president-elect of the National Association of Insurance Commissioners (NAIC) in Kansas City, MO. Praeger says her association’s website, www.naic.org, is a good first route to take, since it compiles all complaint information sent out by each state agency.
You could access your state’s insurance department through the NAIC site (www.naic.org/state_web_map.htm) and fill out a complaint form to get the process moving. NAIC staffers, Prager adds, are ready to advocate on your behalf. “If we see a pattern of an insurance company not paying, we need to look at their financial condition,” Praeger says. “The question becomes, Are they trying to make money off the backs of the insured?”
The NAIC staffers or state agents are willing to intercede, says Praeger. “We can lift an agent’s license for not being truthful and honest. And we can get money back for consumers if the policy was bought under fraudulent misrepresentation.”