Long Term Care Insurance Legislation Holds Payers Accountable

Long Term Care insurance is in many ways a boon to the industry, making assisted living options more financially within reach for many people who in the past would have stayed at home relying on help from friends and family.  However, expanded utilization of these plans have also added new complexities for administrators, complicated a billing process that previously had only two key players – the government (via Medicare and Medicaid) and private payments.

In the best of circumstances, juggling different benefit levels and processing requirements can keep your billing department busy.  But when the insurance companies deny or fail to respond to legitimate claims, residents and administrators alike reach new levels of frustration.

New regulations are being put into place in a number of states to provide recourse against LTC insurance companies that fail to pay, with the National Association of Insurance Commissioners providing a model for legislation that can be applied by states to ensure that LTC customers get the coverage they were promised.  Oregon, Alabama, and Kansas recently joined the ranks of states that have stepped in to provide consumer support when dealing with claim denials or late payments from insurance providers.

Does this increase in legislation and regulation signal a turn in the tide of the LTC insurance industry? Maybe. With several large insurance companies moving out of the LTC sector, some on Wall Street are predicting that the life span for these products might be brief.

24. October 2012 by David Weiss
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