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LTC Suit Hinges On Definition Of "Home"

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A California lawyer says a long term care insurer has raised questions about the meaning of a common word.

Frank Darras of Ontario, Calif., says he has filed a suit, Smith vs. Penn Treaty America Insurance Company, in a state court in Pomona, Calif., on behalf of an elderly woman who has moved to her daughter’s home to get help with activities of daily living.

Penn Treaty America, a unit of Penn Treaty American Corp., Allentown, Pa., has denied payment of home care benefits because it says plaintiff’s residence no longer meets the policy definition of “home,” according to Darras.

The complaint alleges Penn Treaty America has committed breach of contract and breach of the covenant of good faith and fair dealing.

A Penn Treaty spokeswoman declined to talk about details of the Smith case but noted that the company has paid her about $71,000 in benefits.


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