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Life Health > Health Insurance > Health Insurance

Most LTC Claims Are

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Almost 58% of long term care claims submitted to UnumProvident Corp. are for people under age 65, the company says.

That’s true for both group and individual LTC policies, according to a profile of claims activity that UnumProvident, Chattanooga, Tenn., recently released.

In 2005, the company says it handled more than 3,000 group and individual LTC claims and expects to process 4,000 in 2006.

Its analysis of internal data on group LTC showed the top claim triggers for under-65s were cancer (30%) and stroke (more than 10%). Additional leading causes of claims were neurological disease, dementia and multiple sclerosis, each accounting for less than 5% of claims.

A company spokeswoman says comparisons with claims submitted five years ago showed some striking differences.

Cancer and neurological disease were the top two triggers of claims by those under age 65 in 2001, while dementia, stroke and injuries followed in that order, reports the spokesperson, Jessica L. Stone.

oThe average age of under-65 claimants is 53, and more than 15% were younger than 45. For group policies, the average age was 62, while for individuals, it was 77.

oMore than 66% of under-65 claimants received care at home, while 17% received nursing home care.

oA typical claim for policy holders in the age group lasted a year or longer.

John Noble, director of long term care products for UnumProvident, reports the average UnumProvident premium for a group policy covering up to three years of home care and paying $3,000 a month, with a 90-day elimination period, was $68.31 a month for an individual aged 65; $31.05 for a 55-year-old; and $16.56 for a 45-year-old.

UnumProvident says it provides almost 80% of group LTC insurance policies, covering about 550,000 employees, in the United States, excluding federal employee policies and California-specific policies. Its individual policies cover another 200,000.


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