Several producers who sell long term care insurance say they have not seen the kinds of claim payment problems described Monday in a front-page article in The New York Times.
The Times article focused mainly on complaints about 2 large LTC insurance carriers and reported that overall complaint rates for other large LTC carriers are much lower.
Here at an LTC insurance conference sponsored by the Society of Actuaries, Schaumburg, Ill., producers in attendance talked about their own experiences with the LTC claims process.
Cameron Truesdell, chief executive of LTC Financial Partners L.L.C., Kirkland, Wash., says he has had few claims denied.
“I’m not saying some companies don’t have issues, but companies like Genworth, MetLife, Hancock and Travelers aren’t the problem,” Truesdell said. “They bend over backwards to pay claims.”
Christine Crowley, a Colorado-based partner in Truesdell’s firm, said that “in every industry, there’s a bad egg.” But Crowley said she thinks one carrier cited in the Times article for high claims denial got a bad rap.
The carrier “got into financial trouble because they pay so many claims,” Crowley said.
Phyllis Shelton, president of LTC Consultants Inc., Nashville, Tenn., argued that, despite the occasional problem, she has found carriers’ claims-filing process to be smooth and problem-free.
“Producers shouldn’t have to bulldog claims,” Shelton said. “With most carriers, it’s not like the way it was reported in the Times. Normally, I barely have to get involved. Those situations are really atypical.”
But Jesse Slome, executive director of the American Association for Long Term Care Insurance, Westlake Village, Calif., said the Times article poses a potential concern for the industry.
“The fact is, we have a positive message to tell the public,” Slome said. “It’s time for the industry to speak out with one voice to acknowledge the issues [with claim denials] that may exist. If we bury our heads in the sand, we will be doing the exact same thing we blame consumers for doing when it comes to long term care planning.”
Phillip W. Sullivan, president, SellingLTC.com L.L.C., Rabun Gap, Ga., said carriers have a moral obligation to pay legitimate claims.
“If a carrier is going to accept money for a policy, then it should in good faith deliver the product they promised,” he said. “If the CEO knows [unfair claims practices] are going on, he should stop it. If he doesn’t know, then he’s not doing his job.”
Sullivan said, however, that only a small number of companies are the cause of most complaints. “The industry as a whole is meeting its obligations to policyholders,” Sullivan said.