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Legislator Group To Probe LTC Claims Practices

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A New York Times article alleging abuses in the long term care insurance market has led to another official investigation.

The Health, Long-Term Care & Health Retirement Issues Committee of the National Conference of Insurance Legislators, Troy, N.Y., has opened a probe into whether current LTC insurance regulations adequately protect consumers.

In May, the House Committee on Energy and Commerce, headed by Rep. John Dingell, D-Mich., announced an investigation of industry claims-handling practices following a March 29 article in the New York Times alleging that many legitimate LTC claims have been denied or seriously delayed by carriers.

The NCOIL inquiry was spurred by the same article, according to committee members.

A recent panel discussion at the NCOIL’s summer meeting in Seattle, headed by committee chair Rep. Susan Westrom, D-Ky., looked into alleged abuses in the LTC insurance market and potential new consumer protections.

Bonnie Burns of California Health Advocates, Sacramento, Calif., told the committee that states could do more to protect consumers, particularly with long term care partnership programs that allow individuals to protect assets equal to the amount of benefits paid by an insurer when applying for Medicaid.

State Medicaid programs should draft disclosure documents that describe asset protection and estate recovery rules under the partnership policies as well as what happens when a policy owner moves to another state, Burns said.

John Gerni of the American Council of Life Insurers, Washington, and Martin Mitchell of America’s Health Insurance Plans, Washington, told the panel their groups supported the NAIC model act, which would add consumer protections for LTC insurance.

Both also told the group that abuses described in the Times article were aberrations.

Donald Walters of the Insurance Marketplace Standards Association, Bethesda, Md., informed panel members that IMSA may begin drafting quality standards for LTC insurance.