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Life Health > Long-Term Care Planning

Loving LTCI Claim Time

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For me, claim time represents the ultimate affirmation of my career.

Back when I began selling LTCI at an aggressive clip in the early ’90s, I sold tons of policies with 0-Day Elimination Periods. Such policies were plentiful and reasonably priced, as were Lifetime Benefit Periods. Consequently, I am now having a minor deluge of clients going out on claim. Once in awhile, I learn abut claims that went in without my even being aware of them. I don’t have a way of knowing exactly how many LTCI claims my clients have had, but my best guess is that at least 300 of my clients have collected on their policies. Yow!

I like being personally involved at claim time. This does not mean I get involved in the minutiae of claims paperwork. I do not have a good personality for that. But I am great at assessing the “big picture” and recommending appropriate action, then looking like a heroine as a result.

I always make sure my clients know how to reach me. I send out hand-signed birthday cards and occasional newsletters in which I always urge clients to call me any time, with any and all questions, before there is a need for care.

As a result, 10, 15, or 20 years after the sale, the phone will ring. My client, or their child or loved one, will introduce themselves and start to tell me their policy number. Usually, I gently interrupt them and tell them I remember them and it’s not necessary to get into official documentation. Many are astonished by my memory, and they often seem pleasantly pleased, and grateful I am still present, willing, and able to support them so many years after their purchase. They often thank me for taking their call, almost as if it was a privilege speaking with me.

Imminent LTCI claim calls are fairly easy to recognize. Clients often call to ensure that they understand their billing mode, or to get a policy review. As I take out their file and we continue talking, their true concerns often surface. They are not calling for a policy review as much as they are calling because they are close to, or need to file a claim. My role is to encourage them to do so. Shepherding my client along at LTCI claim time is very meaningful for me.

For many years, I’ve been active in caregiving trade associations. I’ve taken as many opportunities as I could to tour assisted living, personal care homes, nursing homes, and adult day care facilities. I’ve attended many lectures on the various aspects of aging, and I’ve forged long-term relationships with home health care agencies, geriatric care managers, movers who specialize in turnkey downsizing, and professionals who help people find the most appropriate facility placement. This has paid off in three ways. First, I’ve learned a lot about the world my clients enter after they go out on claim. Second, many of the professionals I’ve worked with have become my clients. And third, I’ve become pretty skilled at assessing my clients LTC needs well enough to confidently refer them to the most competent people to help them make this big transition.

I believe it is an emotional and financial mistake for advisors to shy away from assisting clients at claim time. It just doesn’t take that long, it’s not that difficult, and it’s so rewarding.

Determining whether a client is ready to go out on claim should be easy for any advisor who has sold more than a few LTCI policies. I ask clients questions such as, do they need someone to stand outside of the shower while they bathe? Do they need to sometimes take this person’s hand to keep their balance as they step out of the shower? Is it easier for them if someone hands them their shirt or helps them put their arm in the sleeve of their shirt, or helps them get up from a chair?

Typically, there is no need to assess whether there is cognitive impairment. In these cases, it is usually a loved one who calls on behalf of my client. I usually just confirm that a diagnosis of cognitive impairment or dementia is already in my client’s medical records. Then, I describe how the policy works, explain how their loved one will benefit from collecting from it, urge them to go forward with their claim, and typically refer them to one or more of the colleagues mentioned above.

When I make such referrals, I already know that the care and services my clients receive will be exemplary. The home health care agencies I refer to do all the claim paperwork for my clients; so the submitted claims are usually complete and get paid promptly. Filing LTCI claims is just not that complicated. I strongly encourage advisors to reach out and form good relationships with these folks for two reasons. First, having such competent colleagues is a powerful reflection on you and will enhance your reputation. Second, these strategic alliances tend to create a cross-flow of very strong reciprocal referrals.


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