Seniors With Long-Term Health Care Claims: Victims of Bad Faith Insurance


As the baby boomer population reaches their senior years, they have begun to seek out the benefits of the long-term care insurance they purchased years ago. These policies were set to provide benefits which are not normally included in traditional health insurance policies.

However, these long-term care policies have lead to a substantial growth of bad faith claims as insurers sold policies without disclosing important information regarding price inflation, reduction or denial of benefits, and failing to inform policyholders of restrictions.

At Millin & Millin, our McAllen bad faith insurance lawyers are dedicated to ensuring you receive the benefits that are owed to you. Those who have been denied a long-term health care policy claim should seek out legal aid to obtain the benefits they are legally owed.

Long-Term Care Policies

Long-term care policies are aimed at providing seniors with the health care services they need as they age. Unfortunately, this is a vulnerable population who often suffer from the fraud and abuse of clever insurers who fail to provide adequate information regarding coverage.

Long-term care policies should cover:

  • Prevention and Diagnostic Care
  • Physical Disabilities
  • Mental Disabilities
  • Chronic Health Conditions
  • Cognitive Disorders
  • Therapy
  • Rehabilitative Services

When bad faith insurance takes place, seniors may face unexpected – and costly – expenses due to a lack of coverage for the services they need most.

Policy Definition and Limited Benefits

In addition to limits of benefits set in the policy definition section, most long-term care policies set daily benefits for reimbursement on care such as adult day care, home health care, nursing home cure, or assisted living facilities.

In addition to this, limited daily benefits can include care providers when necessary, as well as home modifications for easier access and to create a safer environment.

Not being able to perform two Activities of Daily Living (ADL) is used as a reference for determining benefits for physical or cognitive disabilities. ADLs include: bathing, eating, drinking, walking, standing, dressing, transferring, and other activities.

Issues with Long-Term Care Policies

Many of the long-term care policies were sold to in the mid-80’s and 1990’s to baby boomers who wanted to have protection already in place for when they would reach their twilight years.

The issues with long-term care policies started years ago when the policies were being underwritten. Underwriting is the process in which insurance underwriters measure risks and determine how much a premium should be to provide the coverage needed.

Unfortunately, insurance underwriters failed to properly estimate the inflation of costs associated with the services needed by this aging demographic including nursing homes, assisted living facilities, in-home care and more. Now, insurance companies are denying these long-term care claims and are substantially increasing premiums to the detriment of those who need the care most.

Bad Faith Experts to Help You Navigate Policies

In order to fully understand your coverage limits and benefits, it is best to seek help from a professional bad faith lawyer.

The experienced attorneys at Millin and Millin have years of experience with bad faith insurers and can spot hidden limitations, reveal unfair practices, and help you to receive the benefits that are owed to you.

Has your insurance claim been denied? For personal assistance dealing with a bad faith insurer, contact the dedicated McAllen bad faith attorneys of Millin and Millin today at (956) 631-5600.