long term care insurance interview advice law advice insurance advice community law advice case evaluation ask lawyer amp legal topics legal topics accident law bankruptcy law business law criminal law employment labor law estate planning family law financial law general practice government law immigration law insurance law intellectual property litigation malpractice law personal injury real estate law tax law small claims admiralty maritime aviation law insurance law topics insurance law topics insurance law basicsauto insurancebusiness insurancelong term caredisability insurancehealth insuranceinsurance bad faith life insurance lawproperty insuranceviaticals advice law advice insurance law long term care current long term care insurance interview gerry goldsholle written freeadvice staff insurance claim denied delayed case evaluation call following transcript interview gerry goldsholle california attorney extensive experience insurance industry consumer rights attorney goldsholle involved conceptual stages long term care insurance interview provides insight long term care insurance came offers commentary current long term care issues facing insurance industry consumers freeadvice long term insurance gerry goldsholle long term care insurance designed pay policyholder money person insured incapable performing sufficient number activities activities daily living requires assistance perform activities activities daily living include ability bathe oneself feed oneself transport oneself location similar activities freeadvice history long term care insurance relatively product gerry goldsholle long term care insurance developed attempt anticipate needs rapidly aging population past people relied family members take care incapable caring modern america families increasingly spread country addition households working family members frequently difficult impossible spouse child take care family member incapable care long term care insurance provides cash helps enables people hire person needing long term care freeadvice long term care insurance created gerry goldsholle definite social need value long term care insurance need usually opportunity business create provide product service meets need profitable business insurance company side issue insurance company properly price product insurance premiums usually based experience companies began create long term care insurance little real experience know involved early development product data number people nursing homes proving nursing product going big seller people resist going nursing homes ndash just want to nursing recognized industry design product pay benefits person having enter nursing far desirable product larger potential market long term care insurance policies today cover people need nursing homes require assistance care precious little actuarial data show cost created long term care product paying money care people prospect paying money change dynamics insure cross section american public purchasers people claims existence product change demand care large percentage families provided care elderly relative providing care insured hire provide care great uncertainty costs going forward depending policies designed come back bite insurance companies policyholders elderly people want nursing nursing regarded waiting room people long tried avoid need nursing homes care traditionally provided people wanted care provided setting possible long term care insurance essentially migrated nursing policy policy paid benefits people stay needed assistance conduct normal daily activities premiums long term care product especially north age reasonably high life insurance companies looked long term care insurance additional product agents sell typical buyer long term care product s people generally need life insurance long term care insurance product sold affluent age group demographic affluent growing rapidly insurance companies saw long term care insurance product carry high commissions support grow field forces competition companies attract agents insurance companies know high commissions best ways attract agents motivate sell products good consumers companies long run corporate managers take short term viewpoint sales managers measured sales growth good consumer long term profitability cash value life insurance typically product involves high commissions long term care insurance triggered future event ndash inability provide activities daily living ndash may occur may occur time future enables money paid premium today invested insurance company investment income way life insurance companies principal living fact cover certain events catastrophic illness disability inability person engage sufficient number activities daily living basis justify receiving premiums insurance company perspective product potential bring significant amounts premium invested insurance company paid time future insurance companies knew people want nursing homes insurance paid nursing stays people fight avoid going nursing homes withstanding that paid critical issue availability long term care insurance change behavior patterns insurance company paid aide come house hours day hire somebody save family need coming interfering life major factors insurance companies concerned came long term care insurance availability insurance change usage patterns insurance companies overly enamored prospect getting relatively high premiums door likelihood pay immediate claims policies earn investment income money disregarded prospect getting large claims road companies just really price anticipate risks lying road freeadvice explain long term care coverage gerry goldsholle basic types policies type pays reimburse policyholder expenses incurred grandma disabled unable care money paid long term care insurance company pays money care hire lpn licensed practical nurse aide comes hours day reimburse cost subject policy limits policies typically require payment care outsider pay care rendered relative insured person type long term care policy pays event certain circumstances present example types policies trigger benefits merely insured person disabled incapable performing activities daily living pay insured amount money day actual costs incurred policies pay triggering condition met pay money hire lpn bring daughter handle work critical things emerging area insurance companies know price product early built provisions policies permit increase premium companies increasing premium dramatically point time increasing premiums may usage higher anticipated may investment earnings hoped achieve originally priced product lower expected interest rates fallen dramatically rates early making big returns expected investment money freeadvice think reasons lot policy benefits denied gerry goldsholle lack investment performance reserves set long term care insurance may adding pressure product manager long term care line insurance company want look bad making significant amounts money investments certainly generous claim side going improve financial results money pay going charged line business result companies increasingly far restrictive comes claim payments instances improperly denying claims paying factor separate apart financial results insurance companies originally wrote long term care insurance mutual insurance companies companies essentially owned operated benefit policy holders past decade largest best life insurance companies companies prudential metropolitan life john hancock equitable converted stock companies stock companies owned outside shareholders policyholders focus primarily wall street policyholders competing wall street attention show profits growth achieve good price earnings ratios result life insurance companies wrote long term care insurance basically changed structure mission time policies issued just profit company money expense customers lack nexus customer owner owner somebody different customer freeadvice target market long term insurance products gerry goldsholle insurance company perspective sale based fear risk target market older person may concerned may deplete assets nursing think know able stay able take care may lose possibly happen to take care second target market family member older person says god mom dad aunt millie getting years family member responsible care really tie able work able travel impact ability care grandchildren getting older know going happen event relative going need care really want to put relative nursing want to rely mercies social security medicaid system road just insurance protect freeadvice buying long term care insurance children grandchildren gerry goldsholle insurance company love people product young likelihood going wrong young very low product priced lower longer put money assets pay producing long term dollars insurance company invest account wonderful life insurance company sell product young money come buyer may tired paying lapse insurance company collect premium pay claims great deal insurance company great deal agent gets substantial year commission ongoing commissions long term care policies motivates insurance agents sell product freeadvice product marketed gerry goldsholle incentive insurance companies sell money invest increase premium flow good companies issuing long term care insurance life insurance companies popularity need life insurance declining years sales price premiums especially inflation adjusted terms sorts socio economic changes diminished attractiveness life insurance product ask life insurance companies doing support infrastructure expensive infrastructure need bring sources premiums change way business hard big entity similarly agents having difficulty selling more life insurance need declined changes estate tax impacting need insurance dual income families self sufficient spouses life insurance serve function long term insurance marketed individual agents typically generous commission structure long term care insurance offered associations products somewhat reduced commission structure marketed workplace larger employers optional employee benefit form group insurance low commission structure freeadvice recommend purchasing long term care policy gerry goldsholle think need long term care policy really depends individual family situation financial situation health situation risk tolerance comfort level seen long term care insurance purchased wealthy people lot extra money say need long term care want cost care come estate want cost born insurance company willing pay premium shift risk say need buying significant income resources income resources continue come unable fully take care really sense buying long term care insurance different some hand sense impoverish today paying premiums afford real dent lifestyle guard possibility may disability road money freeadvice line specific individuals recommend purchase product purchase gerry goldsholle recommend long term care insurance person lives far family financially comfortable ndash super wealthy afford premium worried unable care somebody long term care insurance sense addition distant parent struggling ends meet may want purchase financial burden fall you essentially trade possibility significant expense road small affordable premium children may want chip long term care policy assuage possible guilt pre fund possible need long term care freeadvice suggestions individuals purchase long term care policy gerry goldsholle look ability insurance company premium increases look financial strength integrity insurance company significant differences insurance companies people aware ratings helpful terms financial stability insurance company particular time rating snapshot predictor series ratings best insurance reviews weiss ratings ratings consider fact insurance company may look terrific today mean road largest insurance failures history company called executive life company enjoyed top line ratings rating agencies ndash just time went freeadvice limitations long term care policy limits gerry goldsholle underwriting point view insurance company wants insure people good health want insure people sick people file claims sooner means money policy holders look people pretty healthy general spectrum population price certain disabilities conditions feel lead early claim example tendency high cholesterol may suggest greater potential stroke triggering conditions requiring payment benefits may price premiums higher issue policy insurance companies know people tend far insurance reasonable somebody circumstance good risks may hiding insurance company may able pick freeadvice areas consumers aware purchasing long term care policy gerry goldsholle waiting periods benefits significantly long benefits continue kick critically important aspects long term care insurance policy benefits far important long continue theory long term care policies start paying benefits day insured person need long term care start collecting benefits day required sufficient assistance activities daily living qualify long term care benefits incurred covered expenses policies require delay qualification date benefits sense pricing practical standpoint absent sudden event disabling stroke gradual decline ability raise questions proof long term care policies typically provide day waiting period ndash insured person longer able engage sufficient number activities daily living ability bathe care day waiting period ndash day waiting period day waiting period months year waiting period reduce premium dramatically longer waiting period lower premium insurance company paying dollar waiting period helps people significantly reduce premiums second point long insurance company paying benefits example insurance company agrees pay benefits maximum years date long term care insurance benefits start significantly limited potential exposure hand long term care insurance company agrees pay benefits years providing half times greater possible exposure provides lifetime benefits insured longer benefit pay period long term care company charge greater premium people far better having longer waiting period long term care insurance benefits longer duration period time benefits payable suggest people consider month waiting period benefits payable life danger people face stroke develop disease rendering disabled long live ndash long time ndash long term care required significant financial catastrophe freeadvice claims denials gerry goldsholle long term care policy disabled qualify benefits time call experts lawyers assist person seeking benefits submit claim relatively small front fee better claim approved instance sue charge hourly fee may best valuable advice got insurance company denies long term care benefits definitely need law firm knows long tem care insurance operates claim eligible benefits entitled freeadvice say word mouth worth buying long term care policy gerry goldsholle little fact zero anecdotal word mouth friends family usually very limited value friend typically little experience long term care insurance sure friend bad experience long term care company sense cautious good experience means particular company product experience typically entitled great weight complaint records state insurance department based number complaints policies issued meaningful freeadvice thank excellent advice gerry goldsholle insurance claim denied delayed case evaluation call view related long term care insurance articles articles view article insurance legal topics insurance attorney ask lawyer looking social read articleshow long term care insurers calculate risklong term care insurance interview gerry goldshollelong term care insurance california stylelong term care policy definitionslong term care glossary termspartnership long term care programs differences private state federal long term care insurance select practice area adoption support amp child custody arbitration aviation maritime amp boat accident banking bankruptcy business car accident civil rights amp ada collection construction contract copyright ip amp trademark criminal dui dwi divorce education law elder law employment environmental estate planning franchise general practice government healthcare nursing abuse immigration insurance international juvenile landlord tenant legal malpractice lemon law libel amp slander litigation medical malpractice military patent pensions amp benefit personal injury product liability railroad accident real estate securities sexual harassment small claims social security disability sports amp entertainment tax technology amp internet wills amp probate worker compensation wrongful death topics select state alabama alaska arizona arkansas california colorado connecticut delaware district columbia florida georgia hawaii idaho illinois indiana iowa kansas kentucky louisiana maine maryland massachusetts michigan minnesota mississippi missouri montana nebraska nevada hampshire jersey mexico york north carolina north dakota ohio oklahoma oregon pennsylvania puerto rico rhode island south carolina south dakota tennessee texas virgin islands utah vermont virginia washington west virginia wisconsin wyoming long term care long term care insurance articlesbuying long term care insuranceproblems denials lawsuitssample long term care policy provisionswhat look long term care policywho needs long term care
Long Term Care Insurance Interview Free Advice Law Advice Insurance Advice Community Law Advice Free Case Evaluation Ask a Lawyer Q amp A Legal Topics All Legal Topics Accident Law Bankruptcy Law Business Law Criminal Law Employment Labor Law Estate Planning Family Law Financial Law General Practice Government Law Immigration Law Insurance Law Intellectual Property Litigation Malpractice Law Personal Injury Real Estate Law Tax Law Small Claims Admiralty Maritime Aviation Law Insurance Law Topics All Insurance Law Topics Insurance Law BasicsAuto InsuranceBusiness InsuranceLong Term CareDisability InsuranceHealth InsuranceInsurance Bad Faith Life Insurance LawProperty InsuranceViaticals Free Advice Law Advice Insurance Law Long Term Care Current Page Long Term Care Insurance Interview with Gerry Goldsholle Written by FreeAdvice Staff Insurance Claim Denied or Delayed Click here for a FREE Case Evaluation or call The following is a transcript from an interview with Gerry Goldsholle a California attorney with extensive experience in the insurance industry and consumer rights Attorney Goldsholle was involved in the conceptual stages of long term care insurance In this interview he provides insight into how long term care insurance came to be and offers commentary on the current long term care issues facing the insurance industry and consumers FreeAdvice com What is long term insurance Gerry Goldsholle Long term care insurance is designed to pay the policyholder money if and when the person who is insured becomes incapable of performing a sufficient number of activities of activities of daily living and requires assistance to perform such activities Activities of daily living include the ability to bathe oneself to feed oneself to transport oneself from one location to another and several similar activities FreeAdvice com What is the history of long term care insurance Is it a relatively new product Gerry Goldsholle Long term care insurance was developed during the s in an attempt to anticipate the needs of the rapidly aging population In the past people relied on family members to take care of them if they became incapable of caring for themselves In modern America families are increasingly spread out across the country In addition most households have two working family members It's frequently difficult or impossible for a spouse or child to take care of a family member who becomes incapable of taking care of him or herself Long term care insurance provides cash that helps or enables people to hire someone to help the person needing long term care FreeAdvice com Why was long term care insurance created Gerry Goldsholle There is a definite social need and value for long term care insurance and where there is a need there is usually an opportunity for a business create and provide a product or service that meets that need which will also be profitable for the business From the insurance company side the issue has always been whether or not the insurance company can properly price that product Insurance premiums are usually based on experience and when companies began to create long term care insurance there was very little real experience to go on I know because I was involved with the early development of the product While there was some data on the number of people who go into nursing homes proving that a nursing home only product was not going to be a big seller People resist going into nursing homes ndash they just don't want to go to a nursing home We recognized that if the industry could design a product that would pay benefits without a person having to enter a nursing home it would be a far more desirable product with a much larger potential market That's why most long term care insurance policies today cover people who need not go into nursing homes but require some assistance and can get that care at home There was precious little actuarial data to show what the cost would be if we created a long term care product paying money to care for people at home as the very prospect of paying money would change the dynamics Would we insure a cross section of the American public or would we find that the purchasers are people who would be most likely to make claims How would the existence of the product change the demand for at home care Would a large percentage of families that otherwise have provided care to an elderly relative stop providing that care because it was insured and instead go out and hire someone else to provide the care Thus there was great uncertainty as to the costs going forward and depending on how the policies were designed that could come back to bite the insurance companies and or the policyholders Most elderly people did not want to go into a nursing home A nursing home was regarded as death's waiting room and people have long tried to avoid the need to go into nursing homes where such care was traditionally provided People wanted to have care provided in their home setting if at all possible Long term care insurance essentially migrated from being a nursing home policy to a policy that paid benefits to people who could still stay at home but needed some assistance in that home to conduct their normal daily activities The premiums on the long term care product especially as you get north of age become reasonably high Many life insurance companies also looked at long term care insurance as an additional product for their agents to sell The typical buyer of a long term care product is someone in his or her s or s and those people generally don't need to buy life insurance Thus long term care insurance was a product that could be sold to what is the most affluent age group This demographic was affluent and growing rapidly Some insurance companies saw long term care insurance as a product that could carry very high commissions and thus support and grow their field forces There is competition among companies to attract agents and insurance companies know that high commissions are one of the best ways to attract agents and motivate them to sell your products That's often not good for consumers or the companies in the long run but some corporate managers take a short term viewpoint and sales managers are measured on sales growth not on what's good for the consumer or for long term profitability Cash value life insurance typically is a product that involves high commissions Long term care insurance is triggered by some future event ndash such as the inability to provide for one's activities of daily living ndash and that may never occur or may occur some time in the future That enables the money that is paid as premium today to be invested by the insurance company Investment income is the way most life insurance companies make their principal living The fact that they have to cover certain events such as a catastrophic illness disability or the inability of a person to engage in a sufficient number of activities of daily living is the basis for them to justify receiving the premiums From an insurance company perspective this was a product that had the potential to bring in significant amounts of premium that could be invested by the insurance company and paid out perhaps some time in the future Insurance companies knew people didn't want go into nursing homes so even if you had insurance that only paid for nursing home stays people would still fight to avoid going into nursing homes not withstanding that that would be paid for The critical issue was how would the availability of long term care insurance change behavior patterns so that if the insurance company paid for it why not get an aide to come into the house for several hours a day Why not hire somebody to save the family member's need for coming in and interfering with his or her own life That was one of the major factors the insurance companies were concerned about when it came to long term care insurance that the availability of this insurance would change usage patterns Some insurance companies were overly enamored with the prospect of getting relatively high premiums in the door with the likelihood that they wouldn't have to pay immediate claims on the policies and thus could earn investment income on the money and disregarded the prospect of getting large claims down the road Many companies just didn't really price for it or anticipate the risks lying down the road FreeAdvice com Can you explain long term care coverage Gerry Goldsholle There are two basic types of policies One type pays only to reimburse the policyholder for the expenses that are actually incurred So if grandma becomes disabled and unable to care for herself no money is paid out by the long term care insurance company unless someone pays money to care for her So if I hire an LPN licensed practical nurse or nurse's aide who comes in for four hours a day they'll reimburse the cost subject to the policy limits Such policies typically require that the payment for the care be to an outsider and do not pay for care rendered by a relative of the insured person Another type of long term care policy pays if an event or certain circumstances are present For example there are types of policies that trigger benefits merely if the insured person becomes disabled or incapable of performing three activities of daily living They then pay the insured an amount of money per day towards the actual costs that are incurred Other policies pay if the triggering condition is met so they will pay the money even if I don't hire an LPN but bring in my daughter to handle that work One of the critical things emerging in this area is that many insurance companies did not know how to price the product early on Some built provisions into their policies to permit them to increase the premium and companies are increasing the premium dramatically at this point in time Why are they increasing the premiums It may be that the usage is much higher than was anticipated but it also may be that the investment earnings that they had hoped to achieve when they originally priced the product have been much lower than they expected Interest rates have fallen dramatically from the rates of the ' s and early ' s and they're not making the big returns they expected on the investment money FreeAdvice com Do you think that's one of the reasons why a lot of policy benefits are being denied Gerry Goldsholle The lack of investment performance on the reserves set up for long term care insurance may be adding to the pressure If you are the product manager of the long term care line at an insurance company you don't want to look bad You're not making significant amounts of money on your investments and certainly being generous on the claim side isn't going to improve your overall financial results The money that you pay out is going be charged to your line of business As a result many companies increasingly are becoming far more restrictive than they would otherwise have been when it comes to claim payments In many instances they've been improperly denying claims they should have been paying Another factor separate and apart from the financial results is that many of the insurance companies that originally wrote long term care insurance were mutual insurance companies These were companies that were essentially owned by or operated for the benefit of their policy holders Over the past decade some of the largest and best life insurance companies companies such as Prudential Metropolitan Life John Hancock and Equitable have converted to stock companies Stock companies are owned by outside shareholders not policyholders Now their focus is primarily on Wall Street not on their policyholders So they are now competing on Wall Street for attention and have to show profits and growth to achieve good price earnings ratios As a result many of the life insurance companies that wrote long term care insurance have basically changed their structure and mission from the time the policies were issued Some have become just another for profit company that's out to make money often at the expense of the customers There's a lack of nexus between the customer and the owner because the owner is now somebody different than the customer FreeAdvice com Who is the target market for long term insurance products Gerry Goldsholle From the insurance company perspective this is a sale based on fear or risk One target market is the older person himself who may be concerned that he may deplete his assets and have to go into a nursing home He might think 'You know I won't be able to stay at home I won't be able to take care of myself I may lose everything I possibly ever had What'll happen to me There's nobody to take care of me ' The second target market is the family member of an older person who says 'My God Mom or Dad or Aunt Millie is getting on in years I'm the family member responsible for his or her care and that will really tie me up I won't be able to work I won't be able to travel It will impact my ability to care for grandchildren and I am getting older too I don't know what's going to happen in the event that this relative is going to need some care and I really don't want to have to put the relative in a nursing home I don't want him to have to rely on the mercies of the Social Security Medicaid System down the road so let's just buy some insurance to protect against that ' FreeAdvice com What about buying long term care insurance for children and grandchildren Gerry Goldsholle The insurance company would love people to buy this product when they're very young as the likelihood of something going wrong when you're very young is very very low and therefore the product is priced lower However the longer you put in the money the more assets you'll pay producing long term dollars the insurance company will invest in its account It's wonderful for a life insurance company to sell a product to someone that's young because not only does the money come in but the buyer may get tired of paying for it and let it lapse so all the insurance company does is collect the premium and it never has to pay out any claims It's a great deal for an insurance company It's also a great deal for the agent because he or she gets a rather substantial first year commission and ongoing commissions for a while on these long term care policies That's what motivates insurance agents to sell the product FreeAdvice com How is the product marketed Gerry Goldsholle There's an incentive for the insurance companies to sell it because they get money to invest They increase their premium flow and that's good for them The companies that have been issuing long term care insurance are life insurance companies However the popularity and the need for life insurance have been declining in recent years as well as new sales the price and the premiums especially in inflation adjusted terms There have been all sorts of socio economic changes that have diminished the attractiveness of life insurance as a product You have to ask what are these life insurance companies doing to support their infrastructure They often have very expensive infrastructure They need to bring in new sources of premiums otherwise they have to change the way they do business and that's hard to do in a big entity Similarly agents are having difficulty selling more and more life insurance because the need for it has declined There are changes in the estate tax that are impacting the need for insurance as well and with dual income families and self sufficient spouses life insurance doesn't serve the very same function Long term insurance itself is often marketed by individual agents typically with a generous commission structure Long term care insurance is also offered through some associations using products with a somewhat reduced commission structure It's also marketed at the workplace by larger employers as an optional employee benefit in the form of group insurance sometimes with a very low commission structure FreeAdvice com Would you recommend purchasing a long term care policy Gerry Goldsholle I think the need for a long term care policy really depends on one's individual family situation on one's own financial situation one's health situation and one's risk tolerance and comfort level I've seen long term care insurance being purchased by very wealthy people who have a lot of extra money They say that if they need long term care they don't want the cost of that care come out of their estate They want the cost to be born by the insurance company and are willing to pay the premium to shift that risk One could say if you don't need it why are you buying it If you have significant income and resources and that income and those resources will continue to come in if you become unable to fully take care of yourself is there really any sense to buying long term care insurance But we are all different and that's why some do and some don't On the other hand it never makes sense to impoverish yourself today by paying premiums you can't afford If it will make a real dent in your lifestyle to guard against the possibility that you may have a disability down the road and get some money for it then why buy it FreeAdvice com Along that same line are there specific individuals that you would recommend to purchase the product or not to purchase it Gerry Goldsholle Yes I would recommend long term care insurance for a person who lives far from his or her family is financially comfortable ndash but not super wealthy can afford the premium and is worried about what if he became unable to care for himself That would be somebody for who long term care insurance makes sense In addition if you have a distant parent who is struggling to make ends meet you may want to purchase it for them so that the financial burden won't fall on you and you will essentially trade off the possibility of a significant expense down the road for a small and affordable premium now Children may want to chip in and buy a long term care policy to both assuage their possible guilt and to pre fund a parent's possible need for long term care FreeAdvice com Do you have any suggestions that would help individuals purchase a long term care policy Gerry Goldsholle I would look at the ability of the insurance company to make premium increases Look at the financial strength and integrity of the insurance company There are significant differences between insurance companies that most people aren't aware of Ratings are helpful in terms of financial stability of the insurance company at the particular time but a rating is very much a snapshot rather than a predictor There are a series of ratings from Best insurance reviews to Moody's to Weiss ratings These ratings are something to consider but the fact that an insurance company may look terrific today doesn't mean it will be down the road One of the largest insurance failures in recent history was a company called Executive Life That company enjoyed top of the line ratings by some of the rating agencies ndash just until the time it went under FreeAdvice com What are some of the limitations with long term care policy limits Gerry Goldsholle From an underwriting point of view the insurance company wants to insure people that are in good health It does not want to insure people that are already sick because those people are likely to file claims sooner and that means they don't make money on those policy holders They look for people who are pretty healthy among the general spectrum of a population and they price for certain disabilities and conditions they feel are more likely to lead to an early claim For example if someone has a tendency for high cholesterol which may suggest a greater potential of stroke and therefore a triggering of the conditions requiring payment of benefits they may price premiums higher or not issue a policy at all Insurance companies also know that people who tend to buy far more insurance than is reasonable for somebody in their circumstance are not good risks as they may be hiding something that the insurance company may not be able to pick up on FreeAdvice com What other areas should consumers be aware of when purchasing a long term care policy Gerry Goldsholle Waiting periods for benefits to begin and more significantly how long the benefits continue after they kick in They are CRITICALLY important aspects of any long term care insurance policy Of the two WHEN benefits begin is far less important than HOW LONG they continue In theory long term care policies could start paying benefits day one so that the insured person in need of long term care could start collecting benefits the day he or she required sufficient assistance with activities of daily living to qualify for long term care benefits and or incurred covered expenses Policies almost always require some delay between qualification and the date benefits begin That makes sense from both a pricing and practical standpoint Absent a sudden event such as a disabling stroke there often is some gradual decline in the ability and that can raise questions of proof Long term care policies typically provide for at least a day waiting period ndash after the insured person is no longer able to engage in a sufficient number of activities of daily living such as the ability to bathe or care for themselves However a day waiting period a ndash day waiting period a day waiting period or a months or a year waiting period will reduce the premium often dramatically The longer the waiting period the lower the premium should be because the insurance company is not paying out on the first dollar So a waiting period helps people significantly reduce premiums The second point is to find out how long the insurance company will be paying benefits For example if the insurance company agrees to pay benefits for up to a maximum of two years from the date the long term care insurance benefits start it has significantly limited its potential exposure On the other hand if the long term care insurance company agrees to pay benefits for up to five years it's providing two and a half times greater possible exposure If it provides lifetime benefits the insured could have a much longer benefit pay out period and therefore the long term care company has to charge a greater premium Most people would be far better off having a longer waiting period before the long term care insurance benefits begin and a much longer duration period for the length of time that benefits are payable Therefore I would suggest that most people consider a six month waiting period but have the benefits payable for life The danger that people face is they might have a stroke or develop Alzheimer's disease rendering them disabled for as long as they live ndash and sometimes that's a long time ndash during which long term care is required That could be a significant financial catastrophe FreeAdvice com What about claims denials Gerry Goldsholle If you have a long term care policy and become disabled so that you qualify for benefits it's time to call in the experts Some lawyers will assist the person seeking benefits on how to submit the claim for a relatively small up front fee It's better to get the claim approved in the first instance than to sue later They'll charge an hourly fee but it may be the best and most valuable advice you ever got If the insurance company denies long term care benefits you'll definitely need a law firm that knows long tem care insurance operates and can if your claim is eligible get you the benefits you are entitled to FreeAdvice com How much would you say word of mouth is worth when buying a long term care policy Gerry Goldsholle Very little In fact almost zero Anecdotal information and word of mouth from friends and family is usually of very very limited value because the friend typically has had very little experience with long term care insurance Sure if a friend has had a bad experience with the long term care company it makes sense to be very cautious But a good experience means less With any particular company or product a friend's experience is typically not entitled to great weight Complaint records with a state insurance department based on the number of complaints per policies issued that's more meaningful FreeAdvice com Thank you for the excellent advice Gerry Goldsholle You're welcome Insurance Claim Denied or Delayed Click here for a FREE Case Evaluation or call View Related Long Term Care Insurance Articles Articles View the Next Article Insurance Homepage All Legal Topics Find a Insurance Attorney Ask a Lawyer Didn't find what you were looking for Make it Social Must Read ArticlesHow Long Term Care Insurers Calculate RiskLong Term Care Insurance Interview with Gerry GoldsholleLong Term Care Insurance California StyleLong Term Care Policy DefinitionsLong Term Care A Glossary of TermsPartnership for Long Term Care Programs What Are They The Differences Between Private State and Federal Long Term Care Insurance Select Practice Area Adoption Support amp Child Custody Arbitration Aviation Maritime amp Boat Accident Banking Bankruptcy Business Car Accident Civil Rights amp ADA Collection Construction Contract Copyright IP amp Trademark Criminal DUI DWI Divorce Education Law Elder Law Employment Environmental Estate Planning Franchise General Practice Government Healthcare Nursing Home Abuse Immigration Insurance International Juvenile Landlord Tenant Legal Malpractice Lemon Law Libel amp Slander Litigation Medical Malpractice Military Patent Pensions amp Benefit Personal Injury Product Liability Railroad Accident Real Estate Securities Sexual Harassment Small Claims Social Security Disability Sports amp Entertainment Tax Technology amp Internet Wills amp Probate Worker Compensation Wrongful Death Other Topics Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas US Virgin Islands Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Long Term Care Long Term Care Insurance ArticlesBuying Long Term Care InsuranceProblems Denials and LawsuitsSample Long Term Care Policy and ProvisionsWhat to Look for in a Long Term Care PolicyWho Needs Long Term Care Insurance