Receive the Benefits You Need with the Help of a Long-Term Care Insurance Lawyer
When age, disability, or an accident forces you to call on long-term care insurance (LTC), receiving a denial is the last thing you want to hear. Perhaps you only need coverage for a few months to recover from a surgery or serious illness, or maybe your loved one has reached the point where they cannot perform basic tasks of daily living without help. Either way, you need an advocate who can defend your interests against your insurance company.
At The Tawwater Law Firm in Oklahoma, our long-term care insurance lawyers have spent over 36 years helping our clients deal with their insurance companies. Our team has the skills and connections to fight the denial and help you receive the coverage you deserve. If you are dealing with a long-term care insurance denial, contact our firm online or call (405) 607-1400 to speak to a member of our team today.
Understanding Long-Term Care Insurance
Individuals with chronic illness, disabilities, or other lasting conditions often need help on a daily basis to perform basic activities. The exact type of help can range from assistance with tasks such as dressing or eating to skilled medical care from nurses, therapists, or other professionals. These services can be costly, so many individuals invest in long-term care insurance to ensure they have access to the help they need.
Depending on the policy, LTC insurance can cover a variety of services, such as:
- Room and board in a nursing home or assisted living facility
- Adult day care services
- Home care
- Modifications to the home
Reading your policy carefully before submitting claims is the best way to prevent denials. Your insurance policy may include clauses designating what the plan covers and how much your provider will pay for certain services. The policy will likely also contain “benefit triggers,” which are conditions you must meet before receiving benefits. Most often, benefits are triggered by inability to perform certain “activities of daily living” or ADLs, such as bathing, eating, dressing, and walking.
For over 36 years, our team at The Tawwater Law Firm has fought against bad faith insurance denials.
Dealing with an Insurance Denial
If you receive a denial from your LTC insurance provider, your first step is to ask for the exact reason of your denial given in writing. You can also inquire at this point about the process of appealing the decision. In many cases, LTC insurance companies deny claims without proper cause and expect individuals to accept the decision so they do not need to pay the claim. This situation is all too common, since those requesting coverage for long-term care are often ill or dealing with the stress of finding care for a loved one who is sick or injured. Insurance companies often use illegal tactics to deny or limit benefits, such as:
- Failing to notify you about the benefits to which you are entitled
- Denying necessary documents were received by certain deadlines
- Using biased health care professionals to justify denials
In this way, companies are able to hang onto the premiums without paying out for claims. If you are faced with an insurance company who refuses to pay you what you think you deserve, you need an attorney with the skills to combat bad faith insurance denials.
We Can Help
For over 36 years, our team at The Tawwater Law Firm has fought on behalf of clients against bad faith insurance denials. Our attorneys are familiar with the tricks insurance companies use to deny claims and can build a strong case on your behalf. We understand you are dealing with a difficult situation, so we can handle every aspect of the case for you. For more information about our services, call our office at (405) 607-1400 or contact us online today.