Knowing the common reasons for long-term care insurance claim denials may improve your chances of success when appealing for a rejection.
Often, a claim is denied for the following reasons:
1. Bad Faith Insurance Practices
Insurance companies may engage in bad faith practices, such australia whatsapp number data as denying claims without a valid reason or failing to properly investigate a claim. This can also include intentionally delaying or denying benefits, providing incomplete information, or making unreasonably low settlement offers.
Insurers use these and other bad faith tactics to protect the company’s bottom line by avoiding paying out valid claims. Always document any communication or correspondence with your insurer. Seek legal assistance if necessary, like with a long-term care insurance dispute lawyer to ensure your rights as a policyholder are protected.
2. Insufficient Evidence, Documentation, or Inaccurate Information
Insurance companies require detailed information when evaluating your application, including personal details like your full name, address, social security number, and date of birth.
Claims without accurate or complete information are often denied. Before filing an appeal, double-check check all the necessary documentation and evidence are included to strengthen your case.
3. Lapses for Premium Payments
If you miss premium payments, your insurance company may deny the claim. However, if the missed payment is caused by cognitive impairment or other medical issues, consult with a lawyer who specializes in insurance disputes. These professionals can help clear matters with the insurer.