Dallas & Houston Long-Term Care Insurance Lawyers

As the United States population as a whole grows older, and more of the approximate 70 million baby boomers enter retirement, the issue of long-term care coverage is increasingly becoming an important matter for many people. Long-term care generally refers to hands-on assistance provided for an extended period of time to people who can’t take care of themselves due to a prolonged disability, illness, cognitive impairment such as Alzheimer’s disease, or some other debilitating condition.

A person generally qualifies for long-term care when a physician or other health professional certifies that you are unable to independently perform at least two ADLs (activities of daily living), such as bathing, dressing, eating, transferring to or from a bed or chair and continence. Long-term care insurance usually provides for the cost of a nursing home, an assisted living center, or home health care. If your insurance company delays or denies payment of insurance proceeds, you may need the help of a qualified Dallas long-term care insurance attorney from Grisham & Kendall, PLLC.

Reasons Given by Insurers to Delay or Deny Benefits

When a long-term care insurance provider denies coverage, there are many reasons they may use to do so, depending on your policy, including:

  • Ineligible care provider (e.g., policy requires that facility have a specific license and specific personnel and care)
  • No prior hospitalization (typically, older policies have wording requiring policyholders to have had hospitalization confinement, a nursing home stay, or both before claims are paid)
  • No benefits for personal care
  • Failure to pay claims due to cognitive impairment
  • Absence of required ADLs (activities of daily living)

When vulnerable populations who both need and have paid for these services are denied access to them, it cannot be allowed to stand.

Contact a long-term care insurance attorney in Dallas

Premiums for this type of insurance are generally very expensive. If your long-term care insurer has wrongly delayed or denied your claim for benefits in your time of need after faithfully paying your insurance premiums for years, please call the Dallas long-term care insurance lawyers of Grisham & Kendall, PLLC at (713) 999-5085 to discuss your case. The initial consultation is free, and we work with the majority of our clients on a contingency-fee basis where you don’t owe us anything unless we make a recovery from your insurance company through settlement or litigation.

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Office Locations

Grisham & Kendall, PLLC

Dallas Office

5910 North Central Expressway #925
Dallas, TX 75206
Phone: (214) 308-2027

Houston Office

3515 Fannin St.
Houston, TX 77004
Phone: (713) 999-5085

Fax: (214) 308-2036

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