Long Term Care Insurance Attorneys
Texas Litigation Firm Representing Clients Across the U.S.
Contact a Long Term Care Insurance Attorney in Dallas & Houston, TX Today
Premiums for long term care 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 & Houston long-term care insurance lawyers of Grisham & Kendall, PLLC at (214) 308-2027 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.
Contact Grisham & Kendall Today
The attorneys at Grisham & Kendall, PLLC have represented Houston residents for more than 20 years. We offer a review of your policy and claim and are happy to discuss the issues that may apply to your individual claim relating to potential injuries sustained from a slip & fall in Houston or the surrounding areas. If you would like our slip & fall attorneys to review your insurance policy at no cost and with no obligation, please call Grisham & Kendall, PLLC at (214) 308-2027 to schedule a call or contact us using the form.
When To Hire a Long Term Care Insurance Attorney
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 Long Term Care 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.
Long Term Care Insurance FAQ
Long-term care insurance policies typically cover all or part of assisted living facilities and in-home care for people 65 or older or those with a chronic condition that requires constant care. Long term care insurance is private insurance available to anyone willing to pay for it.
Insurance companies recommend purchasing long term care insurance at age 40. However, Consumer Reports suggests that you wait until age 60. Waiting too long to purchase a policy can result in extremely high premiums.
There are certain health conditions which may result in you being declined long term care coverage. A few of these reasons are if you are currently needing help with any of the 6 activities of daily living (ADL), use a walker, or have Alzheimer’s, certain forms of cancers, or Parkinson’s Disease.
A long term care insurance policy typically would provide coverage in case you become unable to care for yourself and need assistance to manage your daily living activities. This typically means paying for an assisted living facility or in-home care.
Long-term-care insurance policies typically require two types of benefit triggers before they’ll pay; either you need help with two out of six activities of daily living (these generally include bathing, dressing, toileting, eating, transferring and continence) or you have severe cognitive impairment.
If your long term care insurance provider has denied your claim or not paid out according to the terms of your policy, the long term care insurance attorneys at Grisham & Kendall may be able to help. Oftentimes, just having legal counsel on your side is enough to get the insurance company to want to settle your claim and avoid litigation. As experts in insurance disputes, we will make sure you get fair compensation based on the terms of your policy.