Long Term Care Insurance Fraud in Indiana

long term care

Long-term care (LTC) insurance policies are purchased by seniors and older adults to cover the costs of care that they may need later in life.  Both medical and non-medical care can be covered by LTC insurance policies for people who live at home, in a nursing home, or an assisted living facility if they are unable to perform two or more Activities of Daily Living (ADLs).  For LTC benefits to become payable, the insured must demonstrate their inability to handle at least two ADLs.

The cost of long-term skilled medical care and non-medical homecare can be expensive, reaching costs as high as $10,000 per month.  If a policyholder is denied their LTC benefits to cover the cost of this care, this could be financially devastating.  LTC insurance policies generally result in a loss for insurers so they may raise premiums or deny benefits for various reasons to make up for their losses.  If insurers take these actions in bad faith, it is possible to hold them accountable for long-term care insurance fraud.

You may be able to file a claim and get compensation if you are being denied the benefits of your LTC insurance policy or if your premiums are being raised in bad faith.  Anderson + Wanca provides representation for long-term care insurance class action lawsuits for fraud in Indiana.  Our attorneys will determine if you have a claim by reviewing the terms of your policy and we will take action to secure a long-term care class action settlement.

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What is Long-Term Care Insurance?

Long-term care insurance covers the cost of care for seniors and older adults who need assistance with two or more ADLs and require care for at least 90 days.  Those who are insured must show an inability to perform at least two of the following ADLs: dressing, personal hygiene, toileting, eating, and transferring or ambulation.  People with Alzheimer’s disease, dementia, and other conditions involving severe cognitive impairment can also get LTC insurance.  Whether the insured lives at home, in a nursing home, or an assisted living facility, LTC insurance should cover the cost of required care.

How Have Insurers Lost Money from Long-Term Care Insurance Policies?

Insurance companies aggressively marketed LTC insurance policies to baby boomers in the 1990s and 2000s.  There are still about seven million of these policies in effect that have cost insurers billions of dollars.  The reason these policies have been so costly is because those who are insured have kept their policies without renewing and they have made more claims and lived longer than insurers initially anticipated.  The costs of medical care and related expenses have also risen considerably over that time which has added to these losses.

long term care insurance

Long-Term Care Insurance Fraud

Insurers have acted in bad faith by raising premiums and denying benefits to help offset the losses that they have taken on LTC insurance policies.  The following are common types of long-term care insurance fraud that insurers may engage in:

  • Overstated benefits: One way insurers may defraud someone is by overstating the coverage of an LTC insurance policy. They may sell the policy as covering more than it actually does while the fine print of the contract says differently.  This misleads people into believing that they are getting benefits that are then denied when they are needed.
  • Application misstatements: Misstating the personal information of someone seeking an insurance policy, including their age and medical history, helps insurers entice people to purchase by offering lower premiums. However, misstating personal information to get an insurance policy is illegal. The person buying the insurance may face criminal fraud charges even if it is the insurer that misstated the information.
  • Raising premiums: It is common for insurance providers to raise the premiums of an LTC insurance policy to help offset their losses. Increases in insurance premiums can force the insured into a position where they can no longer afford the insurance to cover much needed care.  Insurance companies can raise premiums, but it is illegal to charge a rate above the limit set by the state of Indiana, and they cannot raise premiums if you have a clause in your policy that states that your rates cannot go up once you pass a certain age.

Long-Term Care Insurance Class Action

Talk to our long-term care insurance fraud attorneys at Anderson + Wanca to review your policy if you are being denied benefits or experiencing year over year rate increases.  Insurance companies can only raise their premiums if they get permission from the right agencies and act within the terms of the policy.

You may be able to get reduced rates and compensation if you have been overcharged in bad faith.  If you were enticed to purchase an LTC insurance policy with low premiums only to have them increase after the purchase, you may be able to file a long-term care class action suit.

At Anderson + Wanca, we are a class action firm that works on a contingency fee basis to handle long-term care class action suits.  We want to help rectify the situation for you and others who are in a similar situation and obtain a long-term care class action settlement.

We have a short form for you to fill out to get started. We will also need a copy of your insurance policy and most recent premium increase notification letter.

You can also reach Anderson + Wanca by calling us at (888) 505-0953 or emailing us at LTCinsurance@andersonwanca.com to schedule a free consultation to determine if you have a claim for long-term care insurance fraud in Indiana. 

We work with licensed attorneys across the United States and can help those who reside outside of Indiana.



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