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Huge exodus 2010/2015 of insurance co. from LTC underwriting as not profitable. Sold off LTC units to smallish companies & outsourced contractors. Technically still whatever insurance Co name it was initially but the LTC unit was spun off and now it’s own separate lil entity.
My suggestion is for you to get in writing what the step are in the Appeal process and get a copy of the assessment / needs determination for your Sister that was done by the LTC insurer ASAP. Also you want details on the individual(s) who did the evaluation, eg. education, certification. There probably is a narrow window for an appeal to be filed. Make sure HIPPA releases and POA are on file so that there is no delay due to that not being in Sissy file for you to have access to her health records.
fwiw Genworth has their service center in Canada & they have a very good system. Gen is the market leader for LTC policies imo. But even they tried to sell their LTC unit & couldn’t find a suitable buyer.
This is what popped up:
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also for more fun in all this there will be a waiting period b4 any payment made. Could be 60-90-120 days. Read the contract carefully and in detail as to how the waiting period is determined. If you’re doing in home care by family for free setting a start date can be squishy as no invoice with a date of service start date. Sometimes you end up having to hire in home health for a bit to get start date established.
if you don’t mind me asking, is this Genworth? Or an old MetLife?
DI'd they send someone out to assess your sister's ability to live alone?
Who has POA?