Articles

• The 5 first steps you need to take after your insurance company denies your claim
  
  
• Common benefit triggers in the insurance policy which qualify a policyholder for coverage
  
  
• How to research your insurance company
  
  
• Activities of Daily Living (ADLs) defined
  
  
• How to file a complaint with your state's Department of Insurance
  
  
• Common insurance company bad faith practices and/or common reasons for denial and what to do about it:
  
  
  • They say the nursing assessment shows that you are not "cognitively impaired".
  • They say the nursing assessment and nursing home records show that you do not need assistance in the activities of daily living required by the policy as a condition of benefits.
  • They ignore medical necessity qualifier and instead deny the claim based on another provision
  • They address the medical necessity trigger but say it is not medically necessary that you receive nursing home or assisted living care.
  • They say the policy provides benefits for nursing home care, and the facility you have selected does not qualify under the definitions of the policy as a "nursing home".
  • They don't return phone calls and don't answer letters.
  • They delay your claim unreasonably.
  • They require unreasonable documentation.
  • They deny based upon unreasonable interpretation of your long term care insurance policy.
  • They say the claim is preempted by ERISA
  
  
• "Post Claim Underwriting"
  
  
• 10 things you should know about your insurance company
  
  
• Glossary of Terms