"I felt like pulling my hair out " Molly said about her frustrations trying to get the claim processed with her LTCI company. "They won't pay" Molly has been trying for the last 6n years to get claims processed for her husband. Both Molly and her husband had excellent LTCI with no benefit cap, with inflation protection. "It is an excellent policy" her friend Jeff said. Jeff is also an insurance agent who also sells LTCI. "Is there anything you can do to hep Molly? They are such a wonderful family".
Molly husband suffered a stroke and unfortunately for him, his one side has been paralyzed for the last several years. For 6+ years, Molly tried everything she knew to get the insurance company to accept the claim and start paying benefits. Molly tried 3 different agencies and each time the insurance company rejected the claim. Molly ended up paying the agencies out of pocket and eventually she had to cancel their services. Molly became the principal and the only care giver.
When we got involved, we realized that the insurance companies were not being difficult. There were details to the process that needed to be taken care of. We were able to start the services within 15 days and has been servicing the client since then. Another client Maria had a different story to share. Her husband has advanced stages of Alzheimer's and she too was facing problems getting the claims processed. She had changed 5 agencies before they came to us. " No agency was willing to do the processing on our behalf", said Maria. "You can deal with your insurance company and our agreement is with you". I have come across several such cases whether there is benefit assignment or not. Maria was close to tears when we said we will do the insurance processing for her and the service is complimentary. "God bless you" is all she could manage to say.
I thought about putting this in my blog today as today was a very good day. I got the approval for claim for yet another client who thought they were not even eligible for the benefit. This was a particularly challenging case. However, we have been very fortunate that the insurance companies have always worked positively with our approach.
We we decided to structure our offerings, we kept the customer in mind. LTC insurance, unlike any other insurance, the benefits are needed when you not in the best physical health. It is a lot to expect of our seniors if we tell them that they have sort through the details of insurance claims process. We want to keep it simple for our seniors. Our seniors have given the best years for us. This is a small way of contributing back towards helping our seniors.With my background of 22 years in the corporate world, I could easily get to the details that the insurance companies wanted. The claims department loves us. "It is fun to process your files, it is so simple and all details are there for us to process it. You make our lives easier". Said Blake who is one of the claims processor.
If you or anyone that you know have long term care insurance and wants help getting the claims processed, please give us a call at 626-639-0226. We are a non-medical private duty home care agency located in Pasadena, CA.
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