Rejected for long-term care insurance? 2 important questions to ask

Not only does long-term care insurance cost a lot of money, the approval process to get it can feel like an Olympic obstacle course — especially if pre-existing conditions or other situations exist.

After all, insurance companies run a business, so they apply strict standards to long-term care insurance applications to exclude people who are too high-risk. As a result, people get a thumbs down all the time. According to industry statistics, as many as a third of all people in their 60s when they apply for long-term care insurance are told NO!

If that happens to you, don’t panic. There is still hope. Here are the questions to ask your agent:

• Does the company have an appeal procedure?

Most of them do. Then take a copy of the rejection letter from the company to your doctor. The letter will state why you were rejected (or hit with a bounty much higher than you expected).

The doctor’s response to the company’s reasons for rejecting you is crucial – and shrouded in mystery. Unless you’re in the medical field, you won’t understand a tenth of what’s in the letter. So you just have to trust that the doctor has made a bulletproof case for the company to accept you.

Remember, insurance companies can pull very, very big boners. In one situation I’m familiar with, the company said part of the rejection was based on some medical conditions the doctor had never seen on the patient. Part of the doctor’s sharp response: “I really appreciate you drawing my attention to these medical issues. In the more than 20 years I’ve been this patient’s doctor, I’ve never encountered these conditions myself. in this patient.”

Despite the brutal tone of the letter, the doctor made such a convincing argument that the insurance company took out a policy anyway.

However, be warned that appeals do not often succeed. But it does happen. I myself know of two situations where a doctor’s note prevailed.

Also keep in mind that doctors are very busy. You may need to give the doctor a few nudges before the letter becomes reality.

• Do you have another policy or company whose coverage isn’t as good, but which I would probably qualify for?

Agents want to get a commission from working with you, so they usually have a few alternative companies or policies to show you if your first choice doesn’t work. And if you’re working with an agent who has experience with long-term care policies (fingers crossed you made it a point to choose such an agent in the first place), they might even still be able to get you a policy with a top company at standard rates.

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In short, being rejected by an insurance company is not the end of the road. It may mean taking a few detours to get where you want to go.