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New Report Examines LTCI Claims

Written by NAIFA | 8/16/12 8:06 PM

The largest long-term-care insurance claim paid totaled $3 million, while the largest claim that is still being paid to an LTCI policyholder has exceeded $1.7 million in paid benefits, according to a report from the American Association for Long-Term Care Insurance.

"Last year the nation’s long-term-care insurance companies paid $6.6 billion in claim benefits to over 200,000 individuals," says Jesse Slome, executive director of the Los Angeles-based organization. According to the AALTCI report, the amount of claim benefits paid increased eight percent compared to the prior year. The association reports that women accounted for nearly two-thirds (65%) of new claims opened last year. About one in four of new claims begin for people between the ages of 70 and 79, while 65.5 percent start after the policyholder reached age 80. "One in 10 claims start when policyholders are in their 50s or 60s,” Slome points out, “often the result of an accident or illness.”

A widespread question individuals who are considering buying LTCI often ask is whether they will ever use it, Slome says. “The best we can do is gather information on how people use their benefits.”

According to the association, Alzheimer's disease was the leading cause for claims in a nursing home or assisted-living community, while cancer was the top cause for claims that begin at home. Half of all new individual LTCI claims pay for home care services, and less than one-third of new claims begin with the policyholder receiving care in a nursing home.

The largest claim still being paid at the end of 2011 had reached $1.7 million. “There are a number of claims still being paid that have exceeded $1 million,” Slome notes. “In this particular case, the claimant is a woman who purchased coverage and began receiving care three years later.” She has been receiving care now for nearly 15 years.

The complete findings of the association’s research are in the 2012 Long-Term Care Insurance Sourcebook. For additional information, call the association at 818-597-3227.

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By Ayo Mseka
Editor-In-Chief
Advisor Today