Securing Your Rightful Long-Term Care Benefits
Long-term care insurance can be a lifeline, covering critical expenses for skilled nursing homes, assisted living facilities, and in-home care. Yet policyholders often face delays, denials or underpayments that leave them vulnerable. At the Law Offices of Sean K. Collins, we focus on helping clients navigate the complexities of long-term care claims to ensure they receive the coverage they deserve. Our extensive experience in this field has positioned us as thought leaders, offering strategic guidance from initial claim reviews to litigation.
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What Is Long-Term Care Insurance?
Long-term care insurance is designed to cover services that traditional health insurance or Medicare often do not—such as extended skilled nursing home, memory care or assisted living facility stays, home health aides, or adult daycare. Policy terms vary widely, and the fine print can be confusing.
Don’t let so-called “experts” give you generalized advice without looking at your particular policy. We break down your policy’s terms, ensuring you fully understand your specific rights and benefits.
Why Are LTC Claims Often Denied?
Insurance companies sometimes argue that their policies do not cover assisted living facilities or memory care facilities, or they demand licensure of home health aides even in states where no such licensure exists. In other cases they argue that a policyholder’s Alzheimer’s condition is not severe enough to warrant coverage, or that they do not really need the physical assistance claimed. In many cases, these denials are unjustified, in bad faith, and just plain wrong. Our team meticulously reviews your documentation, gathers medical evidence, and challenges insurers on any unfair denials.
Ambiguous Policy Language
Alleged Lack of Assisted Living Coverage
Failure to Meet ‘Medical Necessity’ Criteria
Disputes Over Daily Benefit Amounts
Disputes Over Care Provider Eligibility
How We Handle Your Long-Term Care Claim
Our proven, step-by-step process ensures that every aspect of your claim is thoroughly reviewed and aggressively pursued to secure the benefits you deserve.
Step 1 – Policy Evaluation:
We start by carefully analyzing your insurance policy to identify the coverage details and potential gaps. This ensures we know exactly what benefits you are entitled to.
Step 2 – Evidence Collection:
Next, we work with healthcare providers and gather all necessary medical records, financial documents, and supporting evidence to build a strong case.
Step 3 – Claim Submission:
Our team then engages directly with your insurer to submit the claim and gather any additional information needed by the insurer.
Step 4 – Appeals & Litigation:
If your claim is denied or underpaid, we escalate your case by filing appeals or taking legal action to ensure you receive the full benefits you deserve.
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