The attorneys at Advocate Law Group have decades of successful experience recovering money for clients whose claims under privately purchased long term disability insurance policies and long term care insurance policies. These types of insurance are incredibly important to millions of people across the country as roughly 1 in 4 Americans will experience some sort of disability and around 1 in 2 Americans will need to pay for long-term care at some point in their lives. Insurance companies make a fortune selling these policies, but all too often, they unjustly deny claims and refuse to pay up when policyholders need them most.

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Advocate Law Group’s attorneys focus on helping clients whose claims under privately purchased long term disability policies have been denied.

Unlike “short term disability policies” that typically are provided by employers as a “fringe benefit” and pay benefits only for a relatively short period – typically for only 3-6 months – long term disability insurance is designed to pay those who are unable to work due to accident or illness for many years – sometimes up to age 65 and sometimes for life. Most of such long-term disability policies are privately purchased by individuals from an insurance company.

Unfortunately, all too often when the person who bought the long-term disability policy gets sick or injured and becomes unable to work, the insurance company denies the claim. Sometimes the insurance company claims the person is not truly disabled, or not sufficiently disabled to prevent the person from doing some work — such as a dentist with Parkinson’s who had a lucrative practice now working as a dental claims examiner for an insurance company, or perhaps as greeter at Walmart, which may turn on whether the person has an ‘own occupation’ or ‘any occupation’ policy.

Even under the best disability insurance plans, problems can still arise when insurers turn to shady tactics to deny valid claims. Often, disability insurers will try to unjustly reclassify an injury or disability as an illness, or attempt to retroactively cancel a policy. They might turn to their army of attorneys to bury the policyholder in paperwork, or force them to undergo repetitive medical examinations by physicians that they handpick to try to overrule the policyholder’s doctors’ opinions. No matter what they do, one thing is certain – Advocate Law Group has dealt with it before and will be ready to take them on.

Long-term Care Insurance

Long-term Care Insurance is intended to cover the cost of a policyholder’s care – whether for home health services or nursing home care — when the person insured is no longer able to care for herself by performing a sufficient number of the normal activities of daily living. In determining whether or not policyholders are able to care for themselves, insurers use a list of five criteria including whether or not the person insured can perform the activities of daily life (e.g., ability to make food, to use the bathroom, get out of bed alone, etc.). If the policyholder ticks the box for 2 or 3 of these criteria (depending on the person’s state of residence and his or her policy), then the insurer is on the hook for their long-term care.

A number of years ago, long-term care insurance became incredibly popular. Unfortunately, part of this popularity stemmed from these plans’ very low price points – price points that were actually too low for insurers to afford the eventual payment of the benefits these plans purported to provide. Now that many policyholders are reaching the age where they will need these benefits, some insurers are turning to underhanded tactics to prevent payouts.

Some of the tactics we have seen from insurers in this space include skyrocketing premiums designed to price some policyholders out of their plan. Some policies have premiums that can increase over 400% every year, leaving many seniors unable to afford their plans when they actually need them – even though they might have paid these premiums for many years previously. Additionally, we have seen some insurers attempt to make the process of obtaining benefits exceedingly difficult. In these cases, insurers will bury the policyholder under mountains of paperwork until they can no longer understand the process or just give up. At Advocate Law Group, we have over a half-century of holding insurers accountable and will fight for you and your loved ones to get the insurance company to pay all the benefits you and they deserve.