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middledaughter Asked January 2018

Why would the insurance company do this?

My mother has received benefits from her LTC policy for five years. At first, I hired a home care company to send aides 2-3 hours a day to assist her. Six months ago, I got a guardianship -- she was deemed by the court to be mentally incapacitated. (She has vascular dementia.) After I got the guardianship I moved her to assisted living, because she needed more care than the aides were providing. The insurance company continues to pay (up the limits of the policy), but I noticed in the recent plan of care that they are stating that she does NOT have cognitive impairment. Rather, they are covering her because she is dependent in at least 2 ADLs. I wrote to challenge this determination because it's ridiculous. Should I be concerned as long as they are paying?

jjariz Jan 2018
Don't rock the boat!!!

SueC1957 Jan 2018
Sorry for being so blunt. Who cares HOW they are paying as long as they ARE paying?

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BarbBrooklyn Jan 2018
Read the terms of the policy. If, for example, the policy excludes payment in cases of cognitive impairment, the you don't want to challenge it, do you?

Just read it carefully.

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