If you or an elderly loved one gets an insurer’s letter stating that long-term-care policy before benefits are “no longer medically necessary,” contact attorney immediately. A lawyer may be able to have benefits restored.

Here’s what’s gong on with many benefits denials.

In the 1980s and ‘90’s, insurers entered the lucrative long-term-care market in droves. Sales to baby boomers, who clamored for nursing-home and assisted-care insurance, exploded.

Today, however, insurers have four problems. Boomers maintained policy payments, they got older, they began filing claims, and the economy took a tumble. The industry went from boon to bust, so insurers had to actually start paying on policies.

Executives quietly created internal policies to compensate claims handlers for reevaluating the status of elderly policyholders receiving payments. The goal was simple: Find way to reduce or eliminate benefits. Deny as many claims as possible, for as many reasons as possible, for instance, some claims had been “accepted in error.” Many claimants had been rehabilitated and “no longer qualified” for payments.

An attorney experienced in dealing with insurers can help policyholders recover denied benefits by researching customers’ policies, sales transactions, and correspondence, as well as insurers’ internal claim manuals, procedure guides, and training materials.

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